World Asthma Day: 3 May 2011The theme of World Asthma Day 2011 on 3 May 2011, again highlights "you can control your asthma", but, according to the International Union Against Tuberculosis and Lung Disease (The Union), control of asthma remains a distant goal for patients in low- and middle- income countries, where the low availability and the prohibitive cost of asthma inhalers are still major barriers for proper asthma care. That's why The Union established the Asthma Drug Facility (ADF), a project that has demonstrated that these barriers can be overcome.
Through the ADF, low- and middle-income countries can purchase the quality-assured asthma medicines they need at an affordable cost. The ADF has a quality assurance system based on World Health Organization (WHO) norms and standards. It keeps prices down by having a limited competitive process among selected manufacturers based on yearly estimated volumes.
Worldwide some 300 million people suffer from asthma, a chronic lung disease. Once predominantly found in industrialised countries, asthma, like many other non-communicable diseases (NCDs), has become increasingly prevalent in low- and middle-income countries over the last 20 years.
The ADF has already supplied essential asthma medicines to Benin, El Salvador, Kenya, Sudan and Burundi. Through ADF, these countries have seen the cost of inhalers fall by as much as 50%, making one year of treatment with Beclometasone and Salbutamol for a patient with severe asthma cost less than 40 euros. Through the simple monitoring of patient outcomes, as required by the ADF, countries can also evaluate the care offered at their facilities and improve asthma case management.
However, with this small number of countries, The Union is aware that this is just the beginning. "Things need to happen on a global scale now, if we are to reach the millions of people with asthma in low- and middle-income countries who currently have no treatment, or inappropriate treatment", explains Cécile Macé, ADF coordinator for The Union. "Asthma is one of the under-recognised and under-funded lung diseases that The Union is trying to bring forward on the public health agenda", says Dr Nils E Billo, Executive Director of The Union. "We hope that the UN Summit on Non-Communicable Diseases in September 2011 will recognise and promote practical solutions such as the ADF".
Since the ADF does not provide medicines for free, countries need to obtain funds to make an initial purchase and set up a sustainable financing strategy. Benin's National Tuberculosis Programme and EpiLab in Sudan, for example, have established revolving funds and cost recovery systems for the asthma medicines they purchased. By purchasing ADF's low-priced asthma medicines and applying a 12-18% margin, these countries are managing to provide affordable prices and a sustainable supply of medicines for their patients.
In advance of the UN Summit, The Union and the ADF are encouraging donors to consider supporting countries by providing them with a one-off capital sum to purchase medicines and initiate such a revolving fund. A well-run revolving fund provides the sustainable financing needed to guarantee continuous availability of asthma inhalers for this chronic condition.
CNS
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