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Management of Asthma: Beyond the Cost


Allen Kaplan
Connie Katelaris


Allen Kaplan

March 9, 2003

Welcome to the WAF Symposium: "Management of Asthma - Beyond the Cost." The World Allergy Organization (WAO) is pleased to be able to present this Symposium because of the prominence of asthma as a worldwide disease, and the apparent increase in incidence, morbidity, and mortality observed in many countries during the past 10-20 years.

This dynamic may seem paradoxical because we clearly have had new, more effective medications available for the treatment of asthma. The reasons for this prominence are clearly multifactorial, and one about which we can do little in the short run, would be genetic drift leading to a true increase in allergic responsiveness with the lung as a major target organ. However we should be able to intercede and affect the incidence and cause of the disease in our patients by consideration of impediments to optimal care, including prevention and treatment.

Today you will hear lectures from internationally recognized experts from England, France, and the USA who will address many facets of this dilemma, including a discussion of the impact of asthma on society, its contribution to the general problem of rising medical costs, and most importantly, identification of areas that can be addressed to try to reverse the trend.

Among the issues to be discussed are the education of the patient regarding their own management of symptoms, improving compliance with recommendations where cost may be a factor, environmental measures to lower the allergen load as well as exposure to irritants and pollutants, and approaches to improve access to medical care. There is a particular problem in inner city environments where exposure to house dust, cockroach, and cigarette smoke may represent particular challenges. Finally improved use of the many excellent medications currently available and increased research to develop new modalities of treatment, particularly for severe persistent asthma, are important considerations to optimize current therapy and to lead to new approaches for the future.

Allen Kaplan
President, World Allergy Organization
Symposium, Co-Chair


Connie Katelaris

March 9, 2003

Asthma is a common chronic disease that places many burdens on the individual sufferer, his or her family, healthcare systems and society as a whole.

While there have been advances in the management of asthma over recent years, the burden of asthma in terms of morbidity and mortality, world-wide, remains enormous.

During the 1980s, asthma mortality in many countries increased. In many instances, a significant number of asthma deaths could be considered "avoidable". Asthma mortality rates are greater among disadvantaged populations where there are crowded living conditions, poor educational levels, and poverty .The reasons for the differences in mortality rates in different populations are complex but probably include differences in risk factors for the disease, and barriers to good asthma medication and management.

The economic impact of asthma is large and growing in both the developed and developing world. Factors contributing to the socio-economic costs include direct costs such as hospital care, physician services, laboratory and diagnostic service costs and medications. Many other indirect costs must also be considered, including lost days from work and school, caregiver time, allergen avoidance strategies and environmental modifications, as well as the community loss from early mortality.

Reducing the global burden of asthma when resources are scarce will involve a number of important initiatives:

  • Asthma must be seen to be an important health issue and its impact on the individual and the community as a whole must be appreciated;

  • Promotion of education about asthma to identify and avoid risk and triggering factors;

  • Provision of enough well trained health care professionals to service the needs of those with the disease in a given community;

  • Effective communication between health care professionals and patients;

  • Implementation of international management guidelines , providing the means for this to be done effectively, with sensitivity to local conditions;

  • Provision of, and improvement in, the use of cost effective medication;

  • Provision of regular follow up health care to minimise severe exacerbations and hospitalisations.

The World Allergy Organisation is proud to be sponsoring this WAF Symposium where a panel of internationally acclaimed speakers will explore the many complex issues regarding the global burden of asthma management.

WAO sincerely acknowledges the unrestricted educational grant provided by Norvartis to facilitate this event.

Connie Katerlaris
Treasurer, World Allergy Organization
Symposium, Co-chair


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