Raffaella’s Literature Update

The following message is courtesy of Dr. Raffaella Ravinetto, Public Health Department, Institute of Tropical Medicine Antwerp, Belgium.

Ref. Stolbrink M, Chinouya MJ, Jayasooriya S e al. Improving access to affordable quality-assured inhaled medicines in low- and middle-income countries. Int J Tuberc Lung Dis. 2022 Nov 1;26(11):1023-1032.

Dear Friends,

inhaled medicines for asthma and chronic obstructive pulmonary disease (COPD) are included in the WHO Model List of Essential Medicines and should be ‘‘available at all times in adequate amounts’’, but in practice, quality-assured inhalers are often not available or not affordable in low- and middle-income countries (LMICs). Even if you do not work in this specific field, please …..read and share, as it is important to advocate for a neglected patients’ community!

This paper specifically reports on the recommendations of a meeting of global stakeholders on this topic. There was consensus among participants that the barriers to access to inhalers in LMICs are multi-faceted, complex, and involve many actors. Among other things, I would like to point at the lack of awareness by local policymakers, healthcare planners, governments and global organisations; at competing priorities, e.g. communicable diseases and ‘competing’ noncommunicable diseases (NCD) such as diabetes and hypertension; at high prices and unreliable supplies of inhaled medicines; and at the limited advocacy.

The Authors suggest that with sufficient targeted resources, collaborative multi-stakeholder action could overcome the barriers in access to affordable, quality-assured, essential inhaled therapies for people with chronic respiratory diseases in LMICs. Ten areas for collaborative action are indicated: 1) work with patients, to understand their needs and co-create solutions; 2) raise awareness and reduce stigma among local communities; 3) develop clinical guidance and implementation tools that address the needs of healthcare providers in LMICs; 4) ensure that the WHO Essential Medicines List is aligned with current evidence and guidance; 5) streamline procurement processes and guarantee the quality of products; 6) address challenges around the affordability of inhaled medicines; 7) collect and share surveillance, clinical, economic data to inform policy and practice; 8) develop and deliver targeted messages to local and national governments to drive evidence-based policy and mobilise resources; 9) build the case for a World Health Assembly Resolution on improving access to effective asthma and COPD care for all; and 10) share examples of good practice, lessons learnt and resources for advocacy or education.

Have a nice reading, and enjoy a nice winter break! 

This informal mailing will be back in 2023,


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