(First published in The Star, Kenya on 27th May 2013): Asthma deaths will increase by almost 20 per cent in the next 10 years if urgent action is not taken, the World Health Organisation says. At the moment, WHO says over 80 per cent of asthma deaths occur in low and lower-middle income countries. Sharlene (not her real name), a Nairobi resident, understands the challenges associated with asthma only too well. She was diagnosed with asthma in childhood. Due to her condition, she cannot participate in vigorous activities like sports that require a lot of energy, or carry heavy loads.
She also had to put up with stigma, especially in school, because of her condition. “Some people did not want to associate with me, while others felt that I was being given special treatment by the teachers, who understood my problem,” she says. When she suffers an attack, it means that she cannot go to work or even if she goes, she cannot perform optimally. And this may end up affecting her appraisal at the end of the year.
Early this year, a campaign was launched to help raise Sh100 million locally to benefit an estimated 1.3 million children by availing asthma drugs to them. The campaign, dubbed ‘Help Me Breath, So I Can Go to School’, is aimed at supporting more than four million Kenyans suffering from asthma.
The Kenya Association for the Prevention of Tuberculosis and Lung Disease says the funds will be used to buy drugs and will be made available to patients at a subsidised cost. KAPTLD revealed that more than 1.3 million children are forced to stay out of school due to poor diagnosis and management of asthma.
The campaign seeks to eliminate cases of wrong diagnosis caused by lack of proper training for chest physicians, and reduce cases of misinformation on the part of patients and parents who have asthmatic children. This is one among many initiatives that are being put in place to give access to medicine to those with asthma. Christophe Perrin,co-ordinator, Asthma Drug Facility, of the International Union Against Tuberculosis and Lung Disease, says the percentage of adults which are reported for asthma over the past years has been increasing significantly.
He says ADF is the first international centre of its own kind, a mechanism that was established to provide affordable access to quality assured essential asthma drugs. Over the years, ADF has managed to bring down the price of one year treatment of severe asthma by 60 per cent.
Asthma is a disease of the bronchial tubes (“the airways”) that typically presents with wheezing, a high-pitched whistling sound heard during breathing, especially when breathing out. Asthma can also involve shortness of breath or coughing, particularly in children. Asthma “attacks” can be triggered by factors such as having a cold, exercising, smells, or exposure to smoke or pollens.
According to the Global Asthma Report 2011, asthma is a public health priority that affects 235 million people worldwide and has a global impact. The WHO says asthma is not just a public health problem for high income countries: it occurs in all countries regardless of level of development.
The Global Asthma report further says that the burden of asthma has been growing over the past 30 years, particularly in low- and middle-income countries. Experts say that the causes of asthma are not well understood and that it is not curable, but it can be treated and managed with existing medicines. However, experts add that a disorder of the immune system where the body fails to make enough protective antibodies may play a role in causing asthma.
Studies show that lack of accessible, affordable essential asthma medicines is one of the biggest barriers to managing asthma effectively. Additionally, poorly managed asthma leads to emergency treatment and hospitalisation - interventions that are much more costly (for patients and health systems) than effectively managed treatment.
Asthma that is not treated or which is poorly managed, can lead to increased suffering and diminished lives. It can also cause disabilities and in extreme cases, it can lead to death. To prevent asthma, experts recommend that people eat a balanced diet, avoid exposure to trigger factors and avoid smoking or smoky environments as much as possible.
For treatment of asthma, inhaled corticosteroids are essential to successful long-term management of asthma, while bronchodilators provide relief from asthma symptoms. As a country that is currently focused on devolution, we need to think on how to avoid exacerbating the problem of asthma attributable to urbanisation, even as we rush to urbanise and industrialise our towns and cities.
Moses Wasamu, Kenya
Citizen News Service - CNS
(First published in The Star, Kenya on 27th May 2013)
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