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Chronic respiratory disease (CRD) has been fairly low on health policy agendas, both internationally and nationally in low- and middle-income countries (LMIC). This has been understandable, given the impact of communicable diseases such as HIV, malaria and tuberculosis. But the impact and prevalence of CRDs is increasing, alongside a steady rise in life expectancy and better treatments for communicable diseases. It is now a priority to prevent and provide better treatment for CRDs. 

FRESH AIR teams in Kyrgyzstan, Uganda, Vietnam and Greece are helping to raise awareness of the impact. Knowledge of the current situation is one of the starting points for drawing up national action plans and to implement effective strategies. However, national impact data on CRDs have largely been lacking. Therefore, as a first step, the FRESH AIR project is collecting national clinical and economic data on the impact of CRDs.

The FRESH AIR project is looking into optimal implementation strategies for affordable and effective interventions, such as smoking cessation, household air pollution reduction and pulmonary rehabilitation programmes. FRESH AIR local teams will then estimate the impact and cost-effectiveness of FRESH AIR actions to inform successful scaling-up of the interventions and influence national policy plans.

Workshops have been organised in Kyrgyzstan, Uganda and Vietnam on health economics, with the aim of optimising implementation and knowledge transfer. A workshop in Greece is scheduled for April 2017. Participants in the workshops have discussed the basic concepts of health economics, as well as the survey and study plans. The survey and sample sizes were adapted and tailored to the healthcare system, team capacity and environmental factors in the individual countries. Primary data is being collected locally with tools that measure interventions, as well as healthcare resource utilisation and time investment. This is filling the multiple gaps in knowledge that exist, despite using local scientific papers that have been provided by the FRESH AIR country teams.

Vietnam and Kyrgyzstan are finalising their data collection process (which involves approximately 400 in-and out-patients). A smaller sample is being collected in Greece, where data collection is more than halfway. In Uganda, despite some delays, the local team will submit their target sample in the following months. Overall, all the local teams are very enthusiastic and are doing an amazing job.

FRESH AIR partners have started to report results to the European Commission, including clinical data and data on demographics, risk factors, healthcare utilisation, quality of life, and direct and indirect costs of diagnosed respiratory patients. These will inform the use of the socio-technical allocation of resource (STAR) tool, which helps policy-makers prioritise allocation of resources to the most cost-effective interventions.

The FRESH AIR team will continue to analyse the data and plans to publish a scientific article and specific abstracts over the next few months. The team at ARTEG, led by Job van Boven, hopes that data and figures will form a good basis to tackle CRDs in national action plans and locally in policy making.


Fresh air newsletter May 2017