The Forum of International Respiratory Societies Calls for Urgent Action to Expand Access to Pneumonia Prevention and Treatment Worldwide

On World Pneumonia Day, 12^th November 2024, the Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, is calling for urgent action to prevent pneumonia deaths among high-risk groups particularly children younger than five years and older people.  New effective preventive interventions are available, but these are still inaccessible in many low- and middle-income countries (LMICs).

Prof Heather Zar, of the Pan African Thoracic Society Executive Committee, a FIRS member, says:

“New, highly effective interventions to prevent Respiratory Syncytial Virus (RSV) pneumonia in infants and young children have recently become available and can substantially reduce the burden of childhood pneumonia and mortality.  However, access and affordability in LMICs is crucial to reduce global inequity and promote health for all children, especially as most severe illness occurs in LMICs.”

In 2021, pneumonia claimed the lives of 2,2 million people including 502,000 (23%) children aged less than 5 years and 152,000 (7%) newborn babies. The pneumonia burden remains unacceptably high, especially as most deaths are preventable.  In addition, early life pneumonia may lead to poorer health through life and contribute to the development of chronic respiratory disease in adulthood.

S. pneumoniae (pneumococcus) remains one of the most important bacteria causing pneumonia across age groups, while RSV is a major cause of pneumonia and hospitalization in children and older people. However, there are now effective vaccines for these. Pneumococcal conjugate vaccine, a highly effective vaccine preventing pneumonia from S pneumoniae has been available for over two decades but is still not accessible to many children in poor areas. New, highly effective vaccines against RSV are now available. These include vaccines specifically for older adults, a vaccine for pregnant women, and a long-acting antibody to protect infants and young children. However, there is very limited availability of these in LMICs despite the large number of children and older adults developing severe pneumonia in these countries and excellent protection offered by vaccination.

Most deaths occur in the poorest populations in LMICs. Key risk factors for pneumonia include air pollution, malnutrition, smoke exposure, HIV infection, and low vaccination rates. For young children, prematurity and lack of breastfeeding are additional risks. Limited access to effective treatment of pneumonia is also a concern, especially in many LMICs, where healthcare facilities and oxygen systems are often unavailable, particularly for children.

Although pneumonia deaths have substantially declined over the past decade, urgent efforts are still needed to improve access to effective prevention and treatment. On World Pneumonia Day, FIRS is calling on governments and partners to:

• Ensure equitable and sustained access to vaccines against the commonest pathogens.
• Ensure access to new highly effective preventive interventions against RSV for infants and young children globally.
• Strengthen health systems to deliver interventions which reduce pneumonia deaths, including provision of effective vaccines, antibiotics and oxygen delivery systems.
• Strengthen national and international commitment to support interventions against the leading risk factors for pneumonia.
• Improve support for research into cost-effective interventions to prevent and treat pneumonia in LMICs.

About the Forum of International Respiratory Societies
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latinoamericana de Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Disease (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

Respiratory Societies Help in Bringing the World Together for Bronchiectasis

On World Bronchiectasis Day, members of the Forum of International Respiratory Societies bring awareness to a chronic lung disease
JULY 1, 2024

In support of the third annual World Bronchiectasis Day, July 1, the Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, is joining the COPD Foundation and several global organizations to raise awareness, share knowledge, and discuss ways to reduce the burden of bronchiectasis for patients and their families worldwide.

This year’s World Bronchiectasis Day theme is focused on research and the importance of participation in clinical trials, how research can impact innovation in bronchiectasis diagnosis and treatment, and how registries work to aid research efforts.

Bronchiectasis is a lung disease that affects an estimated one million individuals worldwide of which roughly 400,000 are in the United States. The number of affected individuals is likely even higher due to the probability of misdiagnosis with bronchiectasis. In this illness, the airways become enlarged or scarred, making it difficult to clear mucus properly, leading to recurring lung infections. Symptoms include frequent coughing (often with thick, discolored mucus), sputum production, breathlessness, repeat chest infections, increased tiredness, unexplained fever, chills, sweats and weight loss, and chest pain.

In addition, bronchiectasis:

• can occur at any age and is diagnosed by chest computed tomography (CT) scans.
• causes a significant burden on patients and their families. It can lead to accelerated lung function loss which can result in long-term disability and premature death in adults.
• has been associated with disparities in morbidity and mortality outcomes in the socioeconomic disadvantaged.

Although there is currently no cure, detecting and treating bronchiectasis early can improve quality of life and long-term health.

“As the prevalence of bronchiectasis increases, it is vital that we continue to advance research efforts to improve diagnosis and treatment of this chronic lung condition,” said Tim Aksamit, MD, medical director of Bronchiectasis and NTM 360, and a pulmonology and critical care medicine physician at the Mayo Clinic in Rochester, USA. “The COPD Foundation and its global lung health partners are dedicated to advocating for increased research and to providing free educational materials that can help improve the lives of those living with bronchiectasis.”

Learn more about bronchiectasis in this introduction video with Dr. Aksamit. For more information about participating in World Bronchiectasis Day and a full list of activities, visit WorldBronchiectasisDay.org.

About the Forum of International Respiratory Societies:

The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latinoamericana de Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Disease (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

Asthma Education is Key to Reducing Deaths Worldwide, Say Respiratory Health Associations

On World Asthma Day 2024 (7 May), the message is clear: “Asthma Education Empowers.” The Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, stresses the crucial role of education in empowering people with asthma to manage their condition effectively and to know when to seek medical assistance.

FIRS also urges healthcare professionals to enhance their awareness of the preventable morbidity and mortality from asthma and of the published evidence on effective asthma management, so they are equipped to provide reliable information and optimal treatment for their patients.

Asthma is one of the most common chronic non-communicable diseases that affects over 260 million people and is responsible for over 450,000 deaths each year worldwide, most of which are preventable.

Key universal issues on which education is required are:
• under- or inaccurate diagnosis,
• underuse of anti-inflammatory inhaled corticosteroid inhalers,
• overuse, and over-reliance on short-acting beta2–agonist (SABA) inhalers,
• poor recognition of patients requiring specialist assessment and further management.

In low-middle-income countries, lack of availability of inhaled medicines and especially inhaled corticosteroid-containing inhalers is a major contributor to the fact that more than 90% of asthma deaths occur in these countries.

FIRS calls on policymakers and the pharmaceutical industry to recognize the ongoing issue of preventable illness caused by this common disease, despite the existence of highly effective controller treatments, and to step up efforts to make sure environmentally friendly inhaled medications are available in all countries, ensuring everyone has access, “leaving no-one behind”. Read more www.ginasthma.org/reports.

World Asthma Day was first held in 1998, and, has grown each year to become one of the most important asthma events globally. On World Asthma Day, hundreds of awareness-raising activities will take place in countries all over the world. Further information about GINA and World Asthma Day can be found at GINA’s website: ginasthma.org. Documents detailing GINA’s global strategy for diagnosis, management, and prevention of asthma are also available at ginasthma.org.

About the Forum of International Respiratory Societies
The Forum of International Respiratory Societies (FIRS) is an organization comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

Additional World Asthma Day Resources:

• World Asthma Day: WHO calls for better education to empower people living with asthmaGARD collection: Asthma Education
• Empowers | Knowledge Action Portal on NCDs (knowledge-action-portal.com)

Break the chain of transmission to end tuberculosis – World TB Day 2024

Respiratory groups call for comprehensive TB screening in high-burden settings.

24 March 2024

On World TB Day, 24 March 2024, the Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, calls on all stakeholders, including multilateral agencies, governments, national and local programmes, non-governmental organisations, academics, activists and donors to focus on activities that will break the chain of transmission in high-burden settings in order to end tuberculosis (TB).

In high-burden settings, TB is endemic: meaning everyone is at risk, all the time, through the unbroken chain of transmission. To break the chain, it is critical that we screen everyone in high-burden settings for TB, so that we can find and treat all people with TB and prevent them from infecting others. The latest evidence shows that in high-burden settings, most people with infectious TB do not have symptoms (such as, cough or fever) and many are not members of high-risk groups. Hence, it is vital that screening for TB is not limited to those with symptoms or those who are members of high-risk groups.

During the height of the COVID-19 pandemic, before the availability of vaccines, this approach of widespread testing, was rolled out by governments across the globe and proved to be highly effective in controlling the spread of COVID-19.

Professor Guy Marks, President and Interim Executive Director of the International Union Against Tuberculosis and Lung Disease (The Union), a member of FIRS, says: “We must be brave and recognise that the current strategy to end TB in high-burden countries is not achieving the results we hoped for. We need to change our approach if we are to win the fight against this infectious disease.”

In 2022, 10.6 million people fell ill with TB and 1.3 million died from the[i] disease – more deaths than from any other infectious disease[ii].

Professor Marks explains: “The incidence of TB in high-burden countries is falling at a glacially slow pace. The simple reason for this is that far too many people with TB remain undiagnosed and untreated, often because they do not experience or recognise symptoms that lead to a diagnosis. These people are infectious and can transmit the infection to others in their households, workplaces and communities. So, the transmission continues: more people are infected and many of them develop TB.”

It was the same with COVID-19, another airborne infection, where much of the spread in the community occurred from people with infectious COVID-19 who did not have symptoms.

Professor Marks adds: “The latest evidence suggests that in high-burden settings, most people with TB have been recently infected (within the last two years). This means that reducing the rate of new infections (or reinfections) with TB can have a big impact on preventing people from becoming sick with TB, and hence, breaking the chain of transmission and ending TB.”

The standard approach to controlling TB has been to wait for people to seek care, be correctly diagnosed and take medication. However, we now know that many people with infectious TB do not have symptoms, and as a result, do not visit healthcare facilities seeking care.

Additionally, those who do seek care often encounter hurdles in terms of accessing diagnosis and treatment, due to TB not being appropriately prioritised by healthcare systems.

Professor Marks concludes: “These strategic and operational modifications will not achieve an end to TB in isolation. They must be accompanied by a change in public mindset and behaviour towards TB.”

About the Forum of International Respiratory Societies

The Forum of International Respiratory Societies (FIRS) is an organization comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The Global Impact of Respiratory Disease report outlines major causes of respiratory disease and lays out recommendations for global action.

[i] https://www.who.int/news/item/07-11-2023-tuberculosis-response-recovering-from-pandemic-but–accelerated-efforts-needed-to-meet-new-targets

[ii] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0284273#pone.0284273.ref001

Eradicating HIV Will Take Collaborative Action and a Commitment to Curb TB Infections

The Forum of International Respiratory Societies Highlights World AIDS Day.

The COVID-19 pandemic hampered progress in fighting tuberculosis infections worldwide. Diverted funds meant that one of the world’s leading infectious killers caused 1.3 million deaths in 2022. TB is also the leading cause of death among those with HIV /AIDS worldwide. In 2022, 167,000 people died of HIV-associated TB.

This World AIDS Day, the Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, calls on governments, health advocates, and non-government organizations to strengthen their response to AIDS and TB. This collaborative effort is necessary to help realize the World Health Organization’s goal of ending the AIDS epidemic by 2030.

“People with latent TB who are living with HIV should have access to TB prevention therapy,” said American Thoracic Society (ATS) President M. Patricia Rivera, MD, ATSF. “Studies show that this therapy can reduce the chances of dying from TB and AIDS by nearly 40 percent.”

ATS began in 1905 as the National Association for the Study and Prevention of Tuberculosis. Today, the ATS and other FIRS members, representing the world’s leading respiratory societies, are working to improve lung health globally.

In the developing world, TB is often the first sign a person has HIV. Yet, about half of the people living with HIV and tuberculosis are unaware of their co-infection and, therefore, not receiving appropriate care that could prevent not only serious illness but death, according to WHO.

Shortly after AIDS emerged, it fueled a global resurgence of TB that continues in many low- and middle-income countries. In 2022, the WHO reported that the largest number of new TB cases were in WHO’s Southeast Asia Region (46 percent),  followed by the African Region (23 percent) and the Western Pacific (18 percent). According to the Centers for Disease Control and Prevention, HIV infection is the greatest risk factor for progressing from latent to active TB.

HIV increases the risk of other infectious respiratory diseases, including Pneumocystis jirovecii pneumonia and bacterial pneumonia, both of which can be life threatening. There is also an increased risk of non-infectious lung complications.

Education, prevention strategies, and new medicines, particularly antiretroviral therapies, have reduced the number of AIDS-related deaths by 69 percent since the peak in 2004.

Still, the WHO estimates that in 2022, an estimated 39 million people were living with AIDS, 1.5 million of them children.

FIRS believes a global response to HIV/AIDS can be strengthened by:

• Increasing awareness of the continuing global threat of HIV-related disease and its link to TB and other respiratory diseases.
• Improving the health outcomes of people living with HIV through patient care and research into better prevention, early diagnosis, and effective treatment strategies for both HIV and TB, including rapid diagnosis and treatment for multidrug-resistant TB that is harder to cure.
• Reducing the incidence and severity of HIV-related disease by strengthening mother-to-child transmission prevention programs and increasing the early use of antiretroviral therapy.
• Improving HIV education in at-risk communities to reduce the incidence of new HIV infections.
• Reducing HIV-related health disparities and inequities.

“The good news is that antiretroviral therapies work, and TB is preventable and curable,” Dr. Rivera said. “These two facts, along with the millions of lives that we can save, should be motivation enough to ensure that these medical advances are available to everyone.”

About the Forum of International Respiratory Societies
The Forum of International Respiratory Societies (FIRS) is an organization comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The Global Impact of Respiratory Disease report outlines major causes of respiratory disease and lays out recommendations for global action.

Respiratory Groups Stress Lung Cancer Risks and Importance of Early Screening and Treatment for World Lung Cancer Day

On World Lung Cancer Day, August 1, the Forum of International Respiratory Societies (FIRS) and its founding member, GOLD, stress the importance of understanding lung cancer risk factors, as well as the importance of early detection through screening and treatment.

According to the World Health Organization, lung cancer is the leading cause of cancer-related deaths worldwide for both men and women. In 2020, there were 2.21 million new lung cancer cases globally and 1.80 million deaths.

While smoking is the single greatest risk factor for lung cancer, accounting for 85 percent of all cases, other lesser-known risk factors include environmental exposures and genetics. Environmental exposure to radon, asbestos, arsenic, beryllium, and uranium has been linked to lung cancer. The risk of lung cancer also increases with a history of cancer in another part of the body, age, family history, radiation to the chest area, and lung diseases like chronic obstructive pulmonary disease (COPD).

World Lung Cancer Day offers an opportunity to raise awareness for the staggering global impact of this cancer. With one in four cancer deaths attributed to lung cancer, it is of critical importance to promote early detection through symptom awareness and lung cancer screening. Through early detection, treatment can begin, the cancer is less likely to spread, and we can begin to reduce the number of lung cancer deaths worldwide.

If you currently smoke or have a history of smoking and are 50 years or older, you may be a candidate for a screening low-dose CT scan that can potentially detect lung cancer in its earliest stages.

Lung cancer symptoms include a persistent and worsening cough, coughing up blood, chest or back pain, and difficulty swallowing. Tests that may be used to diagnose lung cancer include chest X-rays, Chest CT and PET scans, bronchoscopy, and needle biopsies.

To learn more about lung cancer screening, click here.

For tobacco cessation resources, click here.

About the Forum of International Respiratory Societies
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.
FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latinoamericana de Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Disease (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA) and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

FIRS calls for action to prevent young people from taking up smoking

On World No Tobacco Day (May 31, 2023) the Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, is encouraging policy makers to take steps to prevent young people from taking up smoking.

Despite initiatives around the world to reduce the use of tobacco products amongst young people, such as restrictions in marketing and raising the minimum age of sale to 18 years old, smoking is still prevalent amongst those aged 18 and under:

• The average age to start smoking is 16 years of age. [1]
• Across EU countries, more than one in six (18%) 15-year-olds reported having smoked cigarettes at least once in the past month in 2018. [2]
• Data from the US Department of Health suggest that 90% of smokers begin smoking before 18 years of age. [3]
• The use of electronic nicotine delivery systems has dramatically increased over the past 10 years, particularly among young people. [4]

The brains of children and adolescents are uniquely vulnerable to the effects of nicotine and nicotine addiction. The later an individual begins smoking, the less likely they are to smoke later in life. Smokers are much more likely than non-smokers to develop lung cancer, COPD and other respiratory diseases, it is therefore crucial that we prevent tobacco use in young people to protect them from lifelong addiction and its extensive adverse health effects.

To protect young people from the dangers of tobacco use, FIRS urges policy makers to adopt Tobacco 21 (T21) policies which raise the minimum age for the sale of tobacco products to 21 years.

Many countries have already begun to raise the minimum age of sale of tobacco products beyond the 18 years specified by the World Health Organization’s Framework Convention on Tobacco Control (WHO FCTC):

• The USA introduced T21 law first at regional and state level across 19 states from 2003 to 2019, which then became national legislation in 2019. [5]
• Singapore phased in T21 law, first increasing the age of sale to 20 years in 2020 and then 21 years in 2021. [6]
• Sri Lanka and Kuwait have raised the age of sale of tobacco products to 21 years. [7, 8]
• In December 2021, New Zealand introduced a Smokefree 2025 Action Plan to be smoke free by 2025 by banning the sale of tobacco products to anyone born after 2009. [9]

Studies conducted in the United States suggest that T21 policies have been effective:

• In Needham, Massachusetts, a greater reduction in past 30-day smoking among adolescents was recorded compared with adolescents in surrounding areas following the implementation of T21 law [10]
• Smoking rates among 18 to 20-year-olds in US metropolitan areas showed a 1.2% reduction post introduction of T21 laws. [11]
• Survey data from Cleveland, Ohio reported a reduction in tobacco use among high-school children once T21 legislation was introduced [12]
• After implementation of T21 law in California in 2016, a purchase survey demonstrated a reduction in tobacco products sales among 15 to 16-year-olds. [13]

Modelling suggests that increasing the legal age of tobacco products to 21 years will reduce tobacco initiation, particularly in adolescents aged 15–17 years, resulting in fewer tobacco attributable deaths. [14]

It is estimated that the global yearly death toll as a result of tobacco use is currently 7 million (including exposure to second hand smoke) [15]. As countries move towards ending the use of tobacco products, FIRS urges policy makers to adopt Tobacco 21 policies and reduce the harmful impacts of tobacco products on the global population.

The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

On World Asthma Day Respiratory Health Associations Call for Asthma Care for All

The theme for World Asthma Day 2023 (May 2) is “Asthma care for all”.  The Forum of International Respiratory Societies (FIRS), of which GOLD is a founding member, is calling on healthcare leaders and policy makers to ensure access to effective, quality-assured medications, especially in low- and middle-income countries.

Asthma is a major noncommunicable disease, affecting both children and adults, and is the most common chronic disease among children. Asthma affected an estimated 262 million people in 2019 and caused 455 000 deaths^[i].

Airway Inflammation drives asthma symptoms, including a cough, wheezing, shortness of breath and chest tightness. The major treatment of asthma is treating this inflammation in the lungs.

Most of the burden of asthma morbidity and mortality occurs in low- and middle-income countries, where the disease is often under-diagnosed and under-treated. Essential inhaled medications, particularly those containing inhaled corticosteroids, are often unavailable or unaffordable, and this explains much of the global burden of preventable asthma morbidity and mortality.

It is unacceptable that, despite the availability of highly effective therapies, global inequality in asthma care deprives so many children, adolescents and adults of healthy lives and puts them at increased risk of death. A World Health Assembly Resolution on universal access to affordable and effective asthma care is needed to focus attention and investment on addressing this need. 

World Asthma Day and GINA

World Asthma Day is organized by the Global Initiative for Asthma, (GINA) (a FIRS member) a World Health Organization collaborative organization founded in 1993.  GINA is working to improve the lives of people with asthma in every corner of the globe.  More about GINA’s global strategy for diagnosis, management, and prevention of asthma and World Asthma Day can be found at www.ginasthma.org. 

About the Forum of International Respiratory Societies (FIRS)

The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

For more information about FIRS please contact Fiona Salter fional.salter@firsnet.org

[i] https://www.who.int/news-room/fact-sheets/detail/asthma

On World Tuberculosis (TB) Day, International Lung Health Organizations Advise ‘We must find and treat everyone with TB, to end TB’.

In support of World Tuberculosis (TB) Day 24 March, the Forum of International Respiratory Societies, of which GOLD is a founding member, is determined to break the chain of TB transmission.

In 2021, 1.2 million children fell ill with TB globally[i]. On World TB Day, FIRS members are focusing on child TB, as children with TB are most likely to have been recently infected by an undiagnosed and untreated adult with infectious TB in their household or community. This is not right.

The key to breaking the chain of transmission and ending TB is to find and treat everyone in the community with TB. This simple approach will not only benefit those people who are found and treated, but also protects others from ever being infected with TB.

Despite TB being curable, progress is moving slowly.  Over the last decade, TB deaths fell by only 2 per cent per year. Deaths increased during the Covid-19 pandemic, as experts, equipment and money were diverted elsewhere. Sadly, TB will likely kill more people in low- and middle-income countries in 2023 than Covid-19, making it the world’s biggest infectious disease killer.[ii]

Prof Guy Marks, President and Interim Executive Director of FIRS member The Union, said: “We must use our expertise, evidence base and tools more effectively to make TB history, and that starts with finding and treating everyone with TB. We must stop children from ever getting TB.”

There remains a large global gap between the estimated number of people who fell ill with TB and the number of people newly diagnosed, with 4.2 million people not diagnosed with the disease, or not officially reported to national authorities in 2021, up from 3.2 million in 2019.[iii]

The Union has developed several resources to support healthcare workers in high TB burden settings with diagnosing children with TB and deciding when and how to start TB treatment in children and adolescents. The Union also coordinates the Child and Adolescent Tuberculosis Centre of Excellence, a virtual network of public health experts in child and adolescent TB in the sub-Sahara Africa region, providing a community of learning and practice.

For more on the impact of TB and other respiratory diseases, see the Global Impact of Respiratory Disease Report.

About the Forum of International Respiratory Societies (FIRS)

The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally: American College of Chest Physicians (CHEST), American Thoracic Society (ATS), Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

For more information about FIRS please contact Fiona Salter fional.salter@firsnet.org

[i] https://www.who.int/news-room/fact-sheets/detail/tuberculosis#:~:text=In%202021%2C%20an%20estimated%2010.6,women%20and%201.2%20million%20children.

[ii] https://www.telegraph.co.uk/global-health/science-and-disease/tb-hidden-pandemic-ignore-peril/

[iii] https://www.who.int/publications/m/item/global-tuberculosis-report-2022-factsheet

Forum of International Respiratory Societies calls for collaborative efforts to fight pneumonia – focusing on those at greatest risk

12 November 2022

This World Pneumonia Day, 12 November 2022, the Forum of International Respiratory Societies (FIRS), of which [INSERT MEMBER ORGANIZATION] is a founding member, is calling on governments and other stakeholders to take urgent action to tackle pneumonia – focusing on those who are at greatest risk of severe illness.

The combined effects of the COVID-19 pandemic, air pollution, and poor living conditions associated with conflict and climate change have contributed to pneumonia numbers – placing millions at risk of infection and even of death.

In 2021, the estimated burden of deaths from respiratory infections, including COVID-19, was a staggering 6 million people.1

Pneumonia claimed the lives of 2.5 million, including 672,000 children, in 2019 alone, according to the Global Burden of Disease.2 That’s:

• One person dying every 13 seconds
• One child under 5 dying every 47 seconds
• One adult over 70 years dying every 26 seconds

Most deaths occur in the poorest populations in low and middle-income countries (LMICs). Low vaccination rates or lack of immunisation, malnutrition, or exposure to cigarette smoke and air pollution are key factors that increase susceptibility to pneumonia and to severe illness.

Older adults exposed to air pollution especially from burning fossil fuels and smoking are also at risk. Almost half of the estimated 1.6 million pneumonia deaths among adults aged over 50 years are attributable to air pollution or smoking.3

To prevent, diagnose and treat pneumonia, this World Pneumonia Day, FIRS is calling on governments to:

• Strengthen health systems to deliver interventions which reduce pneumonia deaths, including provision of effective vaccines, antibiotics and oxygen delivery systems for all.
• Implement sustainable interventions that protect against, prevent, and treat pneumonia across age groups.
• Support research into prevention and treatment strategies such as simple, low-cost point-of-care diagnostics for pneumonia and cost-effective oxygen delivery systems.
• Raise awareness about the risk factors for pneumonia
• Ensure equitable and sustained access to prevention and treatment strategies globally.

In addition, vaccine education can be a pivotal tool in reducing pneumonia-related deaths. There have been important advances with new effective vaccines available against pneumonia including pneumococcal conjugate vaccine (PCV) and vaccines against SARSCoV2, the virus that causes COVID-19. However, during the outbreak of the COVID-19 pandemic, PCV coverage dropped in 46 of 195 countries4 and the United Nations Children’s Fund (UNICEF) has predicted a large increase in child deaths if urgent action is not taken to vaccinate these children. Currently only 51% of the world’s children receive PCV.5

Pneumonia may have long-term consequences. Children who have pneumonia in early life have an increased risk of developing chronic lung disease such as asthma or Chronic Obstructive Pulmonary Disease (COPD) into adulthood.
Lack of medical oxygen has compounded the pneumonia emergency with LMICs bearing the brunt of oxygen shortages and related deaths.

“Although lack of oxygen has always been a key issue in LMICs, COVID highlighted this gap, with oxygen unavailability and related deaths mainly affecting LMICs,” said FIRS President Professor Heather Zar.

“There are an estimated 7 million children hospitalised with pneumonia each year who require oxygen and studies show that better oxygen systems can reduce mortality from childhood pneumonia by 50% or more.”

Media contact: Fiona Salter Fiona.salter@firsnet.org

Sources
1.Global Burden of Disease, 2019 and WHO COVID-19 Dashboard.
2,3.Global Burden of Disease, 2019.
4, 5 Every Breath Counts analysis of WHO/UNICEF Estimates of National Immunization Coverage 2021, published in Time for a New Approach to Protecting Children Against the Leading Threats to Their Survival, July 2022.

Further information

FIRS recommended actions to prevent pneumonia and pneumonia deaths:

• Vaccination programmes against the common germs that cause pneumonia such as pneumococcus, measles, Haemophilus Influenzae type b, pertussis (whooping cough), diphtheria, influenza and SARS-CoV2 should be made available.
• Good nutrition should be encouraged, including exclusive breastfeeding for the first 4-6 months of life, adequate complementary feeding and Vitamin A supplementation which may protect children from getting pneumonia.
• People of all ages should avoid and be protected from exposure to tobacco smoke and air pollution.
• Effective strategies to reduce pneumonia, include the prevention of mother-to-child transmission of HIV, early use of antiretroviral therapy in HIV-infected children, as well as cotrimoxazole prophylaxis for HIV-infected children.
• All health services should ensure prompt access to antibiotics and oxygen therapy for those with pneumonia.

The Global Impact of Respiratory Disease report outlines major causes of respiratory disease and lays out recommendations for global action.

More on World Pneumonia Day from Stop Pneumonia.org

About the Forum of International Respiratory Societies:
The Forum of International Respiratory Societies (FIRS) is an organisation comprised of the world’s leading international respiratory societies working together to improve lung health globally. The goal of FIRS is to unify and enhance efforts to improve lung health through the combined work of its more than 70,000 members globally.

FIRS comprises the American College of Chest Physicians (CHEST), American Thoracic Society (ATS), the Asian Pacific Society of Respirology (APSR), Asociación Latino Americana De Tórax (ALAT), European Respiratory Society (ERS), International Union Against Tuberculosis and Lung Diseases (The Union), Pan African Thoracic Society (PATS), the Global Initiative for Asthma (GINA), and the Global Initiative for Chronic Obstructive Lung Disease (GOLD).

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