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. 2020 May;55(5):1282-1292.
doi: 10.1002/ppul.24713. Epub 2020 Mar 6.

A worldwide charter for all children with asthma

Stanley J Szefler  1 , Dominic A Fitzgerald  2   3 , Yuichi Adachi  4 , Iolo J Doull  5 , Gilberto B Fischer  6 , Monica Fletcher  7 , Jianguo Hong  8 , Luis García-Marcos  9 , Søren Pedersen  10 , Anders Østrem  11 , Peter D Sly  12 , Siân Williams  13 , Tonya Winders  14   15 , Heather J Zar  16 , Andy Bush  17 , Warren Lenney  18
Affiliations

A worldwide charter for all children with asthma

Stanley J Szefler et al. Pediatr Pulmonol. 2020 May.

Abstract

Childhood asthma is a huge global health burden. The spectrum of disease, diagnosis, and management vary depending on where children live in the world and how their community can care for them. Global improvement in diagnosis and management has been unsatisfactory, despite ever more evidence-based guidelines. Guidelines alone are insufficient and need supplementing by government support, changes in policy, access to diagnosis and effective therapy for all children, with research to improve implementation. We propose a worldwide charter for all children with asthma, a roadmap to better education and training which can be adapted for local use. It includes access to effective basic asthma medications. It is not about new expensive medications and biologics as much can be achieved without these. If implemented carefully, the overall cost of care is likely to fall and the global future health and life chance of children with asthma will greatly improve. The key to success will be community involvement together with the local and national development of asthma champions. We call on governments, institutions, and healthcare services to support its implementation.

Keywords: asthma; charter; childhood asthma; children; global pediatric asthma.

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Conflict of interest statement

SJS reports acting as a consultant for and research with Boehringer Ingelheim, GlaxoSmithKline plc, AstraZeneca, Novartis, Regeneron, and Sanofi and grants from GlaxoSmithKline plc and Propeller Health. DAF has consulted for GlaxoSmithKline plc and Merck, Sharp & Dohme. YA reports grants from Astellas, GlaxoSmithKline plc, and Pfizer and personal fees from Merck Sharp & Dohme, GlaxoSmithKline plc, and Kyorin Pharmaceuticals. MF and WL are former GlaxoSmithKline plc employees and hold GlaxoSmithKline plc shares. SP reports personal fees from AstraZeneca, ALK, Thermo Fisher Scientific, and Phadia. AØ has consulted for GlaxoSmithKline plc and Boehringer Ingelheim. HJZ reports grants from The Allergy Society of South Africa, South Africa Medical Research Council and acting as a consultant to GSK. All other authors have no competing interests to disclose.

Figures

Figure 1
Figure 1
The probability of best response based on combinations of sensitization and peripheral blood eosinophil count. P values correspond to the test of interaction between the predictor and treatment and indicate whether the pattern of treatment response differs according to subgroup. Sample sizes correspond to participants with evaluable data (N = 230). Reproduced with permission from Fitzpatrick et al 33 [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 2
Figure 2
Trajectories of lung function (forced expiratory volume in 1 second z‐score) from 7 to 53 years of age. The six trajectories represent the latest growth patterns of lung function. The group prevalences do not add up to 100% because of rounding. Reproduced with permission from Bui et al 40 [Color figure can be viewed at http://wileyonlinelibrary.com]
See this image and copyright information in PMC

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