Reflections on 30 years of the International Study of Asthma and Allergies in Childhood (ISAAC) and the Global Asthma Network (GAN)

Professor Emeritus Innes Asher, University of Auckland, New Zealand

ISAAC, formed in 1991, was innovative in developing methodology for measuring asthma prevalence in children which was straightforward, standardised, low cost and repeatable using questionnaires, and could be used in all parts of the world. Collaborators in centres in all regions of the world (233 centres in 97 countries) engaged in ISAAC over the next 20 years, enabling, for the first time, a global picture of asthma and changes in prevalence, severity, and environmental factors. In several regions asthma was more common than previously thought, especially in low- and middle-income countries (LMICs), this data informing public health policy. The association of asthma with atopy was weak especially in LMICs.

Asthma was identified as an important noncommunicable disease (NCD) at the first UN Summit on NCDs 2011, and the first Global Asthma Report (GAR) was launched there as a collaboration between the International Union Against Tuberculosis and Lung Disease (The Union) and ISAAC. Out of this collaboration GAN was established and has since published GARs – in 2014, 2018 and 2022. GAR 2022 was written by 97 authors from 31 countries.

GAN built on the unique network of collaborators built by ISAAC. GAN has completed studies of asthma prevalence, severity and environmental factors in adults and children and changes over time in children confirming that asthma remains a large worldwide public health problem. Importantly, we have shown that large numbers of people in the world lack access to affordable quality-assured essential asthma medicines. Addressing this lack is the subject of this symposium.