Improving access to affordable inhaled medicines – the role of clinical standards

Dr Shami Jayasooriya , University of Sheffield, UK


The majority of people with asthma can be managed effectively provided international asthma management recommendations (e.g., the Global Initiative for Asthma strategy) can be implemented. Unfortunately, this is often not the case in low- and middle-income countries, where limited access to affordable, quality diagnostic tests and treatments restrict the provision of effective asthma care. There are gaps between what is described in the currently available asthma management recommendations and the reality of what is typically available and affordable. We have therefore defined clinical standards tailored to the specific challenges of managing asthma in these settings.


A panel of 52 experts representing 31 countries participated in a two-stage Delphi process to establish and reach a consensus on clinical standards for the diagnosis and management of asthma in low- and middle- income countries.


18 clinical standards were defined. Standards 1-13 for contexts where WHO essential inhaled medicines are accessible and standards 14-18 for settings where these is no access to inhaled medicines. Please see article now in press for standards.


These first consensus-based clinical standards for asthma management in low- and middle- income countries are intended to help clinicians provide the most effective care for people in resource-limited settings.