Updated on 13 June 2013
Dr Anthony S Rebuck, senior consultant, head of strategic drug development, Asia, Quintiles, Singapore
Predictions for the burden and impact of Chronic Obstructive Pulmonary Disease (COPD) have exceeded all expectations. In 1996, the World Health Organization (WHO) estimated that COPD would rise from seventh leading cause of death and disability worldwide to fifth position by 2020. COPD has achieved the ranking seven years ahead of schedule. Currently, the revised prediction is for COPD to achieve third place as cause of death by 2020. When Dr P M A Calverley and Dr P Walker, from Department of Medicine, University of Liverpool, UK , correctly predicted the rise in COPD that was about to occur, they made no distinction between Asian countries and those of Europe and the US. It is now apparent that much of the burden will be felt in Asia, yet despite high rates of cigarette smoking and use of biomass fuels, there are few objective data on the prevalence of COPD in the region. This paper addresses the level of appreciation of the severity of COPD in Asia, regional COPD management initiatives and what Asia-specific actions might be appropriate in reducing the main risk factors.
How well is COPD understood?
The term COPD was first used in 1965 and has overtaken other descriptive labels such as chronic bronchitis and emphysema, to become the preferred name for this disease. COPD is characterized by low airflow on lung function and shortness of breath, both of which are poorly reversible and gradually get worse over time.
There is scant appreciation of the size of the global problem, in part because COPD is not diagnosed in its early stages, especially in Asia. Chronic cough is frequently attributed to an innocent accompaniment of smoking or simply to a manifestation of aging. COPD has become a blanket term to describe bronchiectasis, chronic asthma, chronic tuberculosis and bronchiolitis obliterans, rather than a disease entity in its own right. In fairness, the term COPD was only introduced officially in some Asian countries as recently as 1995.
While the term COPD is relatively new, the disease is not. Classical descriptions of ‘voluminous lungs', ‘distended air sacks' , cough, mucous and ‘catarrh' date back many centuries, and as early as 1814, the condition was recognized as a disabling disorder.