GARD Steering committee report J Bousquet, R Dahl

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report 2- GARD members 3- Modified TOR 4- Preparation of the Launch 5- "GARD manual" 6- Dissemination of GARD to countries

GARD Stepwise approach May 2005 GARD priorities Integrated GARD action plan Step 1 Step 2 Step Pilot studies in countries GARD action plan in countries

GARD priorities Integrated GARD action plan Step 1 Step 2 Step Pilot studies in countries GARD action plan in countries GARD Stepwise approach March 2006

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report

October 5, 2005

Estimate population needs and advocate WG.1- Burden, risk factors and surveillance (G Viegi, S Buist, Y Fukuchi) WG.2- Awareness and advocacy (C Lenfant, A Turnbull, P van Cauwenberge)

Formulate and adopt policy WG.3- Prevention and health promotion (M Boland, A Custovic) WG.4- Diagnosis of CRD (K Rabe, S Wenzel) WG.5- Control of CRD and allergies, Availability and affordability of drugs (J Bousquet, E Bateman, L Fabbri, C van Weel) WG.6- Pediatric asthma (C Baena-Cagnani, E Mantzouranis, FER Simons, E Valovirta)

Formulate and adopt policy WG.3- Prevention and health promotion (M Boland, A Custovic) WG.4- Diagnosis of CRD (K Rabe, S Wenzel) and allergy (GW Canonica) WG.5- Control of CRD and allergies, Availability and affordability of drugs (J Bousquet, E Bateman, L Fabbri, C van Weel) WG.6- Pediatric asthma (C Baena-Cagnani, E Mantzouranis, FER Simons, E Valovirta)

Formulate and adopt policy WG.3- Prevention and health promotion (M Boland, A Custovic) WG.4- Diagnosis of CRD (K Rabe, S Wenzel) and allergy (GW Canonica) WG.5- Control of CRD and allergies (J Bousquet, E Bateman, L Fabbri, C van Weel) Availability and affordability of drugs (N Aït Khaled) WG.6- Pediatric asthma (C Baena-Cagnani, E Mantzouranis, FER Simons, E Valovirta)

In high income countries - patients can receive adequate diagnosis and treatment - but they are insufficiently diagnosed and treated - a disease-specific approach is needed - the goals of GARD are to better diagnose, treat and educate patients In upper-middle income countries - few patients can receive adequate diagnosis and treatment the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in many places In lower-middle and low income countries - very few patients can receive adequate diagnosis and treatment the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in most places In all countries, health promotion and prevention are essential control by disease-specific approach control by syndromic approach no control Current management of CRD

In high income countries - patients can receive adequate diagnosis and treatment - but they are insufficiently diagnosed and treated - a disease-specific approach is needed - the goals of GARD are to better diagnose, treat and educate patients In upper-middle income countries - few patients can receive adequate diagnosis and treatment - the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in many places In lower-middle and low income countries - very few patients can receive adequate diagnosis and treatment - the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in most places In all countries, health promotion and prevention are essential control by disease-specific approach control by syndromic approach no control GARD policy

Identify Policy Implementation Steps National Coordination: The GARD action plan should be applied at the country level Establish national working groups with a national coordinator The national coordination group will: Provide existing national statistics on CRD and allergies Assess the specific needs for the given country Review the GARD action plan Determine the relevant issues for the country action plan Develop a country-specific action plan

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report 2- GARD members

WHO calls for a global and coordinated effort to fight chronic respiratory diseases WE ARE GARD!

GARD members Governmental organizations Scientific societies Patient's organizations Other NGOs Pharmaceutical industry Governments Year 1 Year 2 "Medical" Foundations

GARD members Governmental organizations Scientific societies Patient's organizations Other NGOs Pharmaceutical industry Governments Year 1 Year 2 "Medical" Foundations Targetted approach

GARD members Governmental organizations Scientific societies Patient's organizations Other NGOs Pharmaceutical industry Governments Year 1 Year 2 World Bank Unesco and others Private sector "Medical" Foundations Foundations

GARD members Governmental organizations Scientific societies Patient's organizations Other NGOs Pharmaceutical industry Governments Year 1 Year 2 World Bank Unesco and others Private sector "Medical" Foundations Foundations Targetted approach first Global approach later

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report 2- GARD members 3- Modified TOR

GARD TOR TOR december 2004: approved by members Assembly meeting: revision of TOR NOT sent to WHO to include private sector, WHO proposed a revised TOR (TOR2) (january 2006) TOR2 should be discussed during the meeting and proposal sent to WHO

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report 2- GARD members 3- Modified TOR 4- Preparation of the Launch

Fact sheet "Hundreds of millions of people suffer from chronic respiratory diseases worldwide, including: o 300 million people with asthma o 62 million people with moderate to severe COPD o Millions of others with mild COPD, allergic rhinitis, and other chronic respiratory diseases, which are often undiagnosed."

Chronic respiratory diseases asthma300 millionsGINA, 2004 Moderate to severe COPD62 millionsWHO, 2006 Allergic rhinitismillions Secondary pulmonary hypertension Occupational CRD Chronic rhinosinusitis Post-infectious CRD Lung cancer and neoplasms of the respiratory organs Sequellae of pulmonary embolism Cor pulmonale Sleep apnea syndrome Lung fibrosis TOTAL: Hundreds of millions

Chronic respiratory diseases asthma300 millionsGINA, 2004 COPD150 millions Allergic rhinitis400 millions Secondary pulmonary hypertension25 millions Occupational CRD25 millions Chronic rhinosinusitis50 millions Post-infectious CRDNo data Lung cancer and neoplasms of the respiratory organs Sequellae of pulmonary embolismNo data Cor pulmonaleNo data Sleep apnea syndrome100 millions Lung fibrosisNo data TOTAL: > ONE BILLION

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report 2- GARD members 3- Modified TOR 4- Preparation of the Launch 5- "GARD manual"

Geneva « pre-GARD » WHO meeting GARD accepted by WHO 1st GARD assembly 1st GARD/WHO meeting GARD meeting GARD Launch GARD manual

Geneva « pre-GARD » WHO meeting GARD accepted by WHO 1st GARD assembly 1st GARD/WHO meeting GARD meeting GARD Launch GARD manual GARD source document Fact sheets Press release

Geneva « pre-GARD » WHO meeting GARD accepted by WHO 1st GARD assembly 1st GARD/WHO meeting GARD meeting GARD Launch GARD manual GARD source document Public Health guide Pocket guide Review Published by NGOs Launch at ERS

Steering committee report 1- Consequences for GARD of the publication of the WHO Chronic Disease report 2- GARD members 3- Modified TOR 4- Preparation of the Launch 5- "GARD manual" 6- Dissemination of GARD to countries

Activities within countries China: launch, Chinese Medical Association China: launch, Chinese Medical Association Brazil: Minister of Health (PAHO) Brazil: Minister of Health (PAHO) Poland: Minister of Health Poland: Minister of Health India: President India: President Japan, Korea..: National coordination Japan, Korea..: National coordination Cape Verde, Russia, Tunisia: Pilot studies Cape Verde, Russia, Tunisia: Pilot studies