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‡ 300 million cases worldwide, still increasing

‡ Common chronic disease among children
‡ Majority in low- and lower-middle income countries
‡ Prevalence higher in urban areas
‡ Asthma accounts for about 1 death in every 250 deaths
worldwide
‡ Health cost of asthma increases with ineffective
management

Masoli M et al.
Burden of asthma. http://www.ginasthma.com
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‡ Major cause of unplanned visits to health facilities
in urban centres
‡ Low income and low health expenditure per capita
‡ Priority is given to communicable diseases
‡ Poor access to health services, particularly for the
long-term management needed for asthma
‡ Lack of trained health personnel
‡ Low or non-affordability of asthma medicines for
patients
      

1. Improve 

of essential asthma
medicines in developing countries

2. Improve  of health personnel by the

development of a training package

3. Assess 
by regular monitoring and

evaluation

Ait-Khaled N et al. Allergy 2007;62:230-36.

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particularly inhaled corticosteroids, has
been demonstrated since 1998 in The
Union studies:
± Majority of patients cannot afford the
essential medicines.
± Minority of rich patients are purchasing
very costly unnecessary medicines.
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Ë $5 15
$5-9 11
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$30-55 4
Do not know 22
Survey (46 countries), The Union and ADF, 2005
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Costs increase when asthma not treated or
incorrectly treated. We need to:
'Reduce unnecessary expense of emergency
visits, hospitalisation, and ineffective and
inappropriate medicines
'Reduce indirect costs on
patients, families, governments
 "
 
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‡ ADF organises qualification of manufacturers and products (as

part of its Quality Assurance system), since asthma inhalers
are not part of the WHO Prequalification Programme
‡ ADF establishes contracts with selected manufacturers for
qualified products and proposes these products to countries,
organisations, programmes
‡ Countries purchase generics at affordable prices
‡ ADF provides training materials and EpiData information
system

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‡ Training courses and technical assistance
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Clients must agree to:

‡ Use the products supplied according to the 4 step approach for

treatment and diagnosis proposed in The Union Asthma guide
‡ A minimum order of 5000 corticosteroid inhalers
‡ Take the responsibility for the importation of medicines into the
recipient country
‡ Sell the medicines with a minimal mark-up or to provide them
free of charge to patients
‡ Not re-export or resell these medicines
‡ Make a full payment in advance to ADF
‡ Submit quarterly monitoring reports to ADF
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4 & 4 
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¢
# 6#

Beclometasone 100µg/puff, Beximco 1.07

200 doses, HFA inhaler* (Bangladesh)

Salbutamol 100 µg/dose, Beximco 0.83

200doses, HFA inhaler* (Bangladesh)

Budesonide 200µg/puff, Cipla/Medispray 2.69

200 doses, HFA inhaler* (India)

Fluticasone 125µg/puff, Cipla/Goa 3.23

120 doses, HFA inhaler (India)
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‡ Commitment from respiratory specialists, public
health specialists, health workers, communities

‡ Convince governments to
buy essential medicines
for the majority of patients

‡ Country adoption / adaptation of international

asthma guidelines
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3       #
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