Global Respiratory Leaders Call for Collaboration, Advocacy to Tackle Key Health Challenges

A panel of international respiratory society presidents at the CHEST 2024 annual meeting in Boston, Massachusetts, discussed the most prevalent respiratory issues worldwide and emphasized the need for global collaboration and advocacy to address them.

During the session, “Dominant Respiratory Issues Across the Globe,” Silke Ryan, MD, PhD, president of the European Respiratory Society (ERS), began by listing improvements needed for respiratory health in Europe, the first being cleaner air.

International respiratory society leaders highlighted the need for global collaboration to address key issues. | Image Credit: TAW4 - stock.adobe.com

To help decrease air pollution across the continent, she mentioned that the European Union (EU) established the European Ambient Air Quality Directive, which set up air quality standards and an air quality assessment network throughout Europe. Although these standards have helped mitigate air pollution in some manner, Europe still has room for improvement.

Ryan said a new directive was proposed and is nearly pushed through so Europe can adopt these stricter standards. She used this to demonstrate the importance of advocacy by international societies, like ERS, to help prioritize issues that impact respiratory health. 

Next, Ryan highlighted the need for greater focus on primary prevention and early detection of respiratory diseases in Europe. More specifically, investment in high-quality research, gathering more data, and convincing policymakers to prioritize primary prevention are prioritized.

Lastly, she emphasized the need for patients to understand that respiratory health is not just confined to the lungs. For example, Ryan discussed the significant global burden of sleep apnea, which often receives less attention since it may not be considered a “typical” respiratory disease. 

She concluded by highlighting that many of these issues exist in other areas globally. Therefore, Ryan instructed countries to collaborate to help improve the state of chest medicine.

“We all need to understand that health is global, and, hence, we, ERS, certainly see ourselves as a global partner in promoting issues in relation to respiratory health and respiratory medicine,” Ryan said.

Next, Adrian Rendon, MD, PhD, president of the Latin American Thoracic Association (ALAT), discussed the impact of the COVID-19 pandemic on tuberculosis (TB) within Central and South America countries. Since resources were more focused on COVID-19 during the pandemic, he noted that there was a huge underdiagnosis of TB cases.

This led to a significant increase in TB cases and deaths, with the death toll rising from 1.4 million in 2019 to 1.5 and 1.6 million in 2020 and 2021, respectively. Although TB is thought to be mainly prevalent in low-income countries, Rendon said that this increase in TB cases and deaths post-pandemic also occurred in the US.

“TB doesn’t know barriers,” he said. “TB travels around the world very easily with people. We were talking about pollution, climate change, all of these are fuel for TB because they increase the economic crisis and promote migration; TB uses those factors to move around the world.”

Additionally, John Buckley, MD, MPH, president of the American College of Chest Physicians (CHEST), highlighted the stark contrast between the declining prevalence of TB in high-income countries and its continued burden in other parts of the world. Because of this contrast, he expressed concerns that young US professionals may not be aware of the ongoing TB epidemic.

“I want to keep reminding my young colleagues, my young learners that just because we don’t see it [TB] in our daily practice doesn’t mean it’s not an extraordinarily important issue,” Buckley said. 

After, Irina Petrache, MD, president of the American Thoracic Society (ATS), presented a list of key respiratory health issues that need to be tackled in North America. Like Ryan, she stressed the importance of reducing air pollution. Also, she emphasized the need to tackle the vaping epidemic, especially among the youth since it can be a gateway to smoking and tobacco use.

Next, Petrache highlighted the importance of ensuring equitable health care access and improving global scientific literacy, especially related to respiratory health. Also, looking ahead, she instructed clinicians to learn from the COVID-19 pandemic and better prepare for future pandemics.

Lastly, Petrache acknowledged the increasing stress and burnout among health care professionals accelerated by the pandemic. To help overcome these challenges, she suggested incorporating new AI technologies to help "maintain the joy of the profession" by making more time for them to foster creativity and learning.

"The pressures to produce clinical care in an effective, efficient, low-cost way is really threatening the academic medicine field,” Petrache said. “I'm hoping that we can constructively incorporate novel technologies to overcome this challenge and to allow us to do what we love to inspire the next generation, to produce science with our creativity, and continue progress.”

Buckley wrapped up the session by highlighting the collaborative work of these societies through the Forum of International Respiratory Societies (FIRS). He noted that FIRS is working with the Global Lung Function Initiative (GLI) to develop a lung health spirometry toolkit.

Although there are traditional standards for how respiratory assessments and coronary function testing should be performed, Buckley noted that the reference equations and normative data do not truly represent the global population; this can result in the misidentification of respiratory diseases, especially among the populations less represented in the reference equations.

Therefore, the lung health spirometry toolkit will feature an updated standardized spirometry protocol to ensure high-quality practices and define key elements for training. It will also set minimum standards for research data governance, ethics development, and consent protocols to support future open-science data sharing. Additionally, the toolkit will identify key demographic and exposure factors affecting lung health, which will inform the development of standard questionnaires.