Chop PPOK,Ppt.ppt Rev (1)

8/13/2019 Chop PPOK,Ppt.ppt Rev (1)

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Global Surveillance, Preventionand Control of Chronic

Respiratory Diseases

dr. Juliandi Harahap

dr. Rina Amelia


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Introduction

Chronic respiratory diseases are chronic diseases of theairways and the other structures of the lungs.

Major preventable chronic respiratory diseases includeasthma and respiratory allergies, chronic obstructive

pulmonary disease (COPD), occupational lung diseases,sleep apnea syndrome and pulmonary hypertension. Chronic Respiratory Diseases kill more than four

million people every year and affect hundreds ofmillions more.

These diseases erode the health and well-being of thepatients and have a negative impact on families andsocieties.


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Women and children are particularly vulnerable,especially those in low and middle incomecountries, where they are exposed on a daily

basis to indoor air pollution from solid fuels forcooking and heating. In high income countries, tobacco is the most

important risk factor for chronic respiratory

diseases, and in some of these countries, tobaccouse among women and young people is stillincreasing.


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The Burden of Chronic Diseases

80% of chronic disease deaths occur in low and middleincome countries.

The threat is growingthe number of people, families andcommunities afflicted is increasing.

This growing threat is an under-appreciated cause of povertyand retards the economic development of many countries.

Chronic diseases were estimated 58 million deaths from allcauses in 2005.

Chronic diseases account for twice as many deaths as all

communicable diseases (including HIV/AIDS, tuberculosisand malaria), maternal and perinatal conditions, andnutritional defi ciencies combined

Only 20% of cases of chronic disease occur in high incomecountries.


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The chronic disease threat can be overcome using

existing knowledge. The solutions are effectiveand highly cost effective. Comprehensive and integrated action at country level,

led by governments, is the means to achieve success.

WHO recently launched the Global Alliance againstChronic Respiratory Diseases (GARD). GARD brings together the combined knowledge of

national and international organizations, institutionsand agencies to improve the lives of millions of peopleaffected by chronic respiratory diseases.


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Risk Factors

Major risk factors include:1. tobacco smoke

2. second hand tobacco smoke

3. other indoor air pollutants

4. outdoor air pollutants

5. allergens

6. occupational agents.

Possible risk factors include:

1. diet and nutrition

2. post infectious chronic respiratory diseases. Prevention of these risk factors will have a significant impact on

morbidity and mortality.


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Preventable Chronic Respiratory Diseases:

A Major Global Health Problem

Hundreds of millions of people of all ages (frominfancy to old age) suffer from preventable chronicrespiratory diseases and respiratory allergies in all

countries of the world. More than 500 million of these people live in low

and middle income countries or deprivedpopulations.

Preventable chronic respiratory diseases areincreasing in prevalence, particularly amongchildren and elderly people.


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The burden of preventable chronic respiratory diseases

has major adverse effects on the quality of life anddisability of affected individuals. Many risk factors for preventable chronic respiratory

diseases have been identified and efficient preventivemeasures established.

Effective management plans have been shown toreduce the morbidity and mortality caused by chronicrespiratory diseases.

Prevention and management plans concerning chronic

respiratory diseases are fragmented and need tobecoordinated


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The Global Alliance against Chronic

Respiratory Diseases (GARD) a voluntary alliance of national and international

organizations, institutions and agencies working

towards the common goal of improving globallung health.

Vision: a world where all people breathe freely.

Goal: to reduce the global burden of chronicrespiratory diseases.


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Objective: to initiate a comprehensive approachto fight chronic respiratory diseases. Thisinvolves: developing a standard way of obtaining

relevant data on chronic respiratory disease riskfactors, encouraging countries to implementhealth promotion and chronic respiratory

disease prevention policies, recommendingaffordable strategies for the management ofchronic respiratory diseases.


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GARDs added value: to provide a network throughwhich collaborating parties can combine their strengths,

thereby achieving results that no one partner couldobtain alone; and to improve coordination betweenexisting governmental and nongovernmentalprogrammes, so as to avoid a duplication of efforts andthe waste of resources.

GARDs approach: to promote an integrated approachthat capitalizes upon strategic synergies on preventionand control between chronic respiratory diseases andother chronic diseases; and to consider especially theneeds of low and middle income countries and

vulnerable populations, fostering country-specificinitiatives that are tailored to local needs.


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The emphasis on the needs of low- and middle-income countries is appropriate, as most casesof chronic respiratory disease occur in these

countries, with communicable diseases(including HIV/AIDS) adding to the burden ofchronic respiratory disease morbidity.


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GARD Approach

GARD will work at international and

national level.

GARDs planning steps correspond to

WHOs strategic objectives and action

plans.

GARD will exploit synergies, building on

and complementing existing programmes

and projects.


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Stepwise Framework


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Planning step 1: estimate population

need and advocate for action The basis for action is to estimate disease burden and

population needs, identify risk factors for chronicrespiratory diseases and respiratory allergies, and undertakesurveillance on chronic respiratory disease risk factors, and

trends in disease burden, as well as in costs, quality andaffordability of care. The data will need to be compared between countries

(highincome, and low- and middle-income) to definestrategies for policy-makers and to assess the impact of

chronic respiratory diseases programmes. There is also a need to advocate for action to combat

chronic respiratory diseases in order to raise awarenessamong all stakeholders and make chronic respiratorydiseases a public health priority in all countries.


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Planning step 2 : formulate & adopt policy

Implementation will start with pilot studies, developed by localexperts and stakeholders in each country, relevant to the needs,resources and setting of that country.

Comprehensive and integrated policies and plans for preventionare vital because they minimize overlap and fragmentation in the

health system. Policies and plans to prevent chronic respiratorydiseases should therefore Cut across specific diseases and focus on common risk factors since

many risk factors, such as tobacco smoking and other air pollutants,affect many different diseases.

Encompass promotion, prevention and control strategies.

Emphasize a population-based approach, rather than targeting specifi csubgroups. Integrate activities across settings, such as health-care centres, schools,

workplaces and communities. Link with other government programmes and community-based actions.


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A policy or plan on chronic

respiratory diseases should

1. Promote health through the prevention of chronicrespiratory diseases and respiratory allergies: byreducing the burden of tobacco smoke and othertypes of indoor and outdoor pollution, occupationalhazards and other relevant risk factors.

2. Recommend simple and affordable diagnostictools for the diagnosis of chronic respiratorydiseases and respiratory allergies

3. Control chronic respiratory diseases and allergies,and ensure drug accessibility


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Planning step 3: identify policy

implementation steps

Health priorities, geographic variability in risk factorsand chronic respiratory diseases, the diversity ofnational health-care service systems and variations inthe availability and affordability of treatments, allrequire that any recommendations should be adaptedlocally to ensure their appropriateness to thecommunity in which they will be applied.

GARD action plans developed during the planning step2 will be collated and rolled out to as many countries aspossible. The policy implementation process will followthe stepwise framework the results will be measurable.


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Chop PPOK,Ppt.ppt Rev (1)