Asthma is one of the major non-communicable diseases (NCDs) that affects both children and adults. According to the World Health Organization (WHO), it is the most common chronic disease among children.
The global health agency maintains that asthma affected an estimated 262 million people in 2019 and caused 455,000 deaths. Asthma is often under-diagnosed and under-treated, particularly in low- and middle-income countries.
A 2022 study has revealed that stigma associated with asthma is preventing patients from getting the right treatment in India. In an e-mail interaction with Financial Express.com, Achin Gupta, CEO – One India Business, Cipla Ltd. talked about the status of asthma in India, key challenges in diagnosing and treating asthma, among others. Cipla has been a key player in the respiratory care segment, and this makes for a major part of the company’s total revenue. The company has consistently introduced new products for asthma, chronic obstructive pulmonary disease and allergic rhinitis. Excerpts:
What is the status of Asthma in India?
The status of asthma in India reveals alarming statistics. According to the Global Burden of Disease study in 2019, India bears a significant burden, with 34.3 million reported asthma cases, accounting for nearly 13% of the global burden. Even more concerning, India tops the list for asthma-related deaths globally, contributing over 42% of all such fatalities. Additionally, the country ranks first in the world for disability-adjusted life years (DALYs) attributed to asthma, highlighting the substantial impact of the disease on overall health and quality of life.
The Global Asthma Network (GAN) study adds another layer to this issue, revealing that in India, nearly 70% of individuals with severe asthma symptoms remain undiagnosed, and of those diagnosed, less than 9% receive the recommended treatment (inhaled corticosteroids), which forms the cornerstone of asthma management.
Thus, the glaring disparity between the India’s contribution to the global burden of the disease in terms of prevalence and its associated morbidity can be attributed to two key factors: underdiagnosis and the reluctance to accept proper treatment due to lingering myths and misconceptions. To address this challenge, it is imperative to raise widespread awareness about asthma and promote a better understanding of inhalation therapy, which is fundamental for the effective management of this condition.
What are the challenges that patients of Asthma are facing in India?
Social stigma attached to the disease’s diagnosis, acceptance of the recommended inhalation therapy, and adherence to prescribed treatments for those already on inhalation therapy – are among the key challenges that asthmatics in India still face when it comes to taking control of their condition. All rooted in a lack of understanding about the disease and its recommended treatment, these issues serve as substantial obstacles that impede effective disease management at every step of the patient’s journey.
At a diagnosis level only 23% of patients call their condition ‘asthma’ with a majority using alternative terms like swas or dama. From a treatment standpoint, the widespread perception that inhalers have side effects has led to a strong aversion to them among both asthmatics and caregivers. For example, parents often worry about issues like growth suppression and addiction when it comes to using inhalers, while many asthmatics feel embarrassed to use inhalers or even carry them in public. In fact, the taboo with asthma has even led to many parents concealing the disease, resulting in delayed treatment or even complete avoidance of necessary medications.
And finally, adherence to doctor prescribed treatment is yet another barrier that can be attributed to the incorrect notions associated with inhalation therapies. More than half of asthmatics discontinue treatment once symptoms become more manageable or tolerable, leading to uncontrolled or undertreated asthma. This behaviour of ‘symptom tolerance’ potentially leads to issues like school absenteeism, urgent medical consultations and emergency department visits.
What are the current treatment and management protocols for Asthma in India?
The overarching goals of asthma management are twofold. First, it aims to optimize the control of asthma symptoms, allowing patients to experience minimal disruption in their daily lives. Second, it seeks to reduce the risk of asthma exacerbations, which can have serious consequences. However, there is a disconnect between how patients perceive controlled asthma and the definitions provided by organizations like the Global Initiative for Asthma (GINA). Some patients may primarily associate asthma control with managing exacerbations rather than focusing on day-to-day symptom control and preventing exacerbations.
The current protocols for asthma management underscore the importance of early intervention, effective utilization of inhalation therapy, and comprehensive symptom control where treatment adherence plays a crucial role. It’s essential to address misconceptions and enhance patient understanding to ensure successful, long-term asthma management.
How is Cipla, as a key player in the respiratory space, working towards awareness and management of asthma?
Over the last six decades our presence across the respiratory care continuum from awareness, diagnosis, medication to advanced treatments and devices, has underscored Cipla’s position as responsible lung leaders. Guided by our core philosophy of ‘Caring for life’ we’ve taken an innovative ‘beyond the pill’ approach to connect with patients and deliver the highest level of care.
This encompasses not only raising awareness about chronic respiratory conditions but also facilitating positive shifts in attitudes and behaviours. This endeavour is especially important when it comes to conditions like asthma where the burden of social stigma associated with the disease, is comparable to the disease burden itself.
In pursuit of this mission, Cipla has adopted a multifaceted strategy that spans mass awareness campaigns like #BerokZindagi and Tuffies, as well as patient-centric initiatives such as Breathefree—a comprehensive patient support programe.