INVITATION
Dear Colleagues
The MRA (Mediterranean Respiratory Assembly) is one of the leading medical organizations in the field of respiratory medicine, covering more than 30 countries in the Mediterranean region and with a growing membership.
MRA prioritizes science, education and advocacy to improve lung health, alleviate suffering from disease and raise the standards of respiratory medicine globally.
Our members and decision makers are busy health professionals who volunteer their time and expertise.
MRA National Societies are also instrumental in MRA research, guideline dissemination and a wide range of other activities.
“Never has it been more important to prioritise respiratory health and develop or improve national respiratory strategies.
President
Dr. Mohammad Hasan Al-Tarawneh
1000+
Physicans
30+
Countries
200+
Volunteers
President
Dr. Mohammad Hasan Al-Tarawneh
Scientific Committee
Dr. Ahmed
Beshir
Egypt
Dr. Ashraf Elmaraghy
Egypt
Dr. Haytham
Samy Diab
Egypt
Dr. İbrahim Hamdy Feteih
UAE
Dr. Elena Cristine Mitrofan
Romania
Dr. Korkut Avşar
Germany
Dr. Nicat Ağayev
Azerbaijan
Dr. Oldooz Aloosh
İran
Dr. Sibel Arınç
Turkiye
EVENTS
To mark World Lung Day, IRC Chair Prof. Guy Joos reflects on what must be done to ensure access to prevention and treatment for all in order to Lift The Burden of respiratory disease. The IRC launched in 2021 with a vision for every country to have the tools to implement a national respiratory strategy based on our shared experiences, evidence, and best practice. Today marks World Lung Day, a timely reminder and echo of our call to advance global lung health. We join the Forum of International Respiratory Societies (FIRS) who share our mission for increased access to prevention and treatment for all, leaving no one behind. The evidence is clear that respiratory conditions have a significant societal and economic cost, with the burden negatively affecting healthcare systems, impacting the lives of patients and their families, lowering productivity, and widening the gap in life expectancy between the poorest and wealthiest. A significant proportion of the burden is preventable, but not enough is being done. We know how vital it is to come together with our shared mission to enact change and reduce respiratory disease-related mortality by a third globally by 2030, a roadmap we have outlined in our IRC manifesto earlier this summer. Collective impact must start at an individual level. It’s the actions from our national coalitions that can help us scale awareness, share good practice and be able to drive improvement in prevention, early diagnosis, and access to treatment and care. We take pride in the work of our 14 national-level coalitions, and we’re excited to be expanding and giving a bigger collective voice, to transform the care of people living with respiratory conditions. There is no doubt that there are inequalities in our healthcare systems, and as a society, we have a responsibility to ensure individuals who are suffering have the awareness and resources to seek support for respiratory diseases. During the IRC Summit this June, our national coalitions, partners, and contributors came together to accelerate our movement. One important area we discussed was how, like in many diseases, prevention and early detection are key. Regulatory measures to further reduce and prevent tobacco uptake and improve indoor and outdoor air quality. Governments should without delay adopt the WHO’s new air quality guidelines, while implementing data-backed regulatory measures to reduce outdoor and indoor air pollution and improve air quality. Such measures should include efforts towards continuous air quality monitoring, setting more ambitious emission standards, or clean energy solutions. The accessibility and availability of treatment and services for those impacted or at risk need to be top of mind, adopting, for example, a life course approach to vaccination for vaccine-preventable infectious diseases, supported by targeted awareness campaigns and funded routine vaccination programmes across all age groups. Health education offers the chance to encourage lifestyle changes and control environmental factors that can help promote a healthier and safer quality of life. Of course, there is no one-size-fits-all approach and better health equity can provide the tools and solutions to better address bespoke needs with bespoke solutions. There is a call for policies to be looked at from a localised level, and the work we do together to ensure better health equity can also create change together. World Lung Day provides an opportune moment to join together and call in unison for greater policy change and action, to Lift The Burden of respiratory diseases.
MEDIA
Authored by: Professor Marc Humbert – ERS President, Professor Guy Joos – Pulmonologist, Ghent University and Ghent University Hospital. November 2021. The International Respiratory Coalition is coordinated by the European Respiratory Society, in partnership with founding member organisations: the Global Allergy & Airways Patient Platform, AstraZeneca and Amgen. Now established, the International Respiratory Coalition will seek to grow its membership – welcoming other organisations with an interest in respiratory health to join and help progress this initiative. Each partner will provide funding or contributions of time and expertise to deliver the aims of the Coalition at a global or national level. Improving chronic respiratory care is central to building more resilient healthcare systems The emergence of COVID-19 has put respiratory diseases in the spotlight like never before, exacerbating existing gaps in the delivery of care with significant consequences for patients and health systems.1 Prior to the pandemic, progress to improve chronic respiratory diseases care was slow, and in some countries had stagnated over the past decade.2 To support people living with chronic respiratory diseases, and to better ready ourselves in case of future pandemics, improving respiratory care must be central to government and healthcare system post-pandemic recovery plans. High-level political prioritisation and intervention will be key to achieving this. The International Respiratory Coalition aims to support governments and healthcare systems in their recovery from COVID-19 by strengthening respiratory care. The Coalition will seek to improve outcomes for people living with respiratory diseases including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, bronchiectasis, idiopathic pulmonary fibrosis and pulmonary arterial hypertension, by supporting the creation of ambitious national-level respiratory strategies and by building resilience in managing pandemics. Ahead of World COPD Day on 17 November, the Coalition will join a Summit session organised at the Swedish Pavilion by AstraZeneca at Expo 2020 Dubai, to raise awareness amongst policymakers and political decision makers from around the world of the need to reform chronic respiratory care as a post-pandemic priority. Urgent Unmet Needs: The Burden of Chronic Respiratory Diseases Chronic respiratory diseases, which impair quality of life and increase a patient’s likelihood of developing other serious conditions, affect nearly 550 million people globally3 and lead to four million premature deaths each year. 4 Among all chronic respiratory conditions, the largest burden is from COPD affecting 384 million people worldwide and asthma affecting over 339 million people worldwide.5-7 COPD has risen to become the third leading cause of death worldwide8 and according to The Global Alliance Against Chronic Respiratory Diseases is under prioritised, under-funded and undertreated.9 One in 5 patients die within a year of their first COPD hospitalisation10 and the global cost of COPD is estimated to rise to $4.8 trillion in 2030.11 For the hundreds of millions of patients living with asthma, significant unmet needs remain with an estimated 176 million asthma attacks that occur each year globally.12 Despite this, respiratory conditions do not receive the same global recognition and prioritisation a s other well-known chronic conditions.13 Recently, the burden of chronic respiratory diseases has increased as a result of health inequalities, environmental factors, and growing and aging populations, which threaten health-system resilience in the face of external challenges like the COVID-19 pandemic.14 Millions of people living with airway diseases have faced disruption in their treatment and routine due to strained hospital capacity, inability to attend health appointments during lockdowns.1 For example, during the pandemic, patients with chronic respiratory diseases that contracted COVID-19 were shown to be at greater risk of hospitalisation.14 Furthermore, many health systems were unable to pivot quickly to new remote models of care and effectively use telemedicine to contact and diagnose patients remotely,15 all the while high-risk chronic respiratory patients were having to isolate more urgently than the average citizen.14 Building Stronger Healthcare Systems through Improved Respiratory Health As organisations and individuals with a common interest in improving outcomes for respiratory patients, we want to ensure current challenges are addressed now and remain a priority going forward. The Coalition believes new or updated National Respiratory Strategies, which carry ambitious targets and accountable leadership will be key to this reform. By focusing on increasing prevention and supporting earlier diagnosis, to improving pathways, prioritising disease control and ensuring continuity of care there is an immense opportunity to transform respiratory health. Change won’t happen on its own. The respiratory community must come together and speak as a single, consistent voice to motivate policymakers and Health Ministers to promote respiratory healthcare reform. The conversations at World Expo 2020 will be critical in advancing our mission for respiratory care reform but it will be important to maintain these at the local and regional level. Not only will it benefit our long-affected, current chronic respiratory disease patients, it will prepare us, our colleagues and wider society to better handle potential future challenges which may arise, like the COVID-19 pandemic. The International Respiratory Coalition is open to all who share its vision of advancing respiratory care. We’re excited to see what the future holds for us, and most importantly, for our patients. References Huang BZ, et al. Asthma Disease Status, COPD, and COVID-19 Severity in a Large Multiethnic Population. J Allergy Clin Immunol Pract. 2021. https://doi.org/10.1016/j.jaip.2021.07.030 Commissions from the Lancet journals. After asthma: redefining airways diseases. After asthma: redefining airways diseases (thelancet.com). 12 September 2017. Available at: https://www.thelancet.com/commissions/asthma. GBD Chronic Respiratory Disease Collaborators. Prevalence and attributable health burden of chronic respiratory diseases, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir Med, 2020 Jun;8(6):585-596. Forum of International Respiratory Societies. The Global Impact of Respiratory Disease – Second Edition. Sheffield, European Respiratory Society, 2017. Available online via https://www.who.int/gard/publications/The_Global_Impact_of_Respiratory_Disease.pdf Carvalho, T., Krammer, F., & Iwasaki, A. The first 12 months of COVID-19: a timeline of immunological insights. Nature Reviews Immunology. 2021:245–25 https://doi.org/10.1038/s41577-021-00522-1 6.Adeloye D, et al. Global Health Epidemiology Reference Group (GHERG). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health. 2015; 5 (2): 020415. The Global Asthma Network. The Global Asthma Report 2018. [Online]. Available at: http://www.globalasthmareport.org/Global%20Asthma%20Report%202018.pdf. [Last accessed: 2 July 2021]. Adeloye D, Chua S, Lee C et al. Global and regional estimates of COPD prevalence: Systematic review and meta–analysis. J of Glob Heath. 2015; 5(2):020415. Yorgancioglu A, Khaltaev N, Bousquet J, Varghese C. The Global Alliance Against Chronic Respiratory Diseases: journey so far and way ahead. Chin Med J 2020;133:1513–1515. doi: 10.1097/CM9.0000000000000851 Ho TW, Tsai YJ, Ruan SY, et al. In-Hospital and One-Year Mortality and Their Predictors in Patients Hospitalized for First-Ever Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Population-Based Study. PLOS ONE. 2014; 9 (12): e114866. Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A.Z., & Weinstein, C. (2011). The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum. AstraZeneca Pharmaceuticals. Data on File. Budesonide/formoterol Data on File: Annual Rate of Asthma Exacerbations Globally. (ID: SD-3010-ALL-0017). Forum of International Respiratory Societies. The Global Impact of Respiratory Disease – Second Edition. Sheffi eld, European Respiratory Society, 2017. AstraZeneca. A Blueprint for Change. Available at:http://www3.weforum.org/docs/WEF_Blueprint_for_change_Chronic_airway_disease.pdf. Accessed August 2021. Press V G, et al. Concerns About Coronavirus Disease–Related Collateral Damage for Patients With COPD. Chest. 2020; 158 (3): 866-868.