Chronic respiratory disease in low-income and middle-income countries: From challenges to solutions

In 2019, the British Thoracic Society (BTS) launched a Global Health Group in partnership with the Pan African Thoracic Society (PATS). Each year, this group proposes a symposium at the BTS Winter meeting exploring issues of respiratory disease and care which are most relevant to respiratory health across the life course in low- and middle-income countries (LMICs). The first symposium, offered in February 2021, described the burden of five key respiratory exposures/diseases of interest in LMICs, including childhood pneumonia, air pollution, post-TB lung diseases, asthma, and chronic obstructive pulmonary disease, and a summary of the discussion has previously been published in the PATS journal. The second symposium, conducted in November 2021, discussed barriers to the management of chronic respiratory diseases (CRDs) in LMICs, with perspectives presented from Malaysia, The Gambia, Kenya, and sub-Saharan Africa more broadly. These presentations highlighted the challenges of chronic respiratory care in LMICs, while a presentation from the World Health Organization (WHO) officer for CRDs described the role and remit of the WHO in providing leadership and guidance in this area. A summary of this second symposium is presented here, and we discuss the pathways from challenges to solutions for CRD care in low- and middle-income countries.