COPD in the Developing World


SEATTLE – The increase in tobacco use across the world has had a detrimental effect on the health of more and more people every year, a fact that has failed to deter the advertisement efforts of tobacco marketing companies. Chronic Obstructive Pulmonary Disease, or COPD, is among one of the many tolls tobacco usage has taken, making its way to developing countries with astonishing rapidity.

COPD affects the lungs extensively, making normal breathing a challenge, and as the condition worsens, everyday tasks like walking up stairs or carrying a briefcase can become incredibly challenging. The effects extend beyond the lungs, with other complications including increased blood pressure, heart problems, and depression. COPD also increases susceptibility to respiratory infections, such as the flu and pneumonia, ailments that can sometimes be prevented ahead of time with vaccinations.

The disease is most commonly caused by tobacco, whether through direct usage or second hand smoke. Other possible risk factors are indoor and outdoor pollution, frequent respiratory infections as a child, and breathing in harmful chemicals. As the disease manifests, it may presents as a chronic cough, inability to catch one’s breath, and sputum produced in the lungs.

COPD is diagnosed using a test that measures how much air a person can inhale and exhale, and at what rate. Additionally, chronic bronchitis and emphysema, with similar symptoms and causes, are considered part of the COPD diagnosis now. Once diagnosed, there is no cure, but there are preventative measures that can be taken as well as medications that can subdue some the conditions. Shortness of breath can be controlled with medication that dilates air passages, such as Bronchodilators and Theophylline. Antibiotics and lung therapies can also serve to manage infections and minimize exacerbation. Cutting off tobacco usage is one of the most effective ways to prevent the disease.

Over the past 25 years, tobacco usage in low-income countries has increased severely, with 80 percent of tobacco related deaths occurring in developing countries in 2011. Lower levels of education and blatant targeting from tobacco companies have contributed to these higher rates, rates that have had a direct result on an increase of COPD in the developing world. The major lack of prevention in the developing world is compounded with the lack of resources and expertise to treat the disease and raise awareness.

About 90 percent of the estimated three million annual COPD cases occur in low and middle-income countries, and the World Health Organization (WHO) has estimated that COPD could be the third leading cause of death worldwide by 2030. This growing problem has inspired the WHO to rise to action.

In 2003, the WHO negotiated the first global health treaty when it got 167 countries to ratify the WHO Framework Convention on Tobacco Control (WHO FCTC), which was then enforced starting in February of 2005. This treaty aims to minimize tobacco usage worldwide. In addition to the WHO FCTC, WHO has developed the Global Alliance against Chronic Respiratory Diseases (GARD), an initiative that targets developing countries to reduce the burden of respiratory diseases. GARD is composed of national and international organizations, voluntarily working toward a healthier world.

In the developing world, the importance of efforts to spread the word and assistance to prevent COPD from becoming the third leading killer by 2030 cannot be underestimated. With the voluntary action of those acting in WHO FCTC and GARD, as well as any concerted effort to minimize the strength of tobacco companies worldwide, will make a world of difference in preventing COPD in the developing world in the future.

Maggie Wagner

Sources: WHO 1, Mayo Clinic, Health 24, IPS News, WHO 2
Photo: LA Times


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