GARD

Steering committee reportJ Bousquet, R Dahl

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report2- GARD members3- Modified TOR

4- Preparation of the Launch5- "GARD manual"

6- Dissemination of GARD to countries

GARD Stepwise approachMay 2005

GARD priorities

Integrated GARD action plan

Step 1Step 2

Step 3

2005 2006 2007 2008 2009 2010

Pilot studies in countries

GARD action plan in countries

GARD priorities

Integrated GARD action plan

Step 1Step 2

Step 3

2005 2006 2007 2008 2009 2010

Pilot studies in countries

GARD action plan in countries

GARD Stepwise approachMarch 2006

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report

October 5, 2005

QuickTime™ et undécompresseur TIFF (LZW)

sont requis pour visionner cette image.

Estimate population needs and advocate

WG.1- Burden, risk factors and surveillance (G Viegi, S Buist, Y Fukuchi)

WG.2- Awareness and advocacy (C Lenfant, A Turnbull, P van Cauwenberge)

Formulate and adopt policyWG.3- Prevention and health promotion (M Boland, A

Custovic)

WG.4- Diagnosis of CRD (K Rabe, S Wenzel) WG.5- Control of CRD and allergies,

Availability and affordability of drugs (J Bousquet, E Bateman, L Fabbri, C van Weel)

WG.6- Pediatric asthma (C Baena-Cagnani, E Mantzouranis, FER Simons, E Valovirta)

Formulate and adopt policyWG.3- Prevention and health promotion (M Boland, A

Custovic)

WG.4- Diagnosis of CRD (K Rabe, S Wenzel) and allergy (GW Canonica)

WG.5- Control of CRD and allergies, Availability and affordability of drugs

(J Bousquet, E Bateman, L Fabbri, C van Weel)

WG.6- Pediatric asthma (C Baena-Cagnani, E Mantzouranis, FER Simons, E Valovirta)

Formulate and adopt policyWG.3- Prevention and health promotion (M Boland, A

Custovic)

WG.4- Diagnosis of CRD (K Rabe, S Wenzel) and allergy (GW Canonica)

WG.5- Control of CRD and allergies (J Bousquet, E Bateman, L Fabbri, C van Weel)

Availability and affordability of drugs (N Aït Khaled)

WG.6- Pediatric asthma (C Baena-Cagnani, E Mantzouranis, FER Simons, E Valovirta)

In high income countries- patients can receive adequate diagnosis and treatment - but they are insufficiently diagnosed and treated- a disease-specific approach is needed- the goals of GARD are to better diagnose, treat and educate patients

In upper-middle income countries- few patients can receive adequate diagnosis and treatment the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in many places

In lower-middle and low income countries- very few patients can receive adequate diagnosis and treatment the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in most places

In all countries, health promotion and prevention are essential control by disease-specific approach control by syndromic approach no control

Current management of CRDCurrent management of CRD

In high income countries- patients can receive adequate diagnosis and treatment - but they are insufficiently diagnosed and treated- a disease-specific approach is needed- the goals of GARD are to better diagnose, treat and educate patients

In upper-middle income countries- few patients can receive adequate diagnosis and treatment - the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in many places

In lower-middle and low income countries- very few patients can receive adequate diagnosis and treatment- the first goals of GARD are to reduce under-diagnosis - the second goals of GARD are to provide accessible and affordable treatment for all patients - a syndromic approach (PAL) is needed in most places

In all countries, health promotion and prevention are essential control by disease-specific approach control by syndromic approach no control

GARD policyGARD policy

Identify Policy Implementation Steps

National Coordination: • The GARD action plan should be applied at the country level • Establish national working groups with a national coordinator• The national coordination group will:

• Provide existing national statistics on CRD and allergies• Assess the specific needs for the given country • Review the GARD action plan • Determine the relevant issues for the country action plan • Develop a country-specific action plan

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report2- GARD members

WHO calls for a global and coordinated effortto fight chronic respiratory diseases

WE ARE GARD!

GARD members

Governmental organizationsScientific societiesPatient's organizationsOther NGOs

Pharmaceutical industryGovernments

Year 1 Year 2

"Medical" Foundations

GARD members

Governmental organizationsScientific societiesPatient's organizationsOther NGOs

Pharmaceutical industryGovernments

Year 1 Year 2

"Medical" Foundations

Targetted approachTargetted approach

GARD members

Governmental organizationsScientific societiesPatient's organizationsOther NGOs

Pharmaceutical industryGovernments

Year 1 Year 2

World BankUnesco and others

Private sector

"Medical" Foundations

Foundations

GARD members

Governmental organizationsScientific societiesPatient's organizationsOther NGOs

Pharmaceutical industryGovernments

Year 1 Year 2

World BankUnesco and others

Private sector

"Medical" Foundations

Foundations

Targetted approach firstTargetted approach first

Global approach laterGlobal approach later

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report2- GARD members3- Modified TOR

GARD TOR

• TOR december 2004: approved by members• Assembly meeting: revision of TOR NOT sent to WHO• to include private sector, WHO proposed a revised TOR (TOR2) (january 2006)• TOR2 should be discussed during the meeting and proposal sent to WHO

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report2- GARD members3- Modified TOR

4- Preparation of the Launch

Fact sheet

"Hundreds of millions of people suffer from chronic respiratory diseases worldwide, including:

o 300 million people with asthmao 62 million people with moderate to severe COPDo Millions of others with mild COPD, allergic rhinitis, and other chronic respiratory diseases, which are often undiagnosed."

Chronic respiratory diseases asthma 300 millions GINA, 2004

Moderate to severe COPD 62 millions WHO, 2006Allergic rhinitis millions Secondary pulmonary hypertension Occupational CRD Chronic rhinosinusitis Post-infectious CRD Lung cancer and neoplasms of the respiratory organsSequellae of pulmonary embolism Cor pulmonale Sleep apnea syndrome Lung fibrosis

TOTAL: Hundreds of millions

Chronic respiratory diseases asthma 300 millions GINA, 2004

COPD 150 millions Allergic rhinitis 400 millions Secondary pulmonary hypertension 25 millionsOccupational CRD 25 millionsChronic rhinosinusitis 50 millionsPost-infectious CRD No dataLung cancer and neoplasms of the respiratory organsSequellae of pulmonary embolism No dataCor pulmonale No dataSleep apnea syndrome 100 millionsLung fibrosis No data

TOTAL: > ONE BILLION

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report2- GARD members3- Modified TOR

4- Preparation of the Launch5- "GARD manual"

Geneva« pre-GARD »WHO meeting

GARDaccepted by WHO

1st GARDassembly

1st GARD/WHOmeeting

GARDmeeting

GARDLaunch

06-04 09-04 01-05 05-05 09-05 28-03-06

GARD GARD manualmanual

Geneva« pre-GARD »WHO meeting

GARDaccepted by WHO

1st GARDassembly

1st GARD/WHOmeeting

GARDmeeting

GARDLaunch

06-04 09-04 01-05 05-05 09-05 28-03-06

GARD GARD manualmanual

GARD source document

Fact sheetsPress release

Geneva« pre-GARD »WHO meeting

GARDaccepted by WHO

1st GARDassembly

1st GARD/WHOmeeting

GARDmeeting

GARDLaunch

06-04 09-04 01-05 05-05 09-05 28-03-06

GARD GARD manualmanual

GARD source document

Public Healthguide

Pocket guide

ReviewPublished by NGOs

Launch at ERS

Steering committee report1- Consequences for GARD of the publication

of the WHO Chronic Disease report2- GARD members3- Modified TOR

4- Preparation of the Launch5- "GARD manual"

6- Dissemination of GARD to countries

Activities within countriesActivities within countries• ChinaChina: launch, Chinese Medical Association: launch, Chinese Medical Association• BrazilBrazil: Minister of Health (PAHO): Minister of Health (PAHO)• PolandPoland: Minister of Health: Minister of Health• IndiaIndia: President: President• Japan, Korea..Japan, Korea..: National coordination: National coordination• Cape Verde, Russia, TunisiaCape Verde, Russia, Tunisia: Pilot studies: Pilot studies