Central Data Catalog


Type Journal Article - Journal of global health
Title RESPIRE: The National Institute for Health Research's (NIHR) Global Respiratory Health Unit
Volume 8
Issue 2
Publication (Day/Month/Year) 2018
Page numbers 0-0
URL https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304165/
The National Institute of Health Research (NIHR) Global Health Research Unit on Respiratory Health (RESPIRE) aims to reduce morbidity and mortality from respiratory diseases globally, with an initial focus on South Asia where respiratory conditions account for around one in five of all deaths. This geographically focused approach allows RESPIRE to develop a regional network of excellence in four South Asian countries, namely Bangladesh, India, Malaysia and Pakistan, though over time the intention is to extend the Unit’s activities. Interested colleagues from other countries are invited to contact RESPIRE via the website (www.ed.ac.uk/usher/respire) which gives more information on the work of the Unit, and provides contact details on how to get involved and support RESPIRE’s goals in other countries.
In the 2017 Global Burden of Disease (GBD) study, lower respiratory tract infections (LRTI), chronic obstructive pulmonary disease (COPD), tuberculosis (TB) and lung cancer were all ranked among the top 12 medical conditions (out of nearly 300) in terms of global premature mortality measured as Years of Life Lost (YLL) [1-5]. COPD was ranked 6th (female) and 9th (male) in terms of disability, measured as Years of Life with Disability (YLD) [1-5]. In fact, in 2016, COPD was the 3rd highest cause of death globally, claiming 3 million lives, while lung cancer (along with trachea and bronchial cancers) was the 6th highest [6]. LRTIs were ranked 4th, making them the most deadly set of communicable diseases, causing 3 million deaths worldwide [6]. In 2017, in South Asia alone, just five respiratory conditions accounted for 14.4% of all Disability-Adjusted Life Years (DALYs; LRTIs, 4.9%; COPD, 4.6%; TB, 3.0%; asthma, 1.4%; lung cancer, 0.5% of total DALYs) [7]. Furthermore, awareness of their relative importance is low and these conditions have not attracted the attention and priority they deserve from health systems, policy makers and funding agencies nationally, within the South Asia region, or indeed globally [5,8].
Despite this substantial morbidity and mortality from both communicable and non-communicable respiratory conditions in low- and middle-income countries (LMICs), they are currently relatively neglected by global research funders. Much of this ill-health is preventable through bridging the ‘second translational gap’ [9]. In the target LMICs, this necessitates a detailed appreciation of local challenges – for example, social stigma associated with diagnoses of asthma, limited appreciation of risk factors (eg, smoking/biomass fuel exposure) and the role of self-management, the use of alternative therapies, high clinician workloads and limited continuity of care. Using these to develop innovative tools/solutions involves mobilisation of local assets aligned with global opportunities.
The RESPIRE Collaboration recognises the value of achieving impact by adapting and/or culturally tailoring interventions that have already been found to be effective in other populations. RESPIRE has launched implementation studies of adapted interventions in the context of acute LRTIs and chronic respiratory disorders. In the longer-term, they will be complemented by the development of novel interventions for areas where there is no available evidence from other contexts through initiating relevant underpinning work leading to definitive trials.
Aziz Sheikh, Harry Campbell , Dominique Balharry , Abdullah H Baqui , Debby Bogaert , Kathrin Cresswell , Steve Cunningham , David Dockerell , Shams El Arifeen , Monica Fletcher , Liz Grant , Sazlina Shariff Ghazali , Monsur Habib , Tabish Hazir , Rita Isaac , Sanjay Juvekar , Ee Ming Khoo , Brian McKinstry , Andrew D Morris , Harish Nair , John Norrie , Bright I Nwaru , Hilary Pinnock , Dave Robertson , Samir Saha , Sundeep Salvi , Jürgen Schwarze , Colin Simpson , Devi Sridhar , Andrew Stoddart , David Weller , Moira Whyte , Allison Worth , Siân Williams , Osman Yusuf , Alimuddin Zumla , Igor Rudan , and RESPIRE Collaboration. "RESPIRE: The National Institute for Health Research's (NIHR) Global Respiratory Health Unit." Journal of global health 8, no. 2 (2018): 0-0.
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