GARD

1

• GARD
• Steering committee report
• J Bousquet, R Dahl

2

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report
• 2- GARD members
• 3- Modified TOR
• 4- Preparation of the Launch
• 5- "GARD manual"
• 6- Dissemination of GARD to countries

3

• GARD Stepwise approach
• May 2005

Step 2
Step 1
Step 3
GARD priorities
Integrated GARD action plan
Pilot studies in countries
GARD action plan in countries
2005
2006
2007
2008
2009
2010
4

• GARD Stepwise approach
• March 2006

Step 2
Step 1
Step 3
GARD priorities
Integrated GARD action plan
Pilot studies in countries
GARD action plan in countries
2005
2006
2007
2008
2009
2010
5

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report

6
October 5, 2005
7

• 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)

8

• Formulate and adopt policy
• WG.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)

9

• Formulate and adopt policy
• WG.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)

10

• Formulate and adopt policy
• WG.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)

11
Current 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

12
GARD policy

• 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

13

• 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

14

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report
• 2- GARD members

15
WHO calls for a global and coordinated effort to
fight chronic respiratory diseases
WE ARE GARD!
16

• GARD members

Governments
Pharmaceutical industry
"Medical" Foundations
Governmental organizations Scientific
societies Patient's organizations Other NGOs
Year 1
Year 2
17

• GARD members

Targetted approach
Governments
Pharmaceutical industry
"Medical" Foundations
Governmental organizations Scientific
societies Patient's organizations Other NGOs
Year 1
Year 2
18

• GARD members

Foundations
Private sector
World Bank Unesco and others
Governments
Pharmaceutical industry
"Medical" Foundations
Governmental organizations Scientific
societies Patient's organizations Other NGOs
Year 1
Year 2
19

• GARD members

Foundations
Targetted approach first Global approach later
Private sector
World Bank Unesco and others
Governments
Pharmaceutical industry
"Medical" Foundations
Governmental organizations Scientific
societies Patient's organizations Other NGOs
Year 1
Year 2
20

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report
• 2- GARD members
• 3- Modified TOR

21

• 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

22

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report
• 2- GARD members
• 3- Modified TOR
• 4- Preparation of the Launch

23

• Fact sheet

"Hundreds of millions of people suffer from
chronic respiratory diseases worldwide,
including o 300 million people with asthma o 62
million people with moderate to severe
COPD o Millions of others with mild COPD,
allergic rhinitis, and other chronic respiratory
diseases, which are often undiagnosed."
24

• Chronic respiratory diseases

asthma 300 millions GINA, 2004
Moderate to severe COPD 62 millions WHO, 2006
Allergic rhinitis millions
Secondary pulmonary hypertension
Occupational CRD
Chronic rhinosinusitis
Post-infectious CRD
Lung cancer and neoplasms of the respiratory organs
Sequellae of pulmonary embolism
Cor pulmonale
Sleep apnea syndrome
Lung fibrosis
TOTAL Hundreds of millions
25

• Chronic respiratory diseases

asthma 300 millions GINA, 2004
COPD 150 millions
Allergic rhinitis 400 millions
Secondary pulmonary hypertension 25 millions
Occupational CRD 25 millions
Chronic rhinosinusitis 50 millions
Post-infectious CRD No data
Lung cancer and neoplasms of the respiratory organs
Sequellae of pulmonary embolism No data
Cor pulmonale No data
Sleep apnea syndrome 100 millions
Lung fibrosis No data
TOTAL gt ONE BILLION
26

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report
• 2- GARD members
• 3- Modified TOR
• 4- Preparation of the Launch
• 5- "GARD manual"

27

• GARD manual

Geneva  pre-GARD  WHO meeting
GARD Launch
1st GARD/WHO meeting
GARD meeting
GARD accepted by WHO
1st GARD assembly
09-05
28-03-06
06-04
09-04
01-05
05-05
28

• GARD manual

Fact sheets Press release
GARD source document
Geneva  pre-GARD  WHO meeting
GARD Launch
1st GARD/WHO meeting
GARD meeting
GARD accepted by WHO
1st GARD assembly
09-05
28-03-06
06-04
09-04
01-05
05-05
29

• GARD manual

GARD source document
Geneva  pre-GARD  WHO meeting
GARD Launch
1st GARD/WHO meeting
GARD meeting
Launch at ERS
GARD accepted by WHO
1st GARD assembly
09-05
28-03-06
06-04
09-04
01-05
05-05
30

• Steering committee report
• 1- Consequences for GARD of the publication of
  the WHO Chronic Disease report
• 2- GARD members
• 3- Modified TOR
• 4- Preparation of the Launch
• 5- "GARD manual"
• 6- Dissemination of GARD to countries

31

• Activities within countries
• China launch, Chinese Medical Association
• Brazil Minister of Health (PAHO)
• Poland Minister of Health
• India President
• Japan, Korea.. National coordination
• Cape Verde, Russia, Tunisia Pilot studies