Chronic obstructive pulmonary disease: current burden and future projections

Summary

⇓Information about the comparative magnitude of the burden from various diseases and injuries is a critical input into building the evidence base for health policies and programmes. Such information should be based on a critical evaluation of all available epidemiological data using standard and comparable procedures across diseases and injuries, including information on the age at death and the incidence, duration and severity of cases who do not die prematurely from the disease. A summary measure, disability-adjusted life yrs (DALYs), has been developed to simultaneously measure the amount of disease burden due to premature mortality and the amount due to the nonfatal consequences of disease.

Approximately 2.7 million deaths from chronic obstructive pulmonary disease (COPD) occurred in 2000, half of them in the Western Pacific Region, with the majority of these occurring in China. About 400,000 deaths occur each year from COPD in industrialised countries. The increase in global COPD deaths between 1990 and 2000 (0.5 million) is likely to be partly real, and partly due to better methods and more extensive data availability in 2000. The regional (adult) prevalence in 2000 varied from 0.5% in parts of Africa to 3–4% in North America.

Introduction

Health systems must increasingly address a broad spectrum of health issues, ranging from epidemic outbreaks to advanced therapeutic care. They must, or should, also support disease prevention and health-promotion activities. Recognising that resources for health were unlikely to grow as quickly as demand, in 1993, the World Bank proposed a series of intervention packages for countries at different stages of development which, if implemented, would probably lead to the greatest gains in population health at affordable cost. The evidence for these recommendations was based …