El Salvador, Benin and other low- and middle-income countries have a special reason to celebrate World Asthma Day on Tuesday, 5 May, this year. A purchasing mechanism run by the Paris-based International Union Against Tuberculosis and Lung Disease (The Union) is making it possible for these countries to obtain quality-assured essential asthma medicines at affordable prices for the first time.
Late last month El Salvador became the first country to take advantage of The Union’s Asthma Drug Facility (ADF), which uses pooled procurement and other purchasing strategies to obtain greatly reduced prices from approved suppliers.
It then passes these substantial savings on to patients and public health systems. The El Salvador Ministry of Public Health placed an order for asthma inhalers for its Asthma Management Project, which aims to improve and expand the standardised management of asthma in the country’s general health services.
Benin will be the second country to benefit from the ADF’s services. Its National Tuberculosis Programme placed an order on 4 May. A number of other countries in Africa, Asia and Latin America have also expressed interest after consulting ADF’s prices for the non-CFC medicines it has recently approved.
Worldwide some 300 million people suffer from the asthma, a chronic lung condition. Once predominantly found in industrialised countries, asthma has become increasingly prevalent in low- and middle-income countries over the last 20 years. Research conducted by The Union has found that the high cost of asthma drugs is a major stumbling block to effective treatment in these countries.
The ADF was established by The Union to make quality-assured essential asthma medicines accessible and affordable. To guarantee the quality of the drugs provided and the best possible prices, the ADF has selected the inhalers through a qualification process that is based on the World Health Organization norms and standards, followed by a limited competitive bidding process.
Through the ADF, a country can buy one year of treatment with Beclometasone and Salbutamol for a patient with severe asthma for less than 40 euros.
Standard case management of asthma is also critically important, and the ADF seeks to promote both the correct use of the medicines and quality standardised care. ADF clients are provided with training materials and an electronic information system for monitoring and evaluating patient care based on the recommendations outlined in The Union’s Management of Asthma: a
guide to the essentials of good clinical practice.
We are delighted to celebrate World Asthma Day by receiving the first orders for the ADF,” says Dr Nils E Billo, Executive Director of The Union. “We hope to see the ADF make a valuable difference in the lives of people with asthma in low- and middle-income countries around the world”.

(The author is a World Health Organization (WHO) Director General’s WNTD Awardee 2008 and writes extensively on health and development. He can be contacted at: bobbyramakant@yahoo.com)