Experts urge for better prevention and mgmt of COPD
By A Correspondent - Mumbai

There is an urgent need for making the government, medical community and the public aware of the gravity of COPD incidence in India

The National Conference of Pulmonary Diseases (NAPCON) 2001, jointly hosted by India’s two premier pulmonary associations Indian Chest Society (ICS) and National College of Chest Physicians (NCCP) was special in two ways this year. First, the conference was endorsed by the prestigious American Thoracic Society (ATS) and second, GOLD or Global Initiative for Chronic Obstructive Lung Disease was launched in India at this platform.

The conference, held during 7-9 Nov, deliberated mainly on Chronic Obstructive Lung Disease (COPD), the fourth largest cause of deaths in the world. Speaking to media persons, Dr Rohini Chowgule, chest consultant at Bombay Hospital and secretary general of the conference noted that there was an urgent need for making the government as well as medical community understand the gravity of morbidity and mortality caused due to COPD in India. ‘‘Owing to the use of biomass fuel, an unique practice in India, we need to focus more on COPD,’’ she said.

Speaking on the aim behind launching the GOLD project, Dr Suzanne Hurd, scientific director for both GOLD and GINA (Global Initiative for Asthma), noted that COPD was not receiving as much attention as asthma, TB and Aids. ‘‘The expenditure on COPD in US alone is around $14.7 billion per year. It’s the most expensive lung disease,’’ she stated further. Due to the increasing incidence of COPD worldwide, GOLD was born earlier this year. After US, UK, Germany and Tokyo, it has been now introduced in India, Dr Hurd informed.

COPD is something hitherto rarely heard in the medical circles. So is this a new term? Speaking on this, Dr Sonia Buist, past president of the ATS, member GOLD executive committee said, the medical professionals themselves have used so many different terms for chronic lung diseases that it has now become confusing for them as well as the patients. ‘‘GOLD aims to simplify the definition of this disease and provide guidelines to identify the specific symptoms of COPD to the physicians,’’ she said. Dr Buist further explained that the diagnosis of COPD was not satisfactory worldwide. ‘‘If the symptoms of COPD like cough, sputum production and breathlessness is there, then they should be confirmed by using simple tests like breath test, spirometry, etc. which is rarely done. Hence we are emphasising on the need to perform these simple tests which help identify the disease at an earlier stage,’’ she opined.

GOLD comprises a committed team of experts and medical associations from over 100 countries and is a joint effort of the National Heart, Lung and Blood Institute (NHLBI) and WHO. GOLD has formulated an international guideline for the diagnosis, management and prevention of COPD and it was released in India at NAPCON. The guidelines come in the form of a handbook and Dr Chowgule informed that they would be distributed among the medical community. GOLD has been supported worldwide by pharma giant, GlaxoSmithKline (GSK). In India too, the project has been initiated through an academic grant from GSK. Speaking about COPD in India, Dr Chandrashekar of GSK said that his company would extend its full support for non-commercial, research based or awareness campaigns with regard to GOLD programme.

At present, there is no concrete data on COPD incidence in India. Now with the launch of GOLD, Dr Chowgule hoped that the primary objective would be to carry out the epidemiological study of the disease. Furthermore, the GOLD guidelines would be adopted in a way so as to suit the Indian scenario and a common body would be formed to achieve this goal. According to Dr Vijay Kumar Arora, president-NCCP, introduction of GOLD would help create the suitable environment for research in this segment which is not satisfactory at present in the country.

‘‘The national chest societies would come up with an action plan for better planning of rehabilitation of people already suffering from COPD,’’ Dr Chowgule said adding that in the absence of any cure, it was very important that more rehabilitation centres be set up to improve the patients’ quality of life.

Dr Thomas R Martin, president elect-ATS also emphasised the need to consider COPD seriously worldwide. Speaking to Express Healthcare Management, Dr Martin identified four important research areas where the Association is focussed now epidemiology of the disease, identifying specific pharmacological agents that would be effective against specific airway inflammation; identifying agents that would interfere with the activities of the products formed by the disease bacteria and finally, research on relation between COPD and lung cancer.