by José Luis Cárdenas Tomažič / Dr. Guillermo Maligne

Adapted from the Spanish column originally published in El Economista on November 11th, 2024 (EPOC: Será la tercera causa de muerte)

On November 20, World Chronic Obstructive Pulmonary Disease (COPD) Day is observed by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). COPD is a chronic, progressive respiratory disease that makes breathing difficult and affects millions of people worldwide. Raising awareness about this disease, its impact on quality of life, and the importance of early diagnosis and treatment is essential.

COPD is a general term that includes conditions such as emphysema and chronic bronchitis. It is characterized by persistent airflow limitation, leading to shortness of breath, chronic cough, and sputum production.

COPD is estimated to cost the global economy approximately USD 4.326 trillion between 2020 and 2050, equivalent to an annual “tax” of 0.111% of global Gross Domestic Product (GDP). China and the United States will bear the greatest economic burdens, with estimated costs of USD 1.363 trillion and USD 1.037 trillion, respectively.

According to the World Health Organization (WHO), COPD currently affects around 210 million people worldwide and is the fourth leading cause of death globally, responsible for 3.5 million deaths in 2021—approximately 5% of all global deaths. It is projected to become the third leading cause of death by 2030, as mortality is expected to increase by more than 30% over the next decade.

Nearly 90% of COPD deaths among people under 70 years of age occur in low- and middle-income countries. COPD is also the eighth leading cause of poor health worldwide (measured in disability-adjusted life years). Tobacco use accounts for more than 70% of COPD cases in high-income countries, whereas in low- and middle-income countries this figure drops to 30–40%.

COPD has a significant impact on patients’ quality of life. Breathlessness and fatigue limit daily activities, which can lead to muscle loss and create a vicious cycle of inactivity and health deterioration. In addition, COPD patients are at higher risk of lung infections, cardiovascular disease, and other health conditions.

Although COPD has no cure, treatments are available that can help control symptoms and improve quality of life. These include bronchodilators, inhaled corticosteroids, oxygen therapy, and pulmonary rehabilitation. Smoking cessation is essential for all COPD patients.

Despite the availability of effective treatments, many patients face barriers to access. In some countries, inhalers and other medications are not readily available or are unaffordable. Furthermore, the lack of spirometry in primary care may lead to underdiagnosis. While the underuse of spirometry is the main reason (indeed, the theme for World COPD Day 2024 is “Know Your Lung Function,” highlighting the importance of measuring lung function), other factors have also been widely identified, such as exposure to air pollution, educational level, patient age, and language barriers. Coexisting diseases—such as asthma, bronchiectasis, heart failure, and previously treated tuberculosis—are also reported as determinants of both underdiagnosis and overdiagnosis of COPD.

Medical and patient associations play a crucial role in supporting patients and advocating for their rights. These organizations work to raise awareness about COPD, improve access to treatment, and provide resources and support to those affected.

To effectively address COPD, it is essential to implement public policies that promote respiratory health. This includes strengthening tobacco control laws, improving air quality, ensuring access to diagnostics and treatments, and developing pulmonary rehabilitation programs. It is also critical to support research and education for the prevention and management of COPD.

On this World COPD Day, let us increase awareness of this disease and its health and economic impact, and come together to improve the lives of those affected. Let us improve diagnosis and early access to therapies—this is everyone’s responsibility.