EU must act against 'third biggest killer worldwide'

MEPs have called for tougher action to be taken against chronic obstructive pulmonary disease (COPD), which kills over 250 people around the world every hour.

By Julie Levy-Abegnoli

19 Nov 2014

Each November, the global initiative for COPD organises world COPD day, in collaboration with healthcare professionals and patient groups. Together, they work to raise awareness about the disease and improve COPD care. The theme for this year is 'it's not too late'.

Catherine Stihler (S&D) is a vice chair of parliament's internal market and consumer protection committee

What many people do not realise is just how common an illness COPD is. It affects more of the European population than breast cancer and diabetes and takes the life of around 300,000 Europeans each year.

Up to 10 per cent of Europeans are affected by the disease, an increase of over 60 per cent in just 20 years. COPD is set to become the third leading cause of death worldwide by 2030.

For many years, I have been working closely with various COPD groups in Scotland, as well as with the UK's national health service, the British lung foundation (BLF), the European lung foundation (ELF) and the European respiratory society (ERS).

More recently, I have become involved with a COPD support group in Angus, Scotland. They showed me what it was like living with COPD.

"Up to 10 per cent of Europeans are affected by the disease, an increase of over 60 per cent in just 20 years" - Catherine Stihler

As a result, I wrote to each of Scotland's health boards to discover to what extent each board had complied with 2010 action plan recommendations. The implementation varies across the country. Some areas have fully implemented the recommendations, while others have not started work at all. I believe this is the case across Europe.

I also wrote to the commission requesting an update on an EU strategy for patients with COPD and was very disappointed to hear there are no plans for a specific strategy.

This news was worrying. COPD is one of the leading causes of premature deaths worldwide and yet, awareness of it is insufficient. Given the prevalence and the socioeconomic burden of COPD, not only should there be the ring-fencing of funds for specific diseases such as this which have been underfunded, but we need to start tackling the deficiencies in the way that COPD is treated across Europe.

People suffering with COPD and patients of respiratory diseases in Europe have for decades been enduring huge disparities in the standards of care received. To overcome these inequalities, patient-driven standards on prevention, diagnosis, care and rehabilitation have to be better measured.

The commission and parliament have a heavy responsibility in ensuring that prevention and patient priorities - which have been neglected for far too long - are moved up the agenda. There must be a European strategy that does not solely rely on tobacco control.

Lung testing should be made a basic health right all across Europe. Regular and early checks of the lungs can help people identify debilitating conditions before too much damage is done. This would allow patients a chance to slow the progression of the disease before it destroys their lung function.

People who experience symptoms often feel stigmatised, and therefore, often do not seek advice from a healthcare professional until the disease is already at an advanced stage. This may account for the 75 per cent of those affected by COPD who remain undiagnosed.

On world COPD day, I am hosting the European public health alliance (EPHA) in parliament, who will be issuing information and guidance on COPD. I hope those working in the building take the chance to visit them outside the canteen between 12noon and 2pm.

Karin Kadenbach (S&D) is a member of parliament's environment, public health and food safety committee

Coughing, shortness of breath and other symptoms may be signs that a person is suffering from chronic obstructive pulmonary disease (COPD). The facts are alarming - every hour, COPD is estimated to kill over 250 people worldwide.

According to the world health organisation, COPD is the third biggest killer worldwide, after ischemic heart disease and strokes. We must stop COPD.

"Every hour, COPD is estimated to kill over 250 people worldwide" - Karin Kadenbach

The number of deaths from COPD has increased by more than 60 per cent over the last 20 years. Worldwide, COPD affects 329 million people, which is nearly five per cent of the population. In Europe, four to 10 per cent of adults suffer from COPD. In 2012, it ranked as the third-leading cause of death, killing over three million people.

But there is also an important economic reason. COPD resulted in an estimated economic cost of €1.7 trillion worldwide in 2010. The total COPD related expenses for outpatient care in the EU is approximately €4.7bn per year. Inpatient care generates costs of €2.9 bn, on top of pharmaceutical expenses of €2.7 bn per year. In Europe, COPD-related deaths are expected to increase from almost 270,000 in 2005 to 338,000 deaths by 2030 - we have to take action now.

We should aim for prevention, by nipping COPD in the bud and looking at its root causes. Of course, there are some genetic reasons. However, the primary cause of COPD is tobacco smoke - through tobacco use or second-hand smoke.

The disease now affects men and women almost equally, due in part to increased tobacco use among women in high-income countries.

In my political priorities I would like to put more effort in prevention. One big step has already been taken by the revised EU tobacco products directive.

No promotional or misleading features or elements will be allowed on cigarette packs. This includes, for example, references to lifestyle benefits, to taste or flavourings or their absence - such as 'free of additives' - special offers or suggestions that a particular product is less harmful than another.

Strict rules on packages and attractive flavours should help deter young people from experimenting with, and becoming addicted to, tobacco.

The revision is expected to lead to a two per cent drop in consumption of tobacco over a period of five years. This is roughly equivalent to 2.4 million fewer smokers in the EU. The revision of the tobacco products directive came into force on 19 May.

Air pollution is also a cause of COPD. People who live in large cities have a higher rate of COPD compared to people who live in rural areas. The EU already has much higher standards compared to other world regions.

Thanks to an EU directive from 2008 on ambient air quality and cleaner air for Europe, some key rules have been defined on the issue, including new air quality objectives for fine particles.

COPD can be prevented by reducing exposure to the known causes. This includes efforts to decrease rates of smoking and to improve indoor and outdoor air quality. Even if Europe has made considerable progress in both of these areas, we must take additional steps.


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