Greater action is needed to prevent and manage COPD, according to the board of directors of the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The GOLD group recently published an editorial in the European Respiratory Journal urging governments and healthcare organizations to take a more COPD more seriously.

“COPD has not received the level of attention it requires by Ministries of Health and health services, particularly in low- and middle-income countries, where most of the people with this disease live and where there is limited access to spirometry to confirm the diagnosis, little effective therapy and minimal public health policy on prevention,” the board wrote.

The GOLD board has called for a “whole system approach that moves COPD management up a ladder of quality, driven by action and political pressure,” using the following action points:

Actions required to improve global management of COPD:

  • Increase awareness of COPD at all levels of society
  • Prevent COPD
    • Improve maternal nutrition and promote healthy lifestyles (e.g. avoiding smoking during pregnancy)
    • Minimize childhood exposure to indoor and outdoor air pollution
    • Reduce adult smoking and encourage all countries to ratify the World Health Organization Framework Convention on Tobacco Control
  • Diagnose COPD earlier
    • Promote use of simple questionnaires to identify subjects likely to have COPD
    • Improve the availability of and access to spirometry
    • Use new technology to offer alternatives to conventional spirometry
    • Train community health workers in early COPD detection
    • Assess lung function at an early age
  • Treat COPD effectively and earlier
    • Implement and promote smoking cessation programs
    • Decrease exposure to pollutants
    • Ensure drugs with proven efficacy and safety are available
    • Promote awareness of evidence-based management guidelines
    • Train community health workers in basic COPD management
    • Make medicines available through access programs


“The GOLD Board of Directors challenges all relevant parties to form a coalition with GOLD to achieve our ambition of reducing the impact of COPD worldwide. We must work together to prevent the development of COPD by reducing exposure to risk factors, to ensure the diagnosis is made as early as possible and to ensure all patients around the world receive effective therapy,” they wrote.