Global initiative for asthma: 30 years of promoting evidence‐based asthma care

Abstract

Asthma is a serious global health problem affecting all age groups. Its prevalence is increasing in many countries, especially among children.1 The Global Initiative for Asthma (GINA) was established in 1993 by the National Heart, Lung, and Blood Institute and the World Health Organization, with the aims of increasing awareness of asthma and translating scientific evidence into improved asthma care worldwide.2 In 2023, GINA celebrates 30 years of working to improve the lives of people with asthma around the globe. GINA works with healthcare professionals, researchers, patients, and public health officials around the world to reduce asthma prevalence, morbidity, and mortality. GINA's strategy and program of work is guided by a Board of Directors and committees made up of leading asthma experts and patient representatives from around the world. GINA is an independent organization funded solely through sale and licensing of its educational publications. GINA's flagship publication, the Global Strategy for Asthma Management and Prevention2 (‘GINA Strategy Report’), was first published in 1995 and has been updated annually since 2002 by the GINA Science Committee. It contains guidance for primary care practitioners, specialists and allied health professionals, based on the latest high-quality evidence available. The GINA Strategy Report also serves as a pivotal source reference for clinical practice guideline development in many regions and countries. GINA strives to provide globally relevant guidance, which can be adapted to develop recommendations that are appropriate for local conditions, health systems and resources. The GINA Strategy Report is widely recognized by regulatory authorities, payers, and researchers, who often use GINA treatment recommendations as a reference point for clinical trial protocols and reporting of results. In addition to the annual GINA Strategy Report, GINA publishes other resources including articles in international respiratory, allergy and primary care journals, as well as summary booklets, educational webinars and podcasts. Like the GINA Strategy Report, these resources can be used by local or regional clinical experts and patient groups when developing patient resources suitable for their local health system and local medication availability. GINA also achieves global outreach through social media and through its website (www.ginasthma.org), which is used each year by people in every country to download (or provide feedback on) the GINA Strategy Report and other resources, or to find guidance on asthma management. Publications and resources based on GINA Strategy Reports have been translated into many languages. GINA organizes World Asthma Day in May each year (2 May, in 2023), in collaboration with healthcare organizations and asthma educators throughout the world. GINA's governance structure consists of the Board of Directors, the Science Committee, the Dissemination Task Group, and GINA Advocates. Members of these bodies receive no honoraria. GINA support staff comprise the Executive Director and Project Manager. The GINA Board of Directors has a global geographic representation and draws its membership from leaders with an outstanding demonstrated commitment to asthma research, asthma clinical management, public health and patient advocacy. The GINA Science Committee consists of highly skilled and experienced asthma experts, who continually review and synthesize scientific evidence to provide guidance on asthma prevention, diagnosis and management. The methodology used is described in the GINA Strategy Report2 and website (https://ginasthma.org/about-us/methodology). The GINA Dissemination Task Group is responsible for promoting the GINA Strategy Report and other resources throughout the world. It works with the international network of GINA Advocates to develop and assess strategies for implementing asthma education programs throughout the world and to identify barriers that prevent implementation of evidence-based asthma care. The Dissemination Task Group uses online resources, webinars and social media to reach target groups. GINA Advocates support the work of the GINA Dissemination Task Group in their countries and regions. Advocates are patient representatives and leaders in asthma care, nominated by the Board, who meet regularly through online webinars and at international respiratory meetings. The greatest burden of asthma morbidity and avoidable mortality occurs in low- and middle-income countries (LMICs).1, 3, 4 Implementation of the GINA strategy would greatly improve quality of life in these regions and prevent most premature deaths due to asthma. GINA is involved in worldwide advocacy initiatives to ensure affordable access to effective, quality-assured medications in LMICs.5-9 GINA shares concerns about planetary health and supports efforts to minimise the impact of health care, including inhaled respiratory medicines, on the environment. In this we place a high priority on patient safety and on ensuring that LMICs are not further disadvantaged. GINA provided editorial assistance. AY reports research grants from AstraZeneca and Sanofi; honoraria for independent medical education from AZ, GSK, Novartis, Abdi Ibrahim, Sandoz, Chiesi, DEVA, Vem İlaç, and Bilim. HKR reports research grants from AstraZeneca UK, AstraZeneca Australia, and GSK Australia; honoraria for independent medical education from AstraZeneca Saudi Arabia, AstraZeneca Hong Kong, AstraZeneca Singapore, AstraZeneca Australia, Getz Pharma Pakistan, GSK Australia; and payment for advisory board participation from Chiesi Australia, AstraZeneca USA, and AstraZeneca Sweden. GINA Board of Dırectors Arzu Yorgancioglu (Chair), Department of Pulmonology, Celal Bayar University, Manisa, Turkey. ORCID 0000-0002-4032-0944. Keith Allan, University Hospitals of Leicester, UK. Eric D. Bateman, University Cape Town Lung Institute, Cape Town, South Africa. ORCID 0000-0002-5064-5849. Guy Brusselle, Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium and Departments of Epidemiology and Respiratory Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands. ORCID: 0000-0001-7021-8505. Muhwa Jeremiah Chakaya, Department of Medicine, Kenyatta University, Teaching Hospital, Nairobi, Kenya. ORCID 0000-0002-3229-2429. Alvaro A. Cruz, ProAR Foundation and School of Medicine, Federal University of Bahia, Salvador, Brazil. Hiromasa Inoue, Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. ORCID 0000-0001-8080-3812. Jerry A. Krishnan, Breathe Chicago Center, University of Illinois Chicago. Chicago, US. ORCID 0000-0001-5525-4778. Mark L. Levy, General Practitioner, London. ORCID 0000-0002-1807-3246. Helen K. Reddel, Woolcock Institute of Medical Research, Sydney, Australia. ORCID 0000-0002-6695-6350. GINA Scıence Commıttee Helen K. Reddel (Chair), Woolcock Institute of Medical Research, Sydney, Australia. ORCID 0000-0002-6695-6350. Len Bacharier, Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, Nashville, USA. ORCID 0000-0003-0432-2704. Eric D. Bateman, University Cape Town Lung Institute, Cape Town, South Africa. ORCID 0000-0002-5064-5849. Matteo Bonini, Department of Cardiovascular and Thoracic Sciences, Università Cattolica del Sacro Cuore, Rome, Italy. ORCID 0000-0002-3042-0765. Louis-Philippe Boulet, Québec Heart and Lung Institute, Université Laval, Québec, Canada. ORCID 0000-0003-3485-9393. Arnaud Bourdin, Department of Respiratory Diseases, University of Montpellier, Montpellier, France. ORCID 0000-0002-4645-5209. Chris Brightling, Institute for Lung health, Leicester NIHR BRC, University of Leicester, UK. ORCID 0000-0002-9345-4903. Guy Brusselle, Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium and Departments of Epidemiology and Respiratory Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands. ORCID 0000-0001-7021-8505. Roland Buhl, Pulmonary Department, Mainz University Hospital, Mainz, Germany. Jeffrey Drazen, Brigham and Women's Hospital and Distinguished Parker B. Francis Professor of Medicine, Harvard Medical School, Boston, USA. ORCID 0000-0003-2715-9890. Francine Ducharme, Departments of Pediatrics and of Social and Preventive Medicine, Sainte-Justine University Health Centre, University of Montreal, Montreal, Quebec, Canada. ORCID 0000-0001-5096-0614. Liesbeth Duijts, Department of Pediatrics, divisions of Respiratory Medicine and Allergology, and Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands. ORCID 0000-0001-6731-9452. Louise Fleming, National Heart and Lung Institute, Imperial College, London. ORCID 0000-0002-7268-7433. Hiromasa Inoue, Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. ORCID 0000-0001-8080-3812. Fanny WS Ko, Department of Medicine and Therapeutics, The Chinese University of Hong Kong. ORCID 0000-0001-8454-0087. Refiloe Masekela, Department of Paediatrics and Child Health, University of KwaZulu Natal, Durban, South Africa. ORCID 0000-0001-9665-2035. Kevin Mortimer, Liverpool University Hospitals NHS Foundation Trust and University of Cambridge, UK and Department of Paediatrics and Child Health, College of Health Sciences, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa. ORCID 0000-0002-8118-8871. Paulo Pitrez, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil. ORCID 0000-0001-7319-1133. Aziz Sheikh, Professor of Primary Care Research & Development and Director, Usher Institute, University of Edinburgh, Edinburgh, UK. ORCID 0000-0001-7022-3056. Sundeep Salvi, Pulmocare Research and Education (PURE) Foundation, Pune, India.

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