The United Nations General Assembly adopted a declaration supporting increased access to inhaled medicines for the 650 million children and adults living with chronic respiratory diseases like asthma and COPD.

The Forum of International Respiratory Societies (FIRS), expressed its support for the UN General Assembly’s recognition that chronic respiratory diseases are a major cause of disability and death requiring urgent action with their vote in favor of the “Political declaration of the fourth high-level meeting of the General Assembly on the prevention and control of noncommunicable diseases and the promotion of mental health and well-being,” on 15 December 2025.

More than 650 million children and adults live with chronic respiratory diseases, and 4.4 million die each year, most from chronic obstructive pulmonary disease (COPD) and asthma. Chronic respiratory disease is the third highest cause of death globally, according to the Global Burden of Disease. It also creates massive economic costs due to lost school and work days. A recent study estimated that the global economic burden from COPD alone will amount to US $40 trillion by 2050.

Inhaled medicines reduce these health and economic costs by enabling patients to work and study, and by preventing frequent hospital visits. Yet more than two-thirds of pharmacies and hospitals in low- and middle-income countries (LMICS) do not stock inhaled medicines  far below the global target of 80% facility availability of essential NCD medicines. Where they are available, they are often unaffordable.

“For too long, hundreds of millions of children and adults living with COPD and asthma have struggled without access to effective inhaled medicines,” said Professor Guy Marks, President of FIRS and the International Union Against Tuberculosis and Lung Disease (The Union). “By calling out their importance in the Political Declaration, governments are committing  to closing the unacceptably high access gaps. When Brazil made inhalers free, household asthma costs fell from 29% of income to 2% and the hospitalization rate fell from 90 per 100,000 to 60 per 100,000 people.

FIRS is calling on governments, industry, global health agencies, and donors to immediately mobilize to implement the Political Declaration by investing greater resources to increase access to inhaled medicines for COPD and asthma by addressing five priority areas:

  1. Policy: Inclusion of the latest evidence-based inhalers in all global and national COPD and asthma treatment guidelines, essential medicine lists, and UHC reimbursement lists
  2. Product: Improved availability of recommended inhaled medicines by facilitating registration, technology transfer, voluntary licensing agreements, and participation in the WHO Prequalification Programme, Collaborative Registration Procedure, and other programs 
  3. Price: Reductions in Inhaler prices from bulk purchasing, pooled procurement, tiered/differential pricing, generic alternatives, and other proven strategies
  4. Primary Care: Increased training for primary healthcare providers to diagnose and manage COPD and asthma, including improved access to spirometry and peak flow measurement tools
  5. Patient Advocacy: Investments in campaigns to increase community awareness of COPD and asthma and destigmatise use of inhalers

José Luis Castro, WHO Director-General Special Envoy for Chronic Respiratory Diseases, congratulated government leaders for ensuring the Political Declaration provided such a strong foundation for action to reduce the burden of chronic respiratory diseases. “The 4th High-level Meeting ends the era of neglect for chronic respiratory diseases. Member States now have an historic opportunity to make rapid progress in the five years left to achieve the Sustainable Development Goals and NCD Action Plan targets, and unlock significant economic benefits.”