OA-03-521-21 Chronic Lung Diseases Remain Under-Prioritized in Africa Despite Their Growing Burden: Findings from a Lung Health Policy Analysis

Abstract

Background: Globally, 4 million people die prematurely from CLDs (e.g. asthma and chronic obstructive pulmo- nary disease (COPD)) (Global Impact of Respiratory Disease – Second Edition, 2017). In sub-Saharan Africa (SSA), the burden of CLDs is estimated to be large and growing (Bigna and Noubiap, 2019). This study seeks to provide evidence on CLD policy and programme re- sponses, prioritised CLDs, health system approaches to address CLDs, and CLD financial investments in East Africa, focusing on Kenya and Uganda. Design/Methods: We conducted a desk review of CLD- relevant policies at regional level (East Africa) and na- tional level for Kenya and Uganda. Interviews with lung health stakeholders in Uganda and Kenya were conduct- ed to contextualise findings from the desk review. This paper fills an evidence gap on lung health policy in SSA and will inform future CLD research, policies, and pro- grammes. Results: Preliminary findings reveal no CLD-specific policies in East Africa, Kenya or Uganda and a narrow focus of lung health policies on tuberculosis. East African policies do not name CLDs however national-level policies refer to CLDs, namely COPD and asthma. The main approach to CLD control in the two countries is prevention by addressing their risk factors (e.g. tobacco exposure and poor air quality). Documentation of CLD financial investments was not available. Interviews re- vealed political will, but insufficient resources to man- age CLDs. Conclusions: We found a lack of CLD policy prioriti- zation in Kenya, Uganda, and East Africa. The narrow focus of lung health policy investments on tuberculosis calls for local evidence on CLDs’ disease burden, eco- nomic burden, and interventions to address their risk factors, as well as effective research translation initiatives to drive policy action. Given SSA’s resource-constrained context, investments must be evidence-informed to en- sure resource allocations are commensurate to the scope of the problem and proven to improve management and prevention of CLDs