A new report from WHO/Europe and the European Respiratory Society highlights the widespread underdiagnosis, mismanagement, and underestimation of chronic respiratory diseases (CRDs), such as asthma, chronic obstructive pulmonary disease (COPD), and other lung conditions, across the WHO European Region. The report, marking the first of its kind by the WHO, calls for urgent and coordinated action to address the growing health crisis.
CRDs are a leading cause of disability and death, contributing significantly to cardiovascular diseases and cancer. Despite being preventable and treatable, these conditions are the sixth leading cause of death in the Region. However, diagnostic tools like spirometry remain limited, and primary health care often fails to identify CRDs early. The lack of training for health professionals, high rates of comorbidities, and inadequate health information further hinder proper diagnosis and treatment, masking the full impact of untreated CRDs.
Dr. Hans Henri P. Kluge, WHO Regional Director for Europe, stated that CRDs affect 81.7 million people in the Region, with 6.8 million new diagnoses annually. He emphasized that insufficient policy focus and funding have resulted in underdiagnosis, misdiagnosis, and incomplete data, costing the Region an estimated $21 billion each year. Dr. Kluge called for stronger health systems, integrating CRD care into broader strategies for addressing noncommunicable diseases (NCDs), and urged increased investment in prevention, research, and data collection.
The report also highlights a decline in CRD mortality in previous years, but paradoxically, this success has led to reduced research funding and weak surveillance systems. While global data exists, regional tracking and coordinated efforts are lacking, leaving millions of people with unmet healthcare needs. COPD and asthma are the most common CRDs, with COPD responsible for 80% of CRD-related deaths. Projections show a 23% increase in global COPD cases between 2020 and 2050, with the sharpest rise expected among women and in low- and middle-income countries. Asthma-related hospitalizations and deaths remain high, particularly among young people, despite available treatments.
Tobacco use and air pollution are major contributors to the rising incidence of CRDs in the Region. Tobacco use remains the leading avoidable cause of respiratory illness, with 25.3% of adults still smoking, significantly higher than the global average of 20.9%. The growing use of e-cigarettes and heated tobacco products, especially among youth, poses additional risks. Furthermore, over 90% of people in the Region are exposed to air pollution levels exceeding WHO safety guidelines.
The report also points to the economic burden of CRDs, with productivity losses among people aged 30 to 74 estimated at over $20 billion. Disadvantaged populations are particularly vulnerable, with higher exposure to indoor smoke and unsafe work environments, as well as limited access to essential medicines.
Professor Silke Ryan, President of the European Respiratory Society, stressed that respiratory health remains a neglected area of global health despite its significant impact on mortality and disability. She called for urgent, collective action and a shift in policy priorities to address the growing crisis of CRDs.
In light of these findings, WHO/Europe is urging governments, civil society, and the health community to prioritize CRDs as part of broader NCD strategies in preparation for the 2025 United Nations High-Level Meeting on NCDs and Mental Health. Dr. Gauden Galea, WHO/Europe’s Strategic Adviser to the Regional Director, emphasized the need for integrated action to reduce preventable deaths and urged countries to adopt cost-effective interventions with measurable health impacts, paving the way for a resilient Region by 2050.
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