Q: The recent UN Declaration is a huge milestone and one that FIRS helped play a key part in. What changes will it bring?
The recent UN Political Declaration on noncommunicable diseases marks a significant shift. For the first time, Member States have formally committed to expanding access to essential medicines and basic technologies for noncommunicable diseases and mental health conditions, which FIRS interprets as an opportunity to improve access to inhaled medications for the 750 million people living with chronic obstructive pulmonary disease (COPD) or asthma. This is important because it elevates chronic respiratory diseases on both national and global health agendas. We’re confident this is the start of a new era of progress when it comes to moving the dial on better access to inhaled medications.
Q: What is the specific global target?
The Declaration sets out a clear, measurable objective: by 2030, governments must ensure that at least 80% of primary health care facilities have availability of WHO-recommended essential medicines and basic technologies for NCDs and mental health conditions, at affordable prices
The inclusion of the word “affordable” is key, as there is another target in the document which requires at least 60% of countries should have financial protection policies or measures in place that cover or limit the cost of essential services, diagnostics, medicines, and other health products for NCDs by 2030.
Countries will report to the WHO on both targets so we will be able to monitor their progress.
Q: How large is the current access gap?
The current gap in access to inhaled medicines is very wide, among the widest of all NCD medicines according to WHO. Surveys show that in low- and middle-income countries, fewer than 30% of primary health care facilities stock affordable, inhaled medicines. That’s a long way from 80%!
Where inhalers are available, they can be very expensive, costing a week’s wages for a month’s supply.
Closing it will require deliberate, coordinated national and global action — updating policies, registering and procuring products, reducing prices, training clinicians and supporting patients, and fully integrating COPD and asthma management into primary health care.
Q: What is the next phase of the campaign?
The next phase is focused on implementation. In 2026, FIRS is looking to partner with two or three countries with heavy burdens of COPD and asthma that are committed to closing their inhaler access gaps.
Governments will work with global health and civil society organizations, professional associations, and industry, to strengthen respiratory care delivery.
The goal is to demonstrate solutions that can be replicated elsewhere. We want to show that reaching broader essential medicine coverage is achievable, while also ensuring inhalers are prioritized through coordinated leadership and partnership.
Q: Financing is often cited as a barrier. How do you address that concern?
Most governments in LMICs do not cover the costs of inhaled medicines. Rather patients are forced to pay out-of-pocket. These governments argue that they cannot afford to prioritize inhaled medicines due to constrained budgets. At the same time, global philanthropic funding for NCD medicines generally remains limited.
However, the economic case for investment is strong. Without access to inhaled medications, patients are more likely to require emergency visits or hospitalization — episodes that are far more costly than preventive treatment.
There is also a broader economic impact. Effective disease control enables adults to remain in the workforce and reduces days of missed school for children. Over time, improved respiratory health supports national productivity and reduces long-term health costs. Investment in inhaled medications is one of those strategies that can both improve health and reduce economic costs.
Q: Apart from financing, what other challenges must be addressed?
FIRS is calling for action in five areas, and only one of those is price reductions. Equally important are national policies that ensure inhaled medicines are on Essential Medicines Lists and Insurance Reimbursement Lists and that COPD and asthma clinical management guidelines are best practice.
In many countries, primary health care providers have limited training in diagnosing and managing patients who need inhalers. Prescribing authority is often restricted to hospitals, even though many patients could be effectively cared for at the primary care level.
This is why investing in provider education and expanding prescribing authority where appropriate, countries can build a more sustainable and patient-centered approach to scaling up care.
Q: What role does stigma play?
Unfortunately, stigma and misinformation about inhalers are still real challenges in some communities. Myths about dependency or harm can make people hesitant to use inhalers, even when they truly need them. Social pressures can also make it especially challenging for adolescents and young women to use their inhalers openly and confidently.
That’s why public education and meaningful community engagement matter so much. When inhaled medicines are understood and accepted as a normal part of managing health, people are more likely to use them appropriately, leading to better adherence and healthier outcomes overall.
Q: What should governments do now?
We encourage ministries of health to begin with a five-point national assessment:
- Measure the burden of COPD and asthma – health and deconomic
- Assess inclusion of inhaled medicines in health policies and clinical guidelines
- Map current availability of inhaled medications, including in primary care facilities
- Understand level of inhaler knowledge and practices among health providers at all levels
- Estimate cost-benefit of closing inhaler access gaps
This data provides the foundation for countries to develop national strategies to increase access to inhaled medicines.
Q: Is the 2030 target realistic?
It is ambitious and only achievable if countries start now with a national assessment and an explicit access strategy for inhaled medicines. This is how they will ultimately contribute to the delivery of the historic UN vote on 15 December last year.
At FIRS, we remain committed to supporting UN Member States as they translate this global commitment into actions that will benefit the hundreds of millions of people living with a chronic respiratory disease.