MONICA KAYOMBO/Zambia/Lusaka
THE estimated number of people in Africa currently living with asthma has kept increasing, based on published epidemiological studies.
The range of 65 to 119 million reflects different age groups and time periods across those studies with research showing approximately 74 million cases in 1990, rising to around 119 million by 2010.
Allergy and anaphylaxis rates are rising in Africa, especially in urban areas, impacting health and economic stability, while asthma remains the third leading cause of children being hospitalized in South Africa.
This came to light recently when Impulse Biomedical Limited co-founders Gokul Nair and Giancarlo Beukes made a join presentation dubbed “Breaking Barriers of Access” with regards allergy treatment to journalists from across Africa who attended the training on Chronic Respiratory Diseases (CRD) in Cape Town, supported by the World Health Organisation (WHO) in collaboration with Pace University.
The burden in Africa is significant and growing,” Mr Nair said
Explaining what they are doing at Impulse Biomedical Limited to help improve access to allergy treatments, Mr Nair said: “Asthma is the third leading cause of children being hospitalized in South Africa. 40 to 50 percent of the United States (US) school children are sensitive to common allergens.”
He explained that urbanization, environmental changes, and lifestyle modifications in the developing world are causing allergy rates to increase there too, meaning that these are not just first-world problems.
“There are barriers to accessing allergy treatments worldwide. Inhalers are hard to access and carry a stigma for children. The elderly and children struggle to activate their inhalers independently, sometimes preventing life-saving care and decreasing treatment protocol adherence,” he said.
Mr Nair added that by 2025, half the European population will be affected by allergic disease.
He has since emphasized that access to treatment is vital and that in the decade from 2002 to 2012, there was a doubling of admissions with anaphylaxis due to food allergy alone.
“There are barriers to accessing allergy treatments worldwide,” he observed.
Mr Beukes said the World Health Organisation (WHO) and the European Academy of Allergy and Clinical Immunology (EAACI) state that spacers are essential but unaffordable for most African patients.
He said the elderly and children struggle to activate their inhalers independently, sometimes preventing life-saving care and decreasing treatment protocol adherence.
Mr Beukes said anaphylaxis treatments are expensive and wasteful, costing up to $325 per annum, and that auto-injectors are a massive cost burden for patients and the health system.
“These devices are completely replaced each year, causing waste,” he said.
Mr Beukes said the correct inhaler technique requires a spacer, but commercial spacers cost up to R450 in South Africa and are rarely available in public health facilities across the continent.
He said on the African continent, under-diagnosis is the norm as most African children with asthma are never formally diagnosed.
“Symptoms are attributed to infection, not chronic disease, which delays or prevents appropriate treatment,” he explained.
He said that inhalers that patients can’t activate have standard pressurized metered dose inhalers which require 15–20 N of activation force.
He said elderly patients, young children, and those with arthritis frequently lack the hand strength to use them.
Mr Beukes observed that in South African pharmacies or clinics, like most countries on the continent, there are no auto-injectors available, and that when they are, they are unaffordable and single-use.
He said African medical device innovation remains rare and chronically underfunded, thus most health systems on the continent still depend on devices designed, priced, and manufactured elsewhere.
He said Impulse Biomedical Limited’s vision is to break barriers to drug-delivery devices and the mission is to develop, manufacture, and commercialize drug-delivery devices that solve critical healthcare challenges.
South Africa ranks 7th globally for asthma-related deaths per capita, and asthma is the leading cause of school absences in South African children, while five percent of anaphylaxis patients in Sub-Saharan Africa have access to auto-injectors.
Recently, WHO and Pace University organized training for African journalists on Chronic Respiratory Diseases (CRDs) under the theme: Unpacking the Chronic Respiratory Disease Epidemic, and WHO Special Envoy Director General for CRDs, Dr. Jose Luis Castro, led the delegation.
