Breathless in a World Full of Air

For millions across the globe, breathing doesn’t come easy. It comes with tightness, coughing, wheezing and fear—especially when asthma, a chronic respiratory condition, takes control. On World Asthma Day 2025, the spotlight falls not just on the disease, but on the urgent need to make inhalers accessible for all.

What is Asthma?

Asthma is a chronic inflammatory disease of the airways that leads to recurrent episodes of wheezing, breathlessness, chest tightness and coughing. These episodes are often triggered by allergens, infections, exercise, or even cold air. The airway muscles tighten, the lining swells, and mucus production increases, narrowing the breathing passages and making it difficult to breathe.

Asthma is not curable, but it is highly manageable—especially when diagnosed early and treated consistently with appropriate medication.

Who is Most Affected?

Asthma affects over 330 million people worldwide, and its reach knows no boundaries—urban and rural, rich and poor, children and adults.

However, trends show:

• Children are particularly vulnerable, with many cases developing before the age of 10. Boys are more likely to be diagnosed with asthma in childhood, but this trend reverses in adulthood, with adult women more frequently affected and often with more severe symptoms.
• Asthma is more common in urban populations due to higher exposure to pollutants, allergens, and a sedentary lifestyle.
• Women may also experience hormone-related asthma variations, especially during menstruation, pregnancy, or menopause.

Risk Factors for Developing Asthma

Several factors increase the risk of developing asthma or worsening its severity:

1. Genetic Predisposition – A family history of asthma, allergies, or eczema.
2. Allergens – Pollen, pet dander, mold, dust mites.
3. Respiratory Infections – Frequent viral infections during early childhood.
4. Air Pollution and Occupational Hazards – Exposure to fumes, smoke, and chemicals.
5. Tobacco Smoke – Both active smoking and second-hand smoke.
6. Obesity – Increases systemic inflammation and worsens respiratory function.
7. Socioeconomic Status – Poor access to healthcare, unhealthy living conditions, and lack of awareness can all delay diagnosis and treatment.

Treatment: A Multi-Faceted Approach

Asthma is not managed with a one-size-fits-all approach. Effective treatment involves:

• Avoidance of triggers – Identifying and reducing exposure to allergens and irritants.
• Medications – Broadly divided into:
• Controller medications (preventers) such as inhaled corticosteroids to reduce airway inflammation over time.
• Reliever medications (rescue inhalers) such as short-acting bronchodilators to quickly open up airways during an attack.
• Monitoring – Regular check-ups, spirometry tests, and symptom tracking.
• Patient education – Understanding when and how to use medication properly.

Despite treatment being widely available in theory, the reality is more complex—particularly when it comes to inhalers.

The Inhaler: A Lifeline Still Out of Reach

The inhaler is perhaps the most critical tool in asthma care. These devices deliver medicine directly into the lungs, offering quick and effective relief while minimizing systemic side effects.

There are three main types of inhalation devices:

• Metered-Dose Inhalers (MDIs) – The most common type, delivering a precise dose of medication with each puff, often used with spacers for improved delivery.
• Dry Powder Inhalers (DPIs) – Breath-activated and often easier for older children and adults to use correctly.
• Nebulizers – Machines that convert liquid medication into a mist, typically used in more severe cases, in emergencies, or for very young or elderly patients who may have difficulty with handheld devices.

In addition to inhaled medications, oral medications play a supporting role in asthma management, particularly for individuals with moderate to severe or difficult-to-control asthma. All asthma medications—whether inhaled or oral—must be taken strictly under medical supervision. Self-medication, incorrect usage, or sudden discontinuation can lead to serious complications, including life-threatening asthma attacks.

The Crisis of Accessibility

• In many low- and middle-income countries, inhalers are either unavailable in local pharmacies or unaffordable due to lack of insurance, high markups, or supply chain issues.
• Stigma and misinformation also prevent people from using inhalers correctly. Some believe that using an inhaler regularly will lead to dependence or that it is only for “serious” cases. As a result, patients delay using it until an emergency arises.
• Children, especially in underserved areas, often suffer in silence or are misdiagnosed with pneumonia or chronic bronchitis due to a lack of awareness among parents and teachers.

Make Inhaled Treatments Accessible for ALL

This year’s theme calls for more than just awareness. It’s a declaration and a demand:

• Policy makers must include essential inhalers in national drug lists and subsidize their cost.
• Pharmaceutical companies must support generic inhaler production and ensure affordability in lower-income regions.
• Healthcare systems must decentralize asthma care—bringing education, diagnosis, and inhalers to community clinics and schools.
• Public health campaigns must demystify inhaler use, especially among older populations and in rural areas.
• Doctors and frontline health workers must actively teach patients how to use inhalers properly and recognize early signs of an attack.

Final Inhalation

World Asthma Day should not be an annual checkbox. It should be a wake-up call. We need to stop treating asthma like an invisible inconvenience and start treating it like the global health emergency it truly is.

We don’t need more slogans. We need bold steps. Universal access to inhalers isn’t a dream—it’s a demand. If we can get smartphones into the remotest corners of the world, we can get inhalers there too.

Because breath is not a luxury. It’s life. Let’s make sure everyone, everywhere, gets a fair chance to take it.