Governmental "joined up thinking" is vital to tackle pandemic of respiratory illness affecting NZ children and adults
The central tenet of Te Ha Ora (The Asthma Foundation's National Respiratory Strategy) is that effective intervention to tackle the huge burden of respiratory diseases in New Zealand mandates collaborative action across several Ministerial portfolios and associated agencies, and not just via better health care provision.
Lung disease is the 3rd biggest cause of death in New Zealand, after cancer and cardiac disease. It has been known for a long time that the poorest children and adults have the worst health. This is especially true for Kiwi children from Maori and Pasifika communities, and for the lung diseases listed in this document. In the past, New Zealand has led the world in many things, nowadays this includes having the second highest rate of asthma in children and one of the highest rates of bronchiectasis (lung destruction from chronic infection) in children. Bronchiectasis can, over time, be severely debilitating, and even fatal in some children. It affects approximately 20 out of every 100,000 Pasifika children, which is slightly more than the overall rate for childhood cancers in New Zealand. The Strategy estimates the annual cost of lung disease to be $5.5 billion, although the true amount may well be higher when we consider children with chronic lung disease become adults but are then too sick to work and pay tax. Despite these telling statistics, there has never been a National Respiratory Strategy before now. Nor has there ever been any specific Governmental policy on lung disease.
Lung disease is more common and more severe in households and communities where there is tobacco smoke exposure, environmental pollution, poor nutrition, substandard housing, and endemic poverty. The Respiratory Strategy rightly notes that these factors also need addressing in order to tackle lung disease in New Zealand. All of these problems not only require government departments to collaborate above and beyond the usual departmental divisions, but also to prioritise NZ citizens' health over ideologically derived limits to public expenditure.
Consultant respiratory paediatrician and chair of the Paediatric Society's Respiratory Special Interest Group, Dr Julian Vyas, says that there are numerous areas where intervention can make a difference. "The government could act in many ways to influence the overall burden of these terrible illnesses, such as enacting better tobacco control including plain cigarette packaging, building enough good quality social housing throughout the country, controlling car exhaust emissions, ensuring any future public health legislation will be exempted from the TPP agreement. The list goes on," he says.
However, government action is not all that is needed. "The new strategy rightly emphasises the vital importance of health agencies, local communities and individuals to collaborate with Government to fight lung diseases. However, to avoid significant geographical variance, community-based initiatives must be coordinated at a national level by central government," said Dr Vyas.
"The National Respiratory Strategy document is an exceptional piece of work, for which we congratulate all those involved. It is timely, as the Forum for International Respiratory Societies has recently declared 2016-2025 'The (global) Decade of the Lung.' We hope the Government will endorse the Strategy recommendations by funding and implementing a national policy for lung disease for all New Zealanders," he concludes.
For further information, please contact Lauren Young
021 823 590
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