Global Strategy for Asthma Management and Prevention (2019 update)

Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2019. Available from: www.ginasthma.org

Asthma is a serious global health problem affecting all age groups. Its prevalence is increasing in many countries, especially among children. Although some countries have seen a decline in hospitalizations and deaths from asthma, asthma still imposes an unacceptable burden on health care systems, and on society through loss of productivity in the workplace and, especially for pediatric asthma, disruption to the family.

In 1993, the National Heart, Lung, and Blood Institute collaborated with the World Health Organization to convene a workshop that led to a Workshop Report: Global Strategy for Asthma Management and Prevention.1 This was followed by the establishment of the Global Initiative for Asthma (GINA), a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma, and to provide a mechanism to translate scientific evidence into improved asthma care. The GINA Assembly was subsequently initiated, as an ad hoc group of dedicated asthma care experts from many countries. The Assembly works with the Science Committee, the Board of Directors and the Dissemination and Implementation Committee to promote international collaboration and dissemination of information about asthma. The GINA report (“Global Strategy for Asthma Management and Prevention”), has been updated annually since 2002, and publications based on the GINA reports have been translated into many languages. In 2001, GINA initiated an annual World Asthma Day, raising awareness about the burden of asthma, and becoming a focus for local and national activities to educate families and health care professionals about effective methods to manage and control asthma.

In spite of these efforts, and the availability of effective therapies, international surveys provide ongoing evidence for suboptimal asthma control in many countries. It is clear that if recommendations contained within this report are to improve care of people with asthma, every effort must be made to encourage health care leaders to assure availability of, and access to, medications, and to develop means to implement and evaluate effective asthma management programs. To this end, the major revision of the GINA report published in May 2014 not only reflected new evidence about asthma and its treatment, but also integrated evidence into strategies that would be both clinically relevant and feasible for implementation into busy clinical practice, and presented recommendations in a user friendly way with extensive use of summary tables and flow-charts. For clinical utility, recommendations for clinical practice are contained in the core GINA Report, while additional resources and background supporting material are provided online at www.ginasthma.org. New recommendations about treatment of mild asthma, described in the present report, represent the outcome of more than a decade of work by GINA members and others, and may be considered the most fundamental change in asthma management in the past 30 years.

It is essential that we acknowledge the superlative work of all who have contributed to the success of the GINA program, and the many people who have participated in it; in particular, the outstanding and dedicated work of Drs Suzanne Hurd as Scientific Director and Claude Lenfant as Executive Director over the many years since GINA was first established, until their retirement in December 2015. Through their tireless contributions, Dr Hurd and Dr Lenfant fostered and facilitated the development of GINA. In January 2016, we were delighted to welcome Ms Rebecca Decker, BS, MSJ, as the new Program Director for GINA and GOLD, and we appreciate the commitment and skills that she has brought to this demanding role.

The work of GINA is now supported only by income generated from the sale of materials based on the report. The members of the GINA Committees are solely responsible for the statements and conclusions presented in this publication. They receive no honoraria or expenses to attend the scientific review meetings, nor for the many hours spent reviewing the literature and contributing substantively to the writing of the report.

We hope you find this report to be a useful resource in the management of asthma and that, in using it, you will recognize the need to individualize the care of each and every asthma patient you see.

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