• chronic obstructive pulmonary disease

In the UK 17 500 men and 14 500 women die every year from chronic obstructive pulmonary disease (COPD). Work reported in this issue of Thorax suggests that these figures are likely to be falsely low.¹ The published death rate compares with 13 000 women dying of breast cancer and 9500 men dying of prostate cancer every year. Both of the latter two diseases now attract much publicity, considerable research expenditure and, for breast cancer at least, a very expensive health service screening programme, the value of which is continually debated. Globally, COPD is the fourth or fifth leading cause of death and both morbidity and mortality are predicted to rise. The World Health Organisation (WHO) is one of the few organisations to have recognised the impending burden of this disease to both the individual and to society, publishing both a consultation document on the development of a comprehensive approach for the prevention and control of respiratory disease² and also an implementation strategy.³ At a national level few countries have health initiatives to help those with COPD, and perhaps the respiratory fraternity should take some responsibility for what could be regarded as the neglect of this group of patients—neglect not necessarily at the level of personal care, but neglect in terms of failure to ensure that governments and health departments resource the necessary care, and resource research into better management.

In what areas might we have failed these patients? “I …