• paediatric asthma

Over the last 9 months, the COVID-19 pandemic has been all consuming for virtually every country of the world; destroying lives, overwhelming health services and perplexing governments alike. Other medical disorders have taken a ‘relative’ back seat resulting in research and resources being diverted to best manage the devastating pandemic.

Asthma is a good example being the most common disorder seen in children worldwide but with a recent profile lower than previously, despite its continuing and significant morbidity. The Lancet Commission1 has re-enforced our understanding that asthma is a spectrum of airway diseases often poorly diagnosed and frequently inadequately treated. In previous decades, it was believed to be a disease solely of temperate climate countries, but we now know its frequency and particularly its severity have been rapidly climbing in low-income and middle-income countries. In sub-Saharan Africa (sSA), urbanisation, poverty, air pollution and lack of resources have all been implicated as causative factors. In a systematic review, 10%–20% of all children in sSA were reported to have symptomatic or severe asthma.2 This in countries where there may be only 2 trained doctors per 100 000 …