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Ministry works with doctors, pharma company to curb smoking-related lung disease
People with COPD often find it more difficult to carry out their normal daily activities due to breathlessness.
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he Health Ministry is working with the Indonesian Society of Respirology (PDPI) and multinational biopharma company GSK Plc to scale up early diagnosis of chronic lung disease usually caused by smoking and expand treatment for millions of Indonesians suffering from such illnesses.
Chronic obstructive pulmonary disease (COPD) is a group of progressive and incurable diseases, such as chronic bronchitis and emphysema, that cause lungs to become inflamed, damaged and narrowed, leading to obstructed airflow and breathing problems. It is mainly caused by tobacco smoke – either from active smoking or passive exposure to second-hand smoke – and prolonged exposure to air pollution.
People with COPD often find it more difficult to carry out their normal daily activities due to breathlessness. They are also at higher risk of other health problems such as lung infections, heart problems, weak muscles, brittle bones, depression and anxiety.
COPD is the third leading cause of death worldwide, causing 3.23 million deaths in 2019, according to data from the World Health Organization.
A 2013 survey by the Health Ministry found that some 3.7 percent of Indonesians suffered from COPD, and a 2016 study by the PDPI put the figure at 5.6 percent, meaning 8.5 million Indonesians are estimated to suffer from the disease.
A 2023 report by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) estimated that the increased prevalence of smoking coupled with an aging population would result in more than 5.4 million yearly deaths from COPD and related conditions worldwide by 2060.
Early diagnosis
Pulmonologist Wiwien Heru Wiyono of the University of Indonesia said early diagnoses and treatment for people with COPD were crucial to prevent irreversible lung damage and reduce mortality.
"Patients need daily medication to keep their condition stable and to prevent exacerbations or flare-ups, which are the acute worsening of symptoms," Wiwien said on Monday during the launch of a campaign to increase COPD awareness organized by GSK and the PDPI.
Common signs of a flare-up are when patients become more short of breath or wheeze, cough and produce mucus more than they usually do. It can take up to three months for patients to fully recover from a flare-up, depending on the severity of the symptoms.
"Flare-ups often cause irreversible and permanent damage to patients’ lungs, increasing mortality risks, leading to worsening breathing difficulty and poorer life quality, so preventing them is very crucial," Wiwien added.
However, he said that early diagnosis and treatment for patients remained a major challenge in the country, mainly because of a lack of awareness about the disease both among the public and health workers.
"Patients often ignore the early symptoms of COPD, such as coughing, wheezing and lack of energy. Health professionals also often fail to recognize them as COPD. As a result, many patients only start their treatment when their disease has progressed to moderate or severe symptoms," he said.
Diagnosis was made more difficult by the fact the device used to test for COPD, called a spirometer, was not readily available in many community health centers (Puskesmas).
Multi-sector efforts
Health Ministry spokesperson Mohammad Syahril said that preventing COPD and providing better treatment for patients required efforts from a number of groups, including from patients and their families, health professionals, policymakers and the general public.
"The ministry is currently in the process of procuring and distributing spirometers to puskesmas across the archipelago as part of our efforts to expand testing for 14 common deadly diseases in the country," Syahril said.
Syahril also said GSK and the PDPI had launched a campaign called Peduli Paru OK (Okay Lung Care) to increase awareness of COPD among the general public.
The pharma company has also created an e-learning platform called EducAIR so that health professionals can easily access information about COPD.
The government is also working with the company to bring a new inhaler treatment for COPD to the country’s health facilities, with the drug covered by the National Health Insurance (JKN) program. The new medicine combines multiple drugs into a single inhaler and only needs to be taken once a day.
Paul Jones, a professor of respiratory medicine at St. George's University of London who attended the event, said the single-inhaler therapy was more convenient and effective than multiple inhalers for at-risk COPD patients.
Syahril, meanwhile, said it was vital to have stronger commitment from policymakers to reducing air pollution and strengthening tobacco control to prevent an increase in COPD in the country.
