Immunology Asthma in Iran vs the World

Asthma is a common chronic respiratory disease affecting all age groups and remains a significant contributor to global morbidity and health care burden. According to the Global Asthma Report ۲۰۲۲ and Global Burden of Disease (GBD) estimates, approximately ۲۶۲ million people were living with asthma and it caused ۴۵۵,۰۰۰ deaths worldwide. Although age-standardized prevalence and incidence rates have shown a gradual decline since ۱۹۹۰, the absolute number of cases continues to rise due to population growth and aging, with the greatest burden and highest mortality rates seen in low- and middle-income countries. Globally, improved understanding of asthma pathophysiology and the introduction of updated management strategies—most notably the Global Initiative for Asthma (GINA) recommendations to avoid short-acting ẞ۲-agonist (SABA)-only treatment and to use inhaled corticosteroid (ICS)-containing regimens have improved disease outcomes where implemented effectively. Nevertheless, significant disparities persist in access to affordable and reliable asthma medications, particularly ICS and combination inhalers, limiting optimal disease control in many settings. In Iran, the prevalence of asthma is generally consistent with global averages, and ۱۰.۹% for Pediatric asthma and ۸.۹% for adults (The first national population-based survey in Iran), higher figures especially in urban and industrialized areas with greater air pollution. This heterogeneity reflects the influence of environmental, occupational, and socioeconomic factors on disease risk. Iran benefits from an extensive primary health care network and professional societies that adapt and disseminate guideline-based asthma management. Pilot programs in primary care have shown promise in integrating regular patient review, inhaler technique checks, and action plan provision. However, challenges remain. Periodic shortages and increased costs of essential asthma medicines-at times linked to economic sanctions-undermine treatment continuity. Furthermore, research indicates suboptimal ICS use, over-reliance on SABA, and limited patient adherence to long-term management plans. Comparing Iran with global patterns reveals both shared challenges and local nuances. While the direction of epidemiological trends is broadly similar, Iran's regional disparities in prevalence and its unique supply-chain vulnerabilities demand tailored interventions. Priorities include securing consistent, affordable access to ICS and ICS-LABA inhalers, scaling up GINA-aligned care through primary health services, and strengthening surveillance to identify and address high-burden provinces. In conclusion, such measures could substantially improve asthma control, reduce exacerbations, and lessen the disease burden in Iran, contributing to the global effort to close gaps in asthma care.