Patient safety at the heart of forthcoming WHO asthma guidelines

The World Health Organization (WHO) is developing updated guidance on asthma for primary care, to be published in early 2027, with patient safety positioned as a central concern, according to a departmental update by WHO. The forthcoming guidelines are aligned with World Patient Safety Day 2026, whose theme is “Safe care for noncommunicable diseases”. For people living with long-term conditions, patient safety extends beyond hospitals and health facilities into daily life. In asthma care, this includes access to effective treatment, correct use of inhalers, regular review of symptoms and support when symptoms worsen. The initiative aims to close persistent gaps between evidence-based interventions and their routine implementation.

Asthma affected an estimated 363 million people in 2023 and caused 442 000 deaths. Most asthma-related deaths occur in low- and lower-middle-income countries, where under-diagnosis and under-treatment remain common. Effective treatments exist, but access remains a major challenge. A recent Bulletin of the World Health Organization editorial, “WHO guidance for asthma and chronic obstructive pulmonary disease: why it matters”, underscores the need to translate evidence into practice. The forthcoming guidance responds directly to these documented gaps.

One of the main challenges in asthma care is overemphasis on symptom relief without addressing underlying airway inflammation. Bronchodilator or reliever inhalers open narrowed airways and ease symptoms, but frequent use can indicate poor asthma control and a higher risk of severe attacks. Reliever inhaler overuse has been associated with increased rates of asthma attacks and mortality. Inhaled corticosteroids reduce airway inflammation and lower the risk of severe attacks and asthma-related death, yet they remain underused. This leaves inflammation untreated and increases the likelihood of exacerbations and repeated courses of steroid tablets.

Access to inhaled medicines also remains uneven. In 2023, WHO reported that bronchodilator inhalers were available in public primary health care facilities in fewer than two thirds of low- and lower-middle-income countries, while steroid inhalers were available in fewer than half. In some settings, oral or intravenous medicines are used in place of inhaled therapies.

“The Global Asthma Network survey found that 45% to 60% of people with severe asthma symptoms, depending on age group, were not taking inhaled corticosteroids, with larger treatment gaps in lower-income settings. We have effective medicines, but people need to be able to access them and use them correctly if we are to improve symptoms and reduce asthma attacks,” said Professor Refiloe Masekela, Co-Chair, Global Asthma Network.

Having the right medicine is only part of asthma care, as people also need clear information on what their medicines are for and how to use inhalers correctly. Health workers play an important role in demonstrating inhaler technique, reviewing asthma control and supporting treatment decisions over time. World Patient Safety Day 2026 emphasizes that people living with noncommunicable diseases should be active partners in their care. WHO’s calls to action highlight shared decision-making, correct use of medicines and medical devices, continuity of care and effective follow-up after severe asthma attacks. The forthcoming guidance aims to strengthen evidence-based care and reduce avoidable harm for every person living with asthma.