Ronald Dahl, ERS president 2004 - 2005 Department of Respiratory Diseases

1. Global Lung Health - What can we do?The ERS perspectiveTurkish Thoracic Society 8th Annual Congress Ronald Dahl, ERS president 2004 - 2005 Department of Respiratory Diseases Aarhus University Hospital, Denmark

2. ERS Headquarters4, Ave Sainte-Luce CH-1003, LausanneSwitzerland ERS Brussels Office39-41, Rue d'ArlonBrussels ERS Journals LtdSuite 2.4, Hutton’s Building 146 West StreetSheffield S1 4ES

3. ERS mission Foster education Promote research Stimulate knowledge exchange Improve patient care Research, educate, organise, advocate to improve lung health in Europe

5. The ERS perspective • General statements on global health • Advocacy to influence priorities • Generate evidence of burden of respiratory disease: epidemiology, basic and clinical research • Educate and develop respiratory medicine • Fight tobacco • Fight tuberculosis • Work collective – combine the forces

6. Life conditions determine the prevailing disease spectrum in a society.

7. Life conditions determine the prevailing disease spectrum in a society. Fight povertySecure clean air and waterSufficient proper foodAccess to education and medical carePossibility for leading a healthy life stile

8. Life conditions determine the prevailing disease spectrum in a society. Fight povertySecure clean air and waterSufficient proper foodAccess to education and medical care Possibility for leading a healthy life stile Solidarity - Cooperation

9. Please realise that politicians decide the areas of priority in society.

10. professionals public advocacy Politicians Decision makers lobby opinion research NGO’s Health care Engineering Teaching etc Unions Companies Individuals Farming etc education

11. Advocacy to influence prioritisation among decision makers in order to improve lung health

12. ERS Lausanne Headquarters Brussels Office Sheffield Office

13. ERS Lausanne Headquarters Secretary for EU Affairs (PV) (officer, member at large in EC) Brussels Office Sheffield Office Advocacy towards EU (EC, MS) Tobacco fight (FG + 2)

14. ERS Lausanne Headquarters Secretary for EU Affairs (PV) (officer, member at large in EC) Brussels Office ERS Journals Sheffield Office Advocacy towards EU (EC, MS) Tobacco fight (FG + 2)

16. ERS Coordination of scientific and educational activities. Relations to national societies, international societies and organisations incl. WHO, IUATLD, Industry. Lausanne Headquarters Secretary for EU Affairs (PV) (officer, member at large in EC) Brussels Office ERS Journals Sheffield Office Advocacy towards EU (EC, MS) Tobacco fight (FG + 2)

17. The world according to ERS Forum of European Respiratory Societies = FERS GSRM FSRM AIMAR SEPAR TRS ETC…

18. The world according to ERS Forum of European Respiratory Societies = FERS GSRM FSRM AIMAR SEPAR TRS ETC… Forum of International respiratory societies = FIRS ULASTER ERS ATS APSR

19. The world according to ERS Individual consultations Forum of European Respiratory Societies = FERS GSRM FSRM AIMAR SEPAR TRS ETC… WHO Forum of International respiratory societies = FIRS JRS ULASTER ERS ATS APSR CRS BTS Individual consultations ISAM IACS ICC EFA AAAACI GINA GOLD NAPCON

20. The world according to ERS Forum of European Respiratory Societies = FERS ERS GSRM FSRM AIMAR SEPAR TRS ETC… advocacy advocacy advocacy advocacy EU German French Italian Spanish Turkish

21. Forum of European Respiratory SocietiesFERS • Meeting in Brussels 4th April 2005 • Constitution in place • Collaboration on advocacy towards national authorities and EU politicians to get respiratory into the 7th research framework programme • Generation of curriculum for European respiratory specialist together with UEMS • Joint membership • Guidelines development and dissemination

22. Document the burden of Chronic Respiratory Disease • Obtain data and evidence for the impact of respiratory diseases on the health care systems and on individuals. • Establish epidemiological surveys in Europe • Update edition (2007 or 8) of thewhite book and a derived figures and fact book by ELF. (Chief editor pppresident John Gibson)

24. Surveilance of respiratory diseases, indicators Public awareness, health promotion Education, skills equipments Availability of drugs SOP based on: guidelines and practise recommendations (PAL, STEP, FCTC, GIFT, STOP-TB) Diagnoses and management Surveilance of respiratory diseases, quality control

25. There is a global agreement on adequate practice in asthma, COPD, and other major respiratory diseases Current practice lags behind these recommendations Challenges for organisation of CRD management Major problem of affordability for both drugs and equipment in poor populations

26. We must avoid that treatment of major diseases like tuberculosis, pneumonia, asthma, COPD etc. will be limited to the rich patients We must avoid that the number of patients with poor access to adequate care increase in the comming years

27. And for animals in rich countries! New Zealand. Sunday Star. Times January 4th.2004 Photo: Kevin Stent

28. Guideline board organisation Guidelines in all areas possible board for implementation/dissemination board for update board for update Implemen- tation evaluation update

29. Guideline board organisation ATS/ERS COPD guideline FERS FIRS cooperating societies board for implementation/dissemination board for update board for evaluation Implemen- tation evaluation update

30. ERS School Task Force in collaboration with UEMS and EBAP to develop a Curriculum for a European Respiratory Specialist

31. Curriculum content • Knowledge through a series of school courses • Skills through “hands on courses” • Practise through work and experience in designated departments in specialist clinics • Diploma of European Respiratory Specialist ERS European Respiratory Specialist

32. ERS scientific and educational support • Fellowships • Travel grants • Awards • Research seminars, Taormina • Task forces, working groups. • Reduced ERS membership fee according to country GNP

33. Looking the death in the eyes

34. COPD mortality in Denmarkage 65-74 years women 80 Men 70 60 Death- rate pr 100.000 50 40 30 1978 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 year

35. Scanpix, DK

36. WHO-FCTC is a unique instrument The WHO FCTC is also unique in that it has a provision on the troublesome questions of civil and criminal liability of tobacco companies (Article 19) which has never been addressed by any of the existing framework conventions. The WHO FCTC is unique as the only multilateral treaty in which, the potential saboteurs of its implementation, the tobacco companies, are specifically identified and appropriate provision to warn the parties to the Convention is included.

38. The definitive proofs that passive smoking is a serious health danger for a number of acute and chronic diseases has changed the opinion that “smoking is a private matter” and “there must be room for everybody”

39. Risks from passive smoking

40. Leading causes of death in 1990 and projected leading causes of death in 2010 in Eastern European countries (former socialist economies) Ischaemic heart disease ProjectionIschemic heart disease Cerebrovascular disease Cerebrovascular disease Lung cancer Lung cancer PneumoniaCOPD Stomach cancer Stomach cancer Road traffic accidents Road traffic accidents Self-inflicted injuries Pneumonia COPD Colon and rectum cancers Colon and rectum cancers Self-inflicted injuries Cirrhosis of the liver Cirrhosis of the liver 1990 2010 ERS white book 2003

41. Leading causes of death in 1990 and projected leading causes of death in 2010 in Western European countries with established market economies Ischemic heart disease Projection Ischemic heart disease Cerebrovascular disease Cerebrovascular disease Lung cancerLung cancer Pneumonia COPD COPD Pneumonia Colon and rectum cancer Colon and rectum cancers Stomach cancer Stomach cancer Breast cancer Cirrhosis of the liver Road traffic accidents Breast cancer Cirrhosis of the liver Road traffic accidents 1990 2010 ERS white book 2003

42. Conference 1th year ban celebration SMOKE FREE EUROPE – 2th June 2005 Michael Martin, Ireland. Minister of Enterprise, Trade and Employment Girolamo Sircha, Italy. Minister of health Markos Kyprianos, Commissioner for Health and consumer affairs Vladimir Spidla, Commissioner for Employment and Social Affairs And many others

44. SARS, influenza, avian influenza

46. Aerosol vaccination for Mycobacterium tuberculosis Developments in TB vaccination and new diagnostics and therapeutic agents

47. Chronic disease accounts for 60% of deathsChronic disease account for 80% of health expenditure

48. Preparing a health care workforce for the 21st century THE CHALLENGE OF CHRONIC CONDITIONS World Health Organization 2004 AND European Respiratory Society

49. WHO calls for a global and coordinated effort to fight chronic diseases

50. White book Aspect report Guidelines CRD GARD Publications Congress Work groups Task forces School Meetings WHO publication Curriculum ADVOCACY TOOLS IMPLEMENTATION TOOLS ERS FERS WHO FIRS International authorities and states EU National authorities Science education advocacy