Patient safety at the heart of forthcoming WHO asthma guidelines

The theme of World Patient Safety Day 2026 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.

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. WHO is developing updated guidance on asthma for primary care, to be published in early 2027. A recent Bulletin of the World Health Organization editorial, WHO guidance for asthma and chronic obstructive pulmonary disease: why it matters, highlights the need to close the gap between evidence-based interventions and their implementation in routine care.

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, leaving inflammation untreated and increasing the likelihood of symptoms, exacerbations and the need for repeated courses of steroid tablets, which can themselves cause adverse effects over time.

Access to inhaled medicines remains a challenge in many countries. 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 In some settings, treatment may remain outdated or inappropriate, including use of oral or intravenous medicines instead of inhaled therapies. Availability and affordability of inhaled medicines influence both what health workers can prescribe and what patients can use.

"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. People need clear information on what their medicines are for, how to use inhalers correctly, how to recognize worsening symptoms and when to seek help. 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.

"I need to understand what each inhaler is for, how to use it properly and what I should do if my asthma gets worse. It also helps to be able to ask questions and be involved in decisions about my treatment," said Andrea Jensen, who lives with asthma.

WHO's World Patient Safety Day 2026 calls to action emphasize shared decision-making, correct use of medicines and medical devices, continuity of care and effective follow-up after severe asthma attacks. WHO's forthcoming asthma guidance aims to strengthen evidence-based care and reduce avoidable harm so that every person living with asthma can access appropriate treatment and the support needed to use it effectively.