The European Respiratory Roadmap La Roadmap Respiratoria Europea

Past-President, European Respiratory Society (ERS)It is clear by now that health policy makers did notdevote the deserved attention to respiratory dis-eases in the last decades. The five most importantrespiratory diseases (COPD, asthma, lung cancer,pneumonia and tuberculosis) are now responsiblefor 20% of the mortality worldwide [1,2]. The annu-al cost associated with these diseases amounts to €100 billion in Europe. Worldwide there arepresently about 300 million people with asthmaand 210 million persons with COPD and millionsmore with a host of other lung diseases [3]. COPDis now the fourth cause of death and is predicted tobecome the third cause of death by 2030.Respiratory diseases are also very important causesof disability and reduction in health related qualityof life. Moreover, the mortality due to COPD hasdoubled during the last three decades, whereas themortality due to cardiovascular disease and strokehas decreased significantly [4].Why did we deal better with cardiovascular dis-eases and stroke in the last decade than with respi-ratory disease? A host of reasons can probably beoffered as an explanation. For the purpose of thepresent editorial, we will just present two. The firstand foremost reason is that although the major riskfactors for respiratory disease, i.e. smoking and airpollution, have been known for a long time, we didnot really combat these risk factors vigorously.Indeed, the recent Eurobarometer survey on smok-ing [5] found that smoking prevalence is still highin most European countries, with only Sweden ap-proaching the presently optimal prevalence ofabout 15% while the prevalence in other countrieslike Spain and Greece still exceeds 35% and more.Although the European Commission and theEuropean parliament have played a pivotal role intriggering smoke-free legislation in the memberstates, 2011 is only the first year in which thegrowth of tobacco will not be subsidized by theEuropean Union. The second reason that I wouldlike to mention here is the deficient funding of re-search on respiratory disease. In 2002 in the UK,only 2.8% of the Medical Research Council budgetwas dedicated to respiratory research, while respi-ratory diseases represented 13% of the causes ofdeath [6]. Similarly, although the 7