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Introduction
On the 18
th
of April of 2017, the Institute of Hygiene
anTropical Medicine of the Nova University of Lisbon
(IHMT) held the Pre-Congress Seminar, “Chronic
Respiratory Diseases and Tuberculosis”. The National
Congress of Tropical Medicine was held from April
19th to the 21st.
The list of participants is in Annex 1, the program
in Annex 2.
Objectives of the Seminar
The seminar was organised with the following objec-
tives:
•
Increase the visibility and importance of chronic
respiratory diseases in lusophone and international
space;
•
To advocate the integration of prevention and
control of these diseases at the level of primary
health care;
•
Provide opportunity of collaboration in the
Lusophone space;
•
Provide opportunity of discussion of science in
Portuguese language;
•
Lay the foundations for the creation of a future
Lusophone GARD
GARD Alliance
A presentation was made on GARD Alliance, its his-
tory, actions developed and evolution over 10 years.
Arguments have been put forward to defend the
need of a lusophone space inside GARD.
The GARD-WHO, Global Alliance against Chronic
Respiratory Diseases is a voluntary Alliance of na-
tional and international organizations whose vision
is a world in which everyone can breathe freely. Its
main goal is to reduce the global burden on Chronic
Respiratory Diseases worldwide. The main diseases
encompassed are asthma, Chronic obstructive pul-
monary disease (COPD), allergic rhinitis and ob-
structive sleep apnea syndrome.
Its worldwide presentation was at the first GARD
General Assembly held in Beijing (2006). The last
one was held in Lisbon (2015).
At the recent meeting of the members of the
Executive and Planning Committees held in January
2017 at WHO Geneva Headquarters, strategies for
2017-2019 were defined which include greater ef-
ficiency in supporting low and middle income coun-
tries (LMIC), increased involvement of the respira-
tory community, increase link with infectious respir-
atory diseases such as tuberculosis and the possibility
of establishing a Lusophone GARD.
Following the United Nations policy statement on
chronic diseases (2011) andWHO’s adoption of the
Global Program for Chronic Diseases 2013-2020,
the GARDAlliance promotes an integrated approach
based on primary health care.
The GARD Alliance has its secretariat at WHO
Geneva being its general secretariat Member of
the Executive Committee and the Planning Group.
Members of the Executive Committee and the
Planning Group are elected by the delegates.
The PACK, Practical Approach to Care Kit, devel-
oped under the leadership of Professor Eric Batman
of the University of Cape Town, was presented as an
example of cooperation in the southern hemisphere.
Having started (1999) as an adaptation of theWHO’s
strategy “PAL - practical approach to Lung Health:
Asthma, COPD, respiratory infections and TB”, it
has expanded to become a comprehensive program
addressing adults’ health problems and aiming to sat-
isfy needs of health professionals.
The challenges to which this approach sought to cor-
respond were, among others, the shortage of work-
ers in the health sector, few physicians, the demand
of a lot of administrative work, diverse, sometimes
conflicting and unclear requirements of various pro-
grams and norms / guidelines, comorbidity, turno-
ver and burnout of health personnel. Thus, the PAL
evolved towards the PACK.
The version developed in Brazil, “Adult Brazil
PACK, Clinical Management Tool in Primary Health
Care,
PACK Brasil Adulto, Ferramenta de Manejo Clínico
em Atenção Primária à Saúde
” Florinópolis version, was
briefly presented.This approach includes clinical in-
struments (kit), training, health system involvement
and operational research.
Respiratory diseases,
present situation in each country
Portugal
Portugal presented the National Program for
Respiratory Diseases, which includes asthma,
COPD, sleep apnea syndrome (high frequency pa-
thologies) and cystic fibrosis, pulmonary interstitial
diseases and pulmonary hypertension (highly com-
plex pathologies).
The program components, epidemiological situa-
tion of each pathology, results achieved, including
key indicators and proposals for the future were
presented.
Formação