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Discussion, conclusions
and perspectives for the future
The heterogeneity of national situations was verified in
terms of:
•
Socio-economic situation, illustrated by GDP per
capita, life expectancies ranging from 52 to 81 years,
health priorities and health budgets;
•
Knowledge on disease prevalence, burden of disease,
treatment of respiratory diseases and dissemination of
key indicators;
•
Access to medication and other therapeutic means
(e.g. home respiratory care, inhaler techniques);
•
Access to complementary diagnostic exams, namely
spirometry
•
Training needs of physicians, non-physician clinicians,
health technicians, and patients (peer and peer training);
•
Approach to primary health care / primary care;
•
Integrated clinical management approach to health
problems;
On the other hand, the problems of population aging,
comorbidities, the need for therapeutic resources, equity
in access to them and the need to face the social determi-
nants of the disease, appeared to be common problems.
The evolution to a Lusophone GARD was agreed, ex-
pressing the desire for cooperation between countries and
in Portuguese, which contemplates chronic respiratory
diseases and tuberculosis. The way this work was going
to be organized was less defined. IHMT will continue to
support the initiative and the presence of three elements
of the Executive Committee of the GARD in the meeting
will facilitate the work ahead. It was agreed that it would
evolve into a “Lusophone GARD” working group.
It was suggested that, like the EndTB Strategy, we could
organize our action in three pillars:
1. Integrated, patient-centred care and prevention
•
Promote training in Portuguese between countries at
a clinical and technical level;
•
Promote training of health professionals, patients and
caregivers; for and among pairs;
•
Promote cooperation for the knowledge and applica-
tion of the approach PACK Florianópolis;
2. Bold policies and supportive systems
•
To place the issue of respiratory diseases on the
CPLP (Community of Portuguese Language Speaking
Countries) Ministers of Health’ agenda meeting and
in each country, at ministerial level;
•
Take advantage of international meetings to raise
awareness on respiratory diseases, such as the forth-
coming World Health Assembly, the CPLP Health
Ministers’ meeting in October and the End TB
Strategy meeting in Moscow in November 2017;
•
Seek funding to support the work of the
Lusophone GARD network;
•
Advocacy and promotion of partnerships in the
area of chronic respiratory diseases;
•
Influence essential drugs and equipment list com-
position;
3. Intensified research and innovation
•
To develop research in the following areas:
o
Prevalence of risk factors;
o
Prevalence of diseases (establish an epidemio-
logical module or set of common basic indica-
tors of reliable and comparable data in asthma
and COPD);
o
Effectiveness of interventions and care organi-
zation;
•
Promote training in research, including opera-
tional research
Others:
•
Creation of a common electronic platform,
GARD in Portuguese, with areas of education /
training, research and health care;
•
Creation of an online “School of Respiratory
Health” and other training modules, with various
courses of varying length and for different audiences;
•
Promote the joint purchase of medicines, inhal-
ers, between countries through, for example, a co-
operation agreement for their joint purchase, as well
as the preparation of an equipment technical assis-
tance plan through cooperation agreements;
•
Active collaboration with GARDWHO website.
Formação