Opinion: Why we still don’t have a National Lung Health Strategy

Canada needs a strategy for chronic obstructive pulmonary disease and asthma with integrated surveillance systems, improved access to care, and targeted programs to reduce hospitalizations.

Around the world, governments are moving with urgency to confront the escalating crisis of chronic disease. The recent United Nations Declaration on Non-Communicable Diseases is more than a statement of intent. It’s a global directive to act to prevent illness before it starts, build environments that sustain health, and guarantee equitable access to care.

Consensus at the international level is never easy, yet the path forward is unmistakable. Nations that act boldly will not only save lives, but also strengthen their economies. For Canada, this is a moment to lead, particularly in respiratory health—one of the country’s most overlooked yet fixable public health failures.

Two million Canadians live with chronic obstructive pulmonary disease (COPD), and another 4.6 million with asthma. Millions remain undiagnosed, their conditions quietly worsening. These aren’t statistics; they’re our parents, children, neighbours, and colleagues. They’re the people who keep our economy moving and our communities thriving. They deserve to breathe freely.

The Fourth UN High-Level Meeting on Non-Communicable Diseases (NCD) and Mental Health concluded negotiations on a draft political declaration, which was transmitted to the UN General Assembly for consideration and adoption this past in October. It was not adopted during that meeting; when approved, it will serve as a global framework to accelerate NCD prevention, strengthen primary health care, and ensure equitable access to services.

COPD is now the second most common reason for hospitalization in Canada, accounting for 2.5 per cent of admissions. Adults aged 65 and older make up the largest affected group, but we’re seeing a growing demographic of younger Canadians. Globally, COPD affects approximately 392 million people and caused 3.4 million deaths in 2023. Asthma affected about 263 million people, and caused 444,000 deaths in 2023.

Annual direct and indirect costs of COPD care for Canadians range between approximately $1.5 to $4-billion. By 2030, the economic burden of COPD is estimated to be $9.5-billion.

Global targets have been set. This aligns with the 78th World Health Assembly’s Resolution on Integrated Lung Health, which calls for stronger prevention, early detection, and quality primary care for asthma and COPD alongside action on tobacco and air pollution.

While many high-income nations have implemented co-ordinated national lung health strategies, Canada has yet to do so—a gap that presents both an urgent challenge and an opportunity for leadership.

This country’s leading lung health advocates, clinicians, researchers, and patients with chronic lung conditions gathered in Ottawa last month to advance three simple but powerful priorities that put these global commitments in motion, impacting millions of Canadians and nearly a billion people worldwide. Each aligns directly with UN and World Health Organization objectives. Each is practical, measurable, and ready to go.

Led by the Lung Health Foundation, Canada’s largest charity dedicated to lung health, and Secretariat of the National Lung Health Alliance, the country’s principal advocacy network, these meetings with MPs and policymakers delivered a clear message: inaction on lung health is no longer a sustainable path forward. Canadians struggling to breathe cannot wait another minute for the leadership their health deserves.

Canada supported the UN declaration when it launched, aligning itself with nations committed to evidence-based health policy. Yet today, Canada remains one of the few developed countries without a national lung health strategy. No province or territory has a co-ordinated plan to reduce the burden of COPD and asthma. The result? Lost opportunities for better health, lower health-care costs, and stronger communities.

To meet the global targets and honour our commitment to the UN Declaration, Canada must act on three priorities:

First, we must end youth nicotine addiction. This country must apply cigarette-level regulations to vaping products, banning flavours that lure teenagers, prohibiting sponsorships and targeted marketing, and enforcing restrictions that reflect the seriousness of nicotine addictions, among the most insidious of all addictive substances. Protecting young lungs is both a public health imperative and a moral obligation.

Second, we must introduce a Healthy Homes Tax Credit to help families reduce radon exposure and improve indoor air quality. Canadians spend up to 90 per cent of their time indoors. The air we breathe inside our homes, schools and workplaces should help us stay well, not make us sick.

Third, we must lead globally by developing a co-ordinated national strategy for COPD and asthma with integrated surveillance systems, improved access to care, and targeted programs to reduce hospitalizations. This strategy would guarantee equitable respiratory care for all Canadians, including those in federal care jurisdictions.

These are not radical ideas. They’re proven, evidence-based solutions that can be implemented today. Health policy is nation-building policy. A healthy nation begins with healthy lungs.

Politics and finger-pointing will not solve this crisis. Determined action will. The UN framework provides the route, and Canada simply needs to take it.

Canada has long seen itself as a global health leader. It’s time to live up to that promise.