Cronic obstructive pulmonary disease is a major and increasing global health epidemic

Cronic obstructive pulmonary disease (COPD) is a major and increasing global health epidemic that has received insufficient attention from the health-care profession, governments, and the pharmaceutical industry, argues Professor Peter Barnes, one of the world's leading experts on lung disease.

The World Health Organization predicts that by 2030 COPD will be the world's fourth commonest cause of death, after heart disease, stroke, and AIDS, and the increase in deaths is predicted to be greater in developing countries than in affluent countries.

The neglect of COPD by clinicians, researchers, and drug companies, says Professor Barnes in his Essay in PLoS Medicine, "is largely because COPD is viewed as self-inflicted (by smoking) and also because the underlying disease process is generally perceived to be irreversible."

Smoking is not the only cause of COPD, he says, and yet there has been little research funding aimed at investigating other contributing factors, including genes and environmental toxins. "More research is needed into the underlying disease mechanisms, to identify the genetics of susceptibility and to identify new targets for treatment."

Attitudes towards COPD must change, says Professor Barnes. "The attitude that smoking-related lung diseases are self-induced and therefore less worthy of attention needs to be changed; this attitude does not appear to apply to the same extent to ischemic heart disease, diabetes, or obesity."