Lung Facts: a practical tool to strengthen respiratory advocacy in Europe

Abstract

Respiratory diseases remain a leading health burden across Europe, yet national strategies are often fragmented or absent. The International Respiratory Coalition's Lung Facts platform offers a comprehensive, up-to-date resource for epidemiological and economic data for major respiratory conditions across 53 European countries. This viewpoint outlines the platform's development and the types of data available, including disease burden, societal costs and risk factor attribution. It also demonstrates how national coalitions are using it to advocate for respiratory health policies. By providing accessible, country-specific information in visual formats, Lung Facts supports benchmarking, evidence-based advocacy and planning of national respiratory strategies. The platform is a dynamic tool intended to strengthen respiratory health policy and empower stakeholders to act on the growing burden of lung disease.

Shareable abstract

Lung Facts provides up-to-date data on respiratory disease across Europe, empowering national coalitions to benchmark, advocate and plan effective respiratory health strategies. https://bit.ly/4rnjnTw

Introduction

Respiratory disease remains one of the highest burdens of healthcare in Europe. Despite this, national respiratory plans or policies remain fragmented, intermittent or absent in many countries when compared with other non-communicable diseases. The International Respiratory Coalition (IRC; www.international-respiratory-coalition.org) was developed to bridge this gap. The IRC aims to support organisations within countries to come together to advocate for national respiratory strategies through coalitions of clinical societies, researchers, patient organisations and others.

A key gap identified by the IRC was the lack of easy-to-use epidemiological and economic data for major respiratory conditions by country across the World Health Organization (WHO) European region. Within health policy, country comparisons and health economic estimators are essential to drive and monitor change.

The data

Lung Facts (https://international-respiratory-coalition.org/lung-facts) brings together epidemiological and health system metrics for the major respiratory diseases in the WHO European region's 53 countries.

Data from the Global Burden of Disease (GBD) study were used for several conditions [1], including asthma, COPD, mesothelioma, lower respiratory tract infections (LRTIs), lung cancer, interstitial lung disease (ILD), COVID-19, pulmonary arterial hypertension (PAH) and tuberculosis (TB). Lung Facts presents the incidence, prevalence, mortality, disability-adjusted life years (DALYs) (figure 1) and years of life lost (YLL) for these conditions, along with the societal cost (in the form of monetised DALYs) for each condition. This societal cost presents the economic value of healthy years lost because of a condition (figure 2). It can be used as a reference point to suggest an amount which could be invested in respiratory healthcare based on the equivalent potential societal cost of the lung condition burden.

FIGURE 1.

Disability-adjusted life years (DALYs) are a measure combining length of life and quality of life. They total the number of years lost due to ill health, disability or early death due to a specific condition.

FIGURE 2.

Lung Facts societal cost. DALY: disability-adjusted life years; PPP: purchasing power parity; GDP: gross domestic product. ^#: The benchmarked societal cost is presented in Lung Facts in international dollars (Int$), Euros and countries' own currency for the year 2022 (Int$2022) based on PPP. PPP is a theory which states that exchange rates between currencies are in equilibrium when their purchasing power is the same. As such, PPP-adjusted figures represented by Int$ allows for a better comparison overtime. ^¶: Find out more about how the societal cost is calculated in [6]. ⁺: The figures presented may not directly add up due to rounding calculation differences in the data.

As well as being organised by disease area, the GBD-sourced data is also presented by country so that national-level stakeholders can access the information, in their own language and currency, to understand the burden in their national context.

A spotlight is also put on paediatric health by providing age-grouped data for major childhood conditions, including asthma, COVID-19, ILD, LRTIs and TB. This supports the planning of child-focused respiratory strategies, highlighting the importance of early-life prevention for future lung health.

Lung Facts also utilises risk factor attributable data from the GBD study. These figures estimate the proportion of DALYs for a given disease that would not have occurred if the risk factor had been eliminated. For conditions such as asthma, COPD, lung cancer, LRTIs and TB, the tool presents risk factor attribution by sex for specific risk factors including smoking, ambient particulate matter, ozone, occupational exposures and high body mass index (BMI).

For other respiratory conditions, not available in the GBD study, data were sourced by carrying out systematic reviews, covering the available epidemiological data on alpha-1 antitrypsin deficiency (AATD), bronchiectasis, cystic fibrosis (CF), influenza and obstructive sleep apnoea (OSA) [2]. These data are also presented within the disease section of the Lung Facts website, alongside the GBD study data, addressing the challenges of accessing data for diseases that are not covered by GBD.

All data are easily accessible and presented in easy-to-use formats, such as maps, graphs and charts, which can be downloaded directly from the IRC website (figure 3). Data will be maintained on a 2-year cycle and regularly kept up-to-date as a reliable “go to” resource.

FIGURE 3.

An example map from Lung Facts showing the mortality rate for asthma. WHO: World Health Organization.

How national coalitions are using Lung Facts

Following the launch of Lung Facts, national coalitions were invited to use it. Data can be used in three clear ways:

• to demonstrate the problem (the burden);

• to provide comparative benchmarking (seeing which countries are doing something well and less well) and;

• to provide suggested actions (the societal cost provides an amount which could be invested in respiratory health).

This has happened with success in many of the coalition countries.

The Belgian Respiratory Coalition

The Belgian Respiratory Society (BeRS) and the Belgian Lung Foundation (BeLF) have established collaborations with different patient organisations, healthcare organisations, and entities active in disease prevention, environmental protection and education. The Belgian Respiratory Coalition is actively working on the development a national chronic respiratory diseases plan, awareness creation for respiratory health and the implementation of an educational initiative about vaping prevention in schools. The coalition has initiated several awareness events, for example, participation in the annual 20 km run/walk of Brussels, which includes an information stand to bring visibility and awareness to the coalition and to their initiatives. The Lung Facts data are used in many of their presentations and activities, including a BeLF brochure that is available on paper and online [3].

In November 2025, the coalition held an awareness event in Schaarbeek (Brussels, Belgium) on World COPD Day for the general public, with a focus on patients, families and kids, called “World COPD Day 2025: Jump abroad the respiratory train” [4]. The presentation for the public and the display panels for the kids' area contained data from Lung Facts. A separate scientific forum held on the same day entitled “COPD in Belgium – Scientific update and next steps” also referenced the Lung Facts data during the presentations.

The French Coalition

The French Coalition was established in 2021 as the “Collective of the General Estates for Respiratory Health”. In February 2024, the 26 members of the Coalition decided to unite under the single banner of the French Collective “Right to Breathe”. This new association pursues the same objectives: to promote respiratory health as a public heath priority and obtain a true national respiratory health plan. The association has gathered stakeholders and continues to raise awareness among policy- and decision-makers to promote respiratory health. The coalition's persistent advocacy has had success in achieving policy advances in the areas of prevention and physical health, specifically the inclusion of spirometry in preventative check-ups and the promotion of physical activity. The collective is currently focusing on the implementation of a national respiratory health plan.

To support the French collective's initiatives, the Lung Facts data were used in the IRC presentation in October 2025 during a parliamentary event “Colloque du Collectif Droit à Respirer” in Paris, France in order to demonstrate the need for change.

The Polish Healthy Lungs Coalition

The Polish Healthy Lungs Coalition was established by the Polish Respiratory Society (PRS) in December 2022. The coalition was formed in response to the urgent need to improve the availability and quality of lung disease diagnosis in Poland. Its goal is to support the creation of a Polish pulmonary strategy focusing on three areas: improving care for patients suffering from chronic respiratory diseases, improving lung health in the context of (post-)pandemic challenges, and raising awareness about challenges related to respiratory health.

In September 2025, the Polish Healthy Lungs Coalition along with the PRS used the Lung Facts data in the creation of a key document titled a “Manifesto for Healthy Lungs”. The Lung Facts data contributed to a parliamentary group discussion resulting in a call to action for decision-makers in Poland to take urgent action. An important outcome of these meetings was the signing of a “Letter of Intent” between the WHO and the PRS, marking their commitment to jointly combat lung diseases and improve respiratory health. The Lung Facts data also helped to emphasise the coalition's goal of demonstrating that Poland is not alone and is part of a global movement for more joint action to combat respiratory disease [5].

Consulta della Pneumologia (Italy)

The Italian coalition, the Consulta della Pneumologia, was founded in 2017 by AIPO-ITS/ETS and later added the scientific society SIP/IRS, together with patient associations (https://www.consultapneumologia.it/). Its mission is to bring together all organisations involved in respiratory health in Italy by creating a shared platform that aligns clinical, scientific and patient perspectives within a unified framework.

The coalition works towards a common goal: addressing the increasingly significant and growing needs of individuals living with respiratory diseases. The Consulta della Pneumologia focuses on three closely interconnected priority areas. The first is prevention, understood as both reducing exposure to risk factors and promoting early interventions capable of limiting the onset or progression of respiratory conditions. The second is improving early diagnosis, ensuring that respiratory diseases can be identified sooner, managed more effectively, and treated before they lead to complications or substantial deteriorations in quality of life. The third is guaranteeing innovative and equitable care for all; namely, access to appropriate, up-to-date treatments and care pathways that are consistent across different regions and patient groups.

To support its activities, the Consulta della Pneumologia uses the Lung Facts data as an evidence base to strengthen its initiatives and communications. The use of reliable data and statistics enables the coalition to describe the burden of respiratory diseases, highlight unmet needs, and support the identification of priorities in prevention, diagnosis and care, fostering a more informed dialogue among all stakeholders involved in respiratory health in Italy.

The Ukrainian Respiratory Coalition

The Ukrainian Respiratory Coalition (URC) was established in 2024 to improve lung health for Ukrainian citizens. URC has actively used the IRC Lung Facts tool to strengthen advocacy, education and stakeholder engagement. The visual presentation of disease burden and international comparisons has provided a solid evidence base for discussions with clinicians, policymakers and patient organisations.

A notable example was a patient–clinician conference, titled “Diagnosis and treatment of pulmonary hypertension in Ukraine and abroad: experience of doctors and patients”, held in Lviv in December 2024. A presentation on the newly established IRC was delivered by Oksana Viltsaniuk, a pulmonologist and associate professor at Vinnytsia National Medical University. Lung Facts data were used to illustrate the burden of respiratory diseases in Ukraine and the need for early diagnosis, coordinated care and national-level collaboration. The event gathered patients, clinicians, non-governmental organisations, international experts, and health authorities (https://www.facebook.com/share/p/1K3YTFujMr/).

How to use Lung Facts

Lung Facts is designed to empower those who advocate for lung health at the international and national levels, by providing an easy-to-access evidence base (figure 4). It will continue to evolve and update with new GBD iterations and when more systematic reviews become available.

FIGURE 4.

An example of how a country might use the benchmarked societal cost. WHO: World Health Organization; DALY: disability-adjusted life years; GDP: gross domestic product.

Other papers have been published outlining the methodological details of the systematic reviews [2], the methodology of the societal costs calculations [6] and an editorial placing Lung Facts in the broader respiratory policy context [7].

This article accompanies these publications providing practical steps for using the Lung Facts resource. The intent of the IRC is for Lung Facts to form a core part of respiratory policy discussions across Europe. The key message for readers to take-away is: this resource exists, it is free, and it is there for you to use.

Self-evaluation questions

1. What is the primary purpose of Lung Facts?

   1. To provide a detailed narrative for respiratory diseases
   2. To replicate the content of the European Respiratory Society White Book
   3. To offer concise, visualised epidemiological data on respiratory disease to support advocacy and policy discussions
2. Which of the following types of data are presented in Lung Facts for diseases included in the GBD study?

   1. Incidence, prevalence, mortality, DALYs, YLL and societal cost
   2. Treatment effectiveness
   3. Patient-reported outcomes
   4. Clinical guideline recommendations
3. How does Lung Facts address respiratory diseases that are not included in the GBD framework?

   1. These diseases are excluded from the website
   2. Only narrative descriptions are provided
   3. Epidemiological data are sourced through systematic literature reviews
4. What is the main rationale for presenting “societal cost” as monetised DALYs within Lung Facts?

   1. To estimate hospital expenditure on respiratory diseases
   2. To illustrate the economic value of healthy life years lost and inform potential levels of investment in respiratory health
   3. To predict future healthcare needs

Suggested answers

1. c.

2. a.

3. c.

4. b.