Asthma Care in Resource-Limited Settings: Closing the Treatment Gap Through Access, Innovation, and Action

Asthma is one of the most common chronic diseases worldwide, yet its burden falls most heavily on people living in low- and middle-income countries (LMICs), where the majority of asthma-related deaths occur. This inequity is driven largely by systemic barriers: the limited availability and frequent unaffordability of inhaled corticosteroids, weak primary care infrastructure, diagnostic gaps, over-reliance on reliever medication and oral steroids, and environmental exposures that worsen disease. The result is a striking paradox, because the tools needed to control asthma are relatively inexpensive and effective, yet they fail to reach those who need them most. This editorial reflects on the principal challenges facing asthma care in resource-limited settings, considers emerging innovations that offer reasons for optimism, and outlines priorities for the future. Promising developments include simplified treatment strategies that combine controller and reliever therapy, pooled procurement to lower medicine prices, task-shifting that extends care to nurses and community health workers, integration of asthma management into existing primary care platforms, and digital health tools that support adherence and remote follow-up. Their feasibility varies across settings and depends on adequate training, supervision, and infrastructure. Closing the treatment gap will require simultaneous action on medicine access, health-system strengthening, locally adapted guidelines, and greater political attention to chronic respiratory disease, which is intensifying as climate change worsens air quality and lengthens allergy seasons. Equitable asthma care is not an aspiration beyond our means but a deliverable goal that demands sustained commitment from clinicians, policymakers, and the wider health community.