Ms Sharon Cosgrove:

Yes, I will start. Asthma is the biggest chronic disease that affects the largest number of the population in this country. We estimate that 470,000 people have asthma. The Asthma Society of Ireland has been in operation for approximately 40 years. It represents people with asthma and provides information, education and services. As Dr. McKone said, one of the biggest challenges we have is education for patients, but also we try to advocate on their behalf to have the best possible treatment and guideline-based care in public policy and the health service.

We have an advice line and we deal with 2,000 patients every year. We also hold clinics. We do what we can with the limited resources available to us. We have no statutory funding for our core services for patients. I wished to raise that point at the beginning. A total of 470,000 in the country have asthma. The incidence is the fourth highest in the world. People with asthma are the largest chronic disease group in the country. One in ten people has asthma but the incidence among children is one in five. It is an enormous issue from the point of view of the children and paediatric health.

Asthma is not curable. It is a condition of the lungs which can be controlled and managed with correct medication and patient education. A tragic statistic is that one person per week dies of asthma in this country. A number of those are young people. We have contact from schools and parents concerning children who have lost friends to asthma. Children have died who have been involved in sports days or have been playing football. They were unable to catch their breath properly and have had an asthma attack and, regrettably, they have died. The deaths are preventable, in particular in young people. We are keen to advocate for a comprehensive programme to be implemented to deal with the issue.

Asthma is one of the chronic conditions whereby 85% of those affected can be effectively managed in the main in primary care. The remainder need more secondary care treatment and must be referred to consultants and in the hospital environment. A number of patients require both types of treatment. A total of 20,000 people attend accident and emergency services every year due to an asthma attack or exacerbation. The average length of stay is three days. A total of 50,000 require emergency nebulisation. On average, adults with asthma miss 12 days per year from work and children miss 12 days from school. That has an impact on the education of children and their participation in sports and in regular, everyday activities. Children relate their experiences of playing sports and running and not being able to catch their breath or participate in the same way as other children. Those with asthma are affected in their daily lives in basic activities such as walking up the stairs or running for a bus.

From a public policy viewpoint we seek that the national asthma programme adopted by the Government in 2011 would be implemented. There is a Government drive to implement the programme and we must have impetus behind it to get it through and to ensure the resources are available at primary and secondary care level to address the problems. Xolair is a medication which Dr. Elnazir can explain in more detail. It is intended for severe asthma patients. Access to it is inequitable. It is not covered by any of the reimbursement schemes and it is identified in the global initiative for asthma, GINA, guidelines as the appropriate treatment for the most severe allergic asthma patients. The two main points we wish to pursue today are the implementation of the programme and action to address the inequity of treatment. I spoke to a consultant yesterday who has 40 patients in Cork University Hospital who cannot get access to the drug for his patients who badly need it.