ABSTRACT
I. Introduction The setting up of consensus national guidelines, later culminating in the setting up of the global initiative for asthma (GINA) in collaboration with NHLBI and WHO, has probably been the most important progress in the management of asthma over the last two decades. These have helped to disseminate a uniform approach to asthma management nationally and internationally, and allow many sections of health care professionals and patients themselves to be involved in management of asthma. GINA has developed a global strategy for asthma management and prevention in 1995, with several revisions with a later update in 2007. It was the increasing concern about the worldwide increasing trends in morbidity and mortality of asthma that had triggered the establishment under the WHO of the GINA group that sets up a consensus-and evidenced-based set of guidelines for the management of asthma in 1989. The goals of asthma management were to control chronic and nocturnal symptoms, maintain normal activity, prevent acute episodes of asthma, minimize the need for reliever medication, maintain near-normal lung function, and avoid adverse effects of asthma medications. Key objectives of the document were that to improve outcomes of asthma worldwide the process of asthma care must be improved through education of both patient and carer. It was advocated that asthma management consists of an objective assessment, physician/ patient partnership, control of environmental influences, and pharmacological therapy.
