American Journal of Respiratory and Critical Care Medicine

“I alone cannot change the world, but I can cast a stone across the waters to create many ripples.”

—Mother Teresa

Chronic respiratory disease is the leading cause of disability and death globally, and the figures are truly staggering:

Asthma affects more than 350 million people and is the most prevalent chronic illness of childhood worldwide.

Mild to moderate chronic obstructive pulmonary disease afflicts approximately 200 million and claims the lives of 3.2 million each year, making it the third leading cause of death globally.

Acute lower respiratory infections account for approximately 2.4 million deaths annually.

Lung cancer claims the lives of nearly 2 million people each year, making it the leading cause of cancer-related deaths (1).

Approximately 1.5 million tuberculosis-related deaths occur each year (2).

And millions more live with debilitating respiratory illnesses such as sleep-disordered breathing and occupational lung disease. Furthermore, respiratory-related health issues have been exacerbated by coronavirus disease (COVID-19). For example, in 2019, tuberculosis was responsible for 1.5 million deaths, making it the 10th leading cause of death worldwide. According to the World Health Organization’s 2021 Global Tuberculosis Report, the COVID-19 pandemic has unraveled years of global progress in tackling tuberculosis, as related deaths increased for the first time in more than 10 years because of health care and supply chain disruptions during the pandemic (2): indirect yet important factors to consider when reflecting on the current state of global lung health. Finally, climate change is starting to have unmistakable impacts on global lung health.

Although most chronic respiratory diseases are preventable and treatable, low- and middle-income countries carry a disproportionate burden of the global morbidity and mortality rates. According to the World Health Organization, there is a strong correlation between chronic respiratory diseases and poverty. Chronic respiratory diseases contribute to complex multimorbidities, and lower track respiratory infections, chronic obstructive pulmonary disease, and tuberculosis are among the top 10 leading causes of death in low- and middle-income countries. Limited access to health education, health and screening services, and vaccines, as well as low literacy rates and greater exposure to harmful environmental toxins, are major obstacles to appropriate health care delivery in these countries.

With more than 15,000 members representing 130 countries, the American Thoracic Society (ATS) has a broad international reach and platform to help level the global lung health landscape and advance our mission “to accelerate global innovation in the advancement of respiratory health through multidisciplinary collaboration, education, and advocacy.” On September 25, World Lung Day, the ATS will join our Forum of International Respiratory Societies (FIRS) partners to help focus on these global health disparities. This day is an important reminder of the need to elevate the importance of lung health and disease awareness and our responsibility to engage in advocacy and action that will affect future generations.

As an international society, we provide members with opportunities to get involved locally and collaborate globally with researchers, academicians, and public health professionals to champion change, as outlined below.

It only takes a spark to light a fire, one person to inspire countless others. Philip Hopewell, M.D., exemplifies this very notion. His lifelong service to patients and extraordinary contributions to the medical research community continue to inspire investigators worldwide. The Philip Hopewell Prize for Global Respiratory Health Research, established in his honor, provides support to midcareer investigators in low- and middle-income countries and nurtures them to become established leaders in global respiratory health research, a prime example of how one’s dedication to improving lung health can create a legacy that will continue to motivate others to combat health disparities and affect change on a global scale.

As philosopher Thomas Hobbes said, “scientia potentia est”: knowledge is power. Through the pursuit of knowledge and the advancement of research, we make great strides in improving global health. For nearly 30 years, the ATS MECOR Program has worked to develop lung disease research in low- and middle-income countries at the local and regional levels. To date, more than 1,800 graduates have participated in the program’s worldwide network of multilevel research methods and training courses, which prepare them to design and conduct research relevant to the needs of the settings in which they work.

Investing in the future is essential to maintaining momentum in lung health research, identifying health disparities, and improving patient care for all. With ATS International Trainee Scholarships, we can grant financial support to trainees around the world; connect them with fellow trainees, scientists, and mentors in their areas of research; and provide access to state-of-the-art clinical research. Trainees can also travel to the ATS International Conference to present their research to respiratory health professionals from abroad.

The ATS community is in an ideal position to influence change and help shape global health policy through advocacy for international programs. For nearly a decade, ATS members have traveled to Capitol Hill in Washington, DC, for the Annual ATS Hill Day, where they gain insight on key issues and advocate for lung health at all federal government levels. From the executive branch to Congress and the courts, our members advocate for global health care on behalf of physicians, scientists, health professionals, and, of course, the patients they serve.

Through our partnership with FIRS, collaborations with peer societies on joint webinars addressing challenges and opportunities in lung health, the dissemination of research via our four scientific journals, and knowledge sharing at the ATS International Conference, the ATS is committed to doing its part to address disparities, close the health care gap, and improve lung health for all.

On this World Lung Day, we invite and encourage each of you to do your part: explore the vast resources provided by the ATS, FIRS, the World Health Organization, and our peer societies; participate in learning opportunities; be a mentor; reach out to colleagues and join the conversation; advocate for health equity; and take every opportunity to get involved. When we work together, the potential for positive change is limitless.

To learn more about ATS initiatives and how you can get involved, visit the ATS website. Also, be sure to follow the conversation on social media.

1. Forum of International Respiratory Societies. The global impact of respiratory disease, 3rd ed. Lausanne, Switzerland: European Respiratory Society; 2021 [accessed 2021 Sep 22]. Available from:
2. World Health Organization. Tuberculosis. Geneva, Switzerland: World Health Organization; 2021 [updated 2021 Oct 14; accessed 2022 Jul 12]. Available from:

Supported by NIH/NCATS (UH3TR002445, R01HL132950, R01HL157424), and Department of Defense (PR150109 and PR201498) (G.P.D.); NIH/NCI (R01CA251686-01, 01CA2120101A1) and StandUp2 Cancer (M.P.R.); NIH R01 HL133751/HL/NHLBI NIH HHS (L.S.); NHLBI (R01HL077328, RO1HL144396), DOD (W81XWH2210255), ALA (COVID-ETRA 736704), and the Wollowick Chair of COPD Research, Department of Medicine, National Jewish Health (I.P.); NIH (RO1HL147088 and P500AA024337), Sarcoidosis Foundation, and industry sponsored clinical trials on IPF (J.R.).

Author disclosures are available with the text of this article at


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American Journal of Respiratory and Critical Care Medicine

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