•Taiwo Olusegun
As the world marked World Asthma Day 2026, the release of the Global Asthma Report 2026 has cast a spotlight on the growing burden of asthma in Nigeria, where an estimated thirteen million people live with the chronic respiratory condition.
The report, authored by five Nigerian researchers – Gregory E. Erhabor, Bilkisu Ilah Garba, Feyisara M. Kehinde, Olufemi O. Adewole and Olayemi Fehintola – underscores the scale of the challenge and the urgent need for reforms in diagnosis, treatment, and access to essential medicines, reports Daily Independent.
The global report, themed “Access to anti‑inflammatory inhalers for everyone with asthma – still an urgent need”, highlights common challenges across countries: shortages of trained health workers, limited diagnostic tools, and poor availability and affordability of inhaled medicines.
For Nigeria, these challenges are compounded by environmental pollution, weak infrastructure, and limited health insurance coverage, leaving millions of patients struggling to control their symptoms.
Nigeria’s Asthma Burden
Asthma is described by the Nigerian researchers as a common chronic respiratory condition affecting children, adolescents, and adults.
A nationwide survey reported physician‑diagnosed asthma at 2.5 per cent, clinical asthma at 6.4 percent, and wheeze at 9.0 percent. Prevalence increases with age, rising from 3.1 percent among those aged 6 – 17 years to 10.7 percent in those over 45 years.
Despite this widespread impact, asthma control remains sub‑optimal: only six to eight percent of patients achieve well‑controlled status in population studies, and up to 25 percent in hospital settings.
Determinants of asthma in Nigeria include allergic rhinitis, viral infections, family history, and increasing exposure to environmental pollution.
Air quality in urban centres, particularly Lagos, continues to deteriorate, exacerbating symptoms and contributing to new cases.
Diagnosis Challenges
Asthma diagnosis in Nigeria follows international recommendations and the Nigerian Thoracic Society guidelines, relying on characteristic symptoms such as recurrent wheeze, cough, chest tightness, and breathlessness.
Spirometry is the preferred diagnostic tool, but its use is limited by cost, availability, and the need for trained personnel. As a result, peak expiratory flow measurement is more commonly used, though its limited sensitivity and dependence on patient technique often lead to underdiagnosis and inadequate treatment.
Management And Treatment
Management of asthma in Nigeria is guided by the Global Initiative for Asthma (GINA) and national guidelines, emphasising inhaled corticosteroids (ICS) and ICS–LABA combinations. Education on self‑care management has become more prominent in tertiary centres, improving outcomes for some patients.
However, national essential medicines lists are not fully aligned with World Health Organisation (WHO) recommendations, and adherence is constrained by the unavailability and unaffordability of inhalers. Many patients rely on oral bronchodilators and corticosteroids, which contribute to worsening morbidity and mortality.
Access To Vaccines
Vaccines play a role in reducing infection‑related exacerbations. The pneumococcal conjugate vaccine is included in Nigeria’s routine immunisation programme for children and is widely available in public health facilities.
For adults, the pneumococcal vaccine is typically accessed through out‑of‑pocket payment. The influenza vaccine is not part of the routine schedule but is available in some private hospitals and pharmacies, mainly in urban areas. COVID‑19 vaccines are accessible through both public and private channels.
Key Challenges
The Nigerian report paints a sobering picture of the obstacles facing patients and health professionals alike. Access to essential inhaled medicines remains limited, particularly in public facilities, where shortages are common and affordability is a major barrier.
Patients in rural areas often face even greater difficulties, with treatment options concentrated in urban centres and private hospitals.
This uneven distribution of care has created stark regional disparities, leaving many without reliable access to life‑saving therapies.
Equally concerning is the low level of implementation of guideline‑based care. While international and national recommendations exist, weak infrastructure and limited awareness among caregivers mean that many patients do not receive the standard of care required to manage their condition effectively.
Follow‑up is often inadequate, and adherence to treatment regimens is poor, further undermining outcomes.
Diagnostic capacity is another critical challenge. Spirometry, the gold standard for diagnosis, is rarely available outside major hospitals, and peak flow measurement, though more accessible, is prone to inaccuracies. This lack of reliable diagnostic tools contributes to underdiagnosis and mismanagement, with consequences that ripple through families and communities.
Children miss school, adults lose workdays, and households face mounting financial strain as they struggle to cope with the demands of chronic illness.
Hopes For The Future
Despite these difficulties, the report offers cautious optimism. Nigeria has seen a gradual increase in the number of chest physicians over the past two decades, a development that has strengthened specialist care and improved awareness of guideline‑based management. Training programmes have expanded, and tertiary centres are beginning to integrate self‑care education into routine practice, empowering patients to take greater control of their condition.
The researchers argue that the future of asthma care in Nigeria depends on decisive action in several areas. Strengthening access to medicines is paramount.
They call for the inclusion of asthma medicines in the National Essential Medicines List and for partnerships with pharmaceutical companies and international organisations to ensure affordability.
Expanding health insurance coverage is another priority, with greater resource allocation needed to support the management of chronic lung diseases.
Continuous review of guidelines and sustained training of healthcare providers will be essential to keep pace with evolving best practice, while early identification of severe asthma cases could help prevent avoidable deaths.
These measures, if implemented, could transform the landscape of asthma care in Nigeria, offering millions of patients the chance to breathe more easily and live fuller lives.
The Global Context
The Global Asthma Report 2026 situates Nigeria’s challenges within a wider international struggle.
Across many countries, shortages of trained health workers, limited diagnostic tools, and poor availability of inhaled medicines remain barriers to effective care. Air pollution is identified as a major concern globally, both as a cause of new cases and as a trigger for exacerbations.
Dr Sarah Rylance, Lead for Chronic Respiratory Diseases at the World Health Organisation, notes that while high‑level commitments have been made — including a World Health Assembly resolution on integrated lung health in May 2025 and a United Nations political declaration on noncommunicable diseases in September 2025 — these must be translated into concrete action at country level.
Effective implementation is essential to improve outcomes for patients, families, and communities.
Patient Stories And Human Impact
The Global Asthma Network has introduced GAR: Patient Stories, a special edition that gives people with asthma worldwide a platform to share their experiences. With 59 stories from 33 countries, the collection highlights the lived realities of asthma and the urgent need for equity in care. These narratives underscore the importance of timely diagnosis, evidence‑based treatment, education, and long‑term support.
They also serve as reminders that even in moments of breathlessness, families and individuals hold on to hope for a better tomorrow.
For Taiwo Olusegun, an Animal Scientist, asthma first revealed itself during his mandatory industrial training at a poultry farm. He recalls the onset of breathing difficulties, which led to a medical diagnosis and the prescription of salbutamol. Doctors advised him to avoid dusty environments such as poultry houses, goat units and feed mills – a near‑impossible task given his profession. “Exposure to these environments is part of my core discipline,” he explains. Regular clinic visits provided guidance on managing the condition while continuing his career. Over time, his treatment shifted from salbutamol alone to budesonide‑formoterol, a combination that significantly improved his health and reduced the frequency of attacks. Yet the financial burden remains considerable. “Guideline‑based therapy improves outcomes, but cost is a barrier,” Olusegun says, highlighting the tension between professional demands and the realities of chronic disease management.
Call To Action
The report concludes with a clear message: now is the time for governments, health leaders, and partners to act decisively. Investment in asthma care and lung health is essential to ensure that political commitments deliver real change.
For Nigeria, this means aligning essential medicines lists with global recommendations, expanding insurance coverage, and strengthening diagnostic and management capacity.
With an estimated thirteen million Nigerians living with asthma, the scale of the public health challenge is significant. The Global Asthma Report 2026 indicates that without improvements in access to medicines, diagnostic capacity, and health system support, the burden will remain high. Evidence from both national and international studies suggests that coordinated policy measures, wider availability of affordable inhalers, and stronger infrastructure could help reduce the impact of the disease.
The extent to which these measures are adopted will shape Nigeria’s ability to manage asthma more effectively and lessen its social and economic consequences.
