Lung health in LMICs: tackling challenges ahead

Jamilah Meghji and colleagues1 deliver a welcome wake-up call about chronic respiratory diseases in stretched health systems. However, the proposed solutions in their Review could be strengthened by a preventive approach addressing crucial contributors of chronic respiratory diseases. In short, we expected a stronger plea for clean air to improve lung health in low-income and middle-income countries (LMICs).
Although air pollution contributes substantially to the burden of cardiorespiratory diseases in LMICs,2 the Review barely evokes the high amounts of urban air pollution in LMICs3 and the urgent need to reduce emissions from anthropogenic sources. Meghji and colleagues acknowledge the adverse effects of exposure to biomass smoke, but they temper these effects because of the limited success of clean stove trials. However, these largely unsuccessful trials do not imply that biomass smoke is harmless for the lungs.4