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Preface 

Asthma is a serious global health problem affecting all age groups. Its prevalence is increasing in many countries, especially among children. Although some countries have seen a decline in hospitalizations and deaths from asthma, asthma still imposes an unacceptable burden on health care systems, and on society through loss of productivity in the workplace and, especially for pediatric asthma, disruption to the family. 

The Global Initiative for Asthma was established in 1993 by the National Heart, Lung, and Blood Institute and the World Health Organization, with the aim of increasing awareness about asthma and providing a mechanism to translate scientific evidence into improved asthma care worldwide. In 2001, GINA initiated an annual World Asthma Day, raising awareness about the burden of asthma, and becoming a focus for local and national activities to educate families and health care professionals about effective methods to manage and control asthma. GINA’s flagship publication, the Global Strategy for Asthma Management and Prevention (‘GINA report’), first published in 1995, has been updated annually since 2002, with pivotal changes in 2006, 2014 and 2019. The main GINA report contains recommendations for clinical practice and brief supporting evidence, while additional resources and supporting material are provided online at www.ginasthma.org. Publications and resources based on the GINA reports have been translated into many languages. GINA is independent of industry. Its work is supported only by income generated from the sale and licensing of its resources. 

We acknowledge the superlative work of all who have contributed to the success of the GINA program, and the many people who have participated in it. In particular, we recognize the outstanding and dedicated work of Drs Suzanne Hurd as Scientific Director and Claude Lenfant as Executive Director over the many years since GINA was first established, until their retirement in 2015. Through their tireless contributions, Dr Hurd and Dr Lenfant fostered and facilitated the development of GINA. In 2016, we were delighted to welcome Ms Rebecca Decker, BS, MSJ, as the Program Director (now Executive Director) for GINA, and we appreciate the commitment and skills that she has brought to this demanding role. The members of the GINA Committees are solely responsible for the statements and conclusions presented in this publication. They receive no honoraria or reimbursement of expenses for their many hours of work in reviewing evidence or attending meetings. The GINA Advocates and Assembly, dedicated asthma care experts from many countries, work with the Science Committee, the Board of Directors and the Dissemination and Implementation Committee to promote international collaboration and dissemination of information about asthma. 

We share the sadness that the global asthma community feels at the loss of Mark FitzGerald (18 June 1955-18 January 2022). In his 25 years of work with GINA, Mark was a compassionate leader and strong advocate for improving asthma diagnosis and management. Mark’s guidance will be missed dearly but his research, legacy, and commitment to helping the world breathe better remain a guiding force. In Mark’s honor, GINA is establishing a scholarship for junior researchers from low- or middle-income countries. 

In spite of all of the above efforts, and the availability of effective therapies, international data provide ongoing evidence for suboptimal asthma control in many countries. The majority of the burden of asthma morbidity and mortality occurs in low- and middle-income countries, and is avoidable. It is clear that if recommendations contained within this report are to improve care of people with asthma, every effort must be made to encourage health care leaders to assure availability of, and access to, effective quality-assured medications, and to develop means to implement and evaluate effective asthma management programs. 

We hope you find this report to be a useful resource in the management of asthma and that, in using it, you will recognize the need to individualize the care of each and every asthma patient you see.

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