May is Asthma Awareness Month, an important opportunity to focus on the challenges faced by people living with asthma in South Africa, particularly those with severe and uncontrolled symptoms.
Asthma is one of the country’s most common chronic illnesses, affecting millions of adults and children. South Africa has one of the highest asthma-related death rates globally, with many patients struggling to access the care and treatment needed to manage their condition effectively.1 Although there have been advances in understanding asthma as a chronic, inflammatory disease, outdated management practices including reliever-only overuse that increases the risk of severe attacks and dependence on oral corticosteroids (OCS) is rife.2+6
Dr Dwayne Koot, Medical Manager at Sanofi South Africa, says: “We’re still seeing too many patients with severe asthma being maintained on oral corticosteroids that have been relegated to last resort in treatment guidelines.” This may ease symptoms, but the dose burden is cumulative, and long-term use is associated with serious side effects including osteoporosis, diabetes, and adrenal suppression. It’s critical that we support patients and healthcare providers in moving towards evidence-based care and aligning our funding policy to international best practice recommendations.2
Throughout May, medical experts and health organisations are highlighting the need for earlier diagnosis and improved treatment pathways. Patients with severe asthma and type 2 inflammation – thought to be the underlying cause in around 80% of cases3 – may also benefit from advanced biologic therapies, which have been shown to reduce attacks, improve lung function, and decrease reliance on OCS.4a+b
Recent research from the Severe Asthma Index 2025 continues to point to major gaps in the South African asthma care system. The index ranks South Africa below the global average in five key areas: policy context, access to care, health system characteristics, and environmental factors. These findings highlight the urgency of improving national asthma strategies and ensuring treatment guidelines are followed.5a
“Many patients still rely heavily on ‘reliever’ inhalers,” explains Dr Koot. “But these do not treat the inflammation that drives asthma. Regular use without accompanying inhaled corticosteroids (ICS) can allow the disease to worsen silently, potentially leading to life threatening events. Even people with mild asthma should be using an ICS inhaler (as a combination where available) as part of their management and guided by their healthcare professional.”2
This year’s global theme for Asthma Awareness Month is ‘Make inhaled treatment accessible for all’ and ‘Asthma care for all.’ “In South Africa, this message carries particular weight, as access and adherence remain major barriers to effective treatment,” Koot says. “Addressing these challenges requires not only clinical solutions but also policy reforms, better education, and support for both healthcare providers and patients.”
By promoting informed decision-making, reducing dependence on potentially harmful treatments such as oral corticosteroids, and improving access to current best practice, evidence-based therapies, healthcare leaders hope to shift the current state of asthma care in South Africa and improve long-term outcomes for patients.5b
For more information about asthma management and Sanofi’s commitment to respiratory health, please visit www.sanofi.co.za.
References:
1. The Global Asthma Report 2018. Available from: https://globalasthmareport.org/2018/management/southafrica.php
2. GINA 2025 Strategy Report: Global Strategy for Asthma Management and Prevention. Available from: https://ginasthma.org/wp-content/uploads/2025/05/GINA-Strategy-Report_2025-WEB-WMS.pdf
3. Patient Care Online. Role of Type 2 Inflammation in Asthma https://www.patientcareonline.com/view/role-of-type-2-inflammation-in-asthma
4. Haughney, J., Winders, T., Holmes, S. et al. A Charter to Fundamentally Change the Role of Oral Corticosteroids in the Management of Asthma. Adv Ther 40, 2577–2594 (2023). https://doi.org/10.1007/s12325-023-02479-0
5. Severe Asthma Index Expansion Report 2025. Available from: Severe_Asthma_Index_Expansion_Report_2025_afa09066dc.pdf
6. Kalla IS. The plight of the ‘asthmatic patient’ in South Africa – a subgroup analysis of the SABINA III study. Afr J Thorac Crit Care Med. 2022 Dec 19;28(4):10.
