Chronic Respiratory Diseases: The Health Crisis That Barely Makes the News

Chronic respiratory diseases kill approximately 3.5 million people every year. That figure rivals the annual toll of many conditions that command far greater funding, policy attention, and public concern. Yet asthma and COPD remain, in the words of José Luis Castro, WHO Director General Special Envoy for Chronic Respiratory Diseases, “the Cinderella of public health.”

In February, Castro joined Simon Jones on the Air Quality Matters podcast to make the case for why this needs to change. The conversation is worth listening to in full. Some of the scientific points raised deserve particular attention.

Lung damage begins long before diagnosis

One of the clearest arguments against treating COPD as a lifestyle disease is the timeline. Respiratory damage frequently begins in childhood, shaped by the environments in which people live and grow. By the time a diagnosis is made, the lungs may have been under stress for decades. Smoking is a factor, but it is rarely the only one, and often not the first.

The built environment breathes with us

The human lung has a surface area roughly equivalent to a badminton court. That scale matters because it means the body is continuously absorbing whatever is present in the surrounding air. Castro frames this as a question of environmental contract: if buildings allow pollutants to compromise children’s lung development, the basic promise of shelter is broken.

Visibility changes behaviour

A working paper from the National Bureau of Economic Research cited in the same episode found that making indoor air quality data visible to households led to a measurable reduction in PM2.5 exposure during occupancy hours. People did not change their lives; they changed their ventilation habits. The economic return on subsidising monitors was calculated as effectively infinite, given the scale of the health costs avoided.

This study clearly illustrates what Airly focuses on every day: when air quality becomes visible, meaningful action becomes possible. Communities, local authorities, and building managers make better decisions when they have access to reliable data.

You can listen to the full episode here: https://www.airqualitymatters.net/podcast/the-invisible-crisis-of-copd