Asthma Friendly City Strategy: Intersectoral Action to Promote the Right Care

Background: Asthma represents a significant health challenge in Brazil, with approximately 350,000 hospital admissions annually, imposing substantial financial and social burdens. Many patients and healthcare providers are unaware of the chronic nature of asthma management, often relying solely on short-acting β2-agonists (SABA) instead of continuous treatment with inhaled corticosteroids. Objective: The Asthma Friendly City Strategy aims to encourage intersectoral and interinstitutional actions to promote proper asthma care, particularly in cities that participated in the Teach the Teacher programme. Methods: Asthma Friendly City Strategy was piloted in Guarulhos, São Paulo, starting October 2022, aligning with the Sustainable Development Goals. The project includes stakeholder meetings, situational diagnostics of asthma, co-design workshops, intersectoral committee creation, and a consultative committee for oversight. Cities are awarded progressively from adherence to CAPA, establishing care protocols, to creating legal frameworks supporting asthma care. Results: By December 2024, a workshop was conducted involving 30 stakeholders, including healthcare professionals, managers of the health, education and environment departments, and patients. Discussions focused on structured themes derived from IPCRG's asthma right care declarations, such as timely diagnosis, right disease management, appropriate inhalation therapy, smoking cessation, and vaccination. This participatory approach resulted in actionable proposals to align with local realities and project goals. Conclusions: Asthma-Friendly City Strategy has laid the groundwork for sustainable asthma care improvement in Guarulhos. Next steps include forming an intersectoral committee for ongoing implementation, developing a guide for asthma-friendly cities, and an end-of-project meeting to share outcomes and lessons learned.