Better lung health for all: A British Thoracic Society and Pan African Thoracic Society initiative

Like many organizations, the British Thoracic Society (BTS) has a strategic plan which is both reviewed regularly and adjusted to changing circumstances.^[1] The society states its objectives, based on its mission and foremost it promotes its vision. The vision of the society has only five words, “Better Lung Health for All.”

BTS is a national society and predominantly United Kingdom National Health Service based but many BTS members have canvassed regularly to increase the Society’s “global outlook” and “do more for global lung health.” The clear steer is that lung health does not start or end at any geographical border and, in a globalized world, it is vital that we learn from and support each other. This has been impacted and heightened further by the current global pandemic caused by a respiratory virus. What has sometimes been less clear is what should be done and how this can be delivered most effectively considering the UK is a small part of a very big world and BTS a small part of the worldwide respiratory community.

In 2018, the time was right to take forward this vision and, from the outset, certain principles were very important. The first was the need to align with a global partner to maximize benefit. The second was the principle of mutual learning, recognizing how much different parties can learn from each other. The third was the scope and focus with recognition of the vital importance of a deliverable work plan over a defined period. The vision may be global, but the delivery had to be realistic and carefully thought out. A number of BTS members already had close links with different areas of the world but our initial task was to identify a partner organization to work with and develop initiatives that could, in time, be replicated on a wider scale.

The Pan African Thoracic Society (PATS) is a robust and well-established organization representing many African low- and middle-income countries (LMICs). Approximately two-thirds of the poorest 50 nations are in Africa, represented by PATS, and the vast contrast in the general health and health systems of these nations to that of the UK provides real opportunities for joint working and education. PATS has worked with the American Thoracic Society on the PATS-Methods in Epidemiologic, Clinical and Operations (MECOR) training program so is experienced at mutual working. The PATS-MECOR program aims to support, supervise, and train young African researchers and leaders. BTS members already work with PATS which provided a strong foundation on which to build.

The newly formed “BTS Global Health Group” was charged with working with PATS members to devise a deliverable program of activity. This initiative was launched at the 2019 BTS Winter Meeting which was attended by the PATS President and Executive Board members. At the launch, people struggled to get into the overflowing room and provided many helpful suggestions for the 3-year work plan. An early output was a joint African/British Lancet publication on the challenges to improvement in lung heath in LMICs, and how these might be met.^[2]

The first aim was together to establish and launch the new Journal of the PATS; the penning of this commentary confirms this achievement after an immense amount of work by various PATS members and some financial support from BTS. The journal matters as it is a focus and hub for PATS members, it supports collaboration and provides a platform to share initiatives and promote improvement in respiratory health across Africa. It is a place which can be the first step on the publication ladder for young African clinicians and investigators. It is the desire of all involved that, over the next few years, the journal showcases the output and learning from this partnership as well as from across Africa. Three issues annually are now published under the skilled editorship of Dr. Obianuju Ozoh.

The second aim is to improve education access by better harnessing and building on existing educational opportunities. Both PATS and BTS organize annual scientific meetings albeit their format and delivery has been very different over the last year. The 2020 BTS Winter Meeting not only moved from its regular December schedule to February 2021, it was also entirely online which thwarted opportunities both for PATS members to attend the conference in person but also to link attendance with another initiative, short BTS-sponsored fellowships. Instead, all PATS members were provided access to the virtual meeting and approximately 60 were able to participate which is far more than would have been feasible for a standard, face-to-face conference. The annual PATS/BTS Symposium focused on African respiratory medicine’s “Big Five” challenges including pneumonia in the under 5s, air pollution and non-communicable respiratory disease. It is the hope of all that the original plan can soon be delivered including scientific abstract submission to a new “Global Health” category. The 2021 PATS Congress has been delayed but the established plans for the meeting are deferred not forgotten. These include a pre-conference pulmonary rehabilitation training workshop, a publication workshop supported by Thorax, BMJ Open Respiratory Research and British Medical Journal editorial teams with BTS members contributing to other symposia supported by short-term BTS-sponsored fellowships and bursaries. Over time, the vision is to expand, increasing the scope and depth of reciprocal fellowships and seeking ongoing financial support to deliver this, but we must first walk by taking small steps.

The third aim is to increase the profile of global lung health by the organizations working together. The Forum of International Respiratory Societies aims to advocate for improved lung health across the world and influence the United Nations agenda; both PATS and BTS will work in partnership to support these aims.

Our thanks go to the many people who have already contributed and invested in the initiative. Building “Better Lung Health for All” requires partnership, mutual support, and shared goals. We hope and believe that this is the start of achieving the vision.