The challenge for the present is to organize asthma care effectively and to ensure that both patients and health care professionals are educated to make the most of the excellent treatments available. The challenge of the future is to understand why more people are developing asthma and take steps to prevent the onset of the condition in at-risk individuals. It is possible that within 10 years we may have advanced our understanding of asthma to the extent that we can compare the costs and advantages of a communitywide asthma prevention program versus the cost of lifelong medication for those who develop asthma. Preventing the development of a condition is clearly a more attractive option than treating an established condition. Although advances have been made in understanding prevention in relation to passive smoking and occupational asthma, primary prevention is as yet an area of unproven benefit.
Much more research is needed.
Also included are suggestions for communitywide primary prevention programs. More likely is the probability that a greater proportion of those who inherited the tendency to the condition are having that tendency activated so that they manifest the disease. Thus a combination of environmental and lifestyle factors may play a role. Primary prevention strategies directed at adjusting the environment of those at risk of developing asthma are more feasible than altering a genetic component. The age and length of time that an at-risk infant is particularly vulnerable may be important.