Global Initiative for Chronic Obstructive Lung Disease - GOLD

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PREFACE
Chronic Obstructive Pulmonary Disease (COPD) is a
major public health problem. It is the fourth leading
cause of chronic morbidity and mortality in the United
States 1 and is projected to rank fifth in 2020 as a worldwide
burden of disease according to a study published by
the World Bank/World Health Organization 2 . Yet, COPD
fails to receive adequate attention from the health care
community and government officials. With these concerns
in mind, a committed group of scientists encouraged
the US National Heart, Lung, and Blood Institute
and the World Health Organization to form the Global
Initiative for Chronic Obstructive Lung Disease (GOLD).
Among GOLD’s important objectives are to increase
awareness of COPD and to help the thousands of people
who suffer from this disease and die prematurely from
COPD or its complications.
The first step in the GOLD program was to prepare a
consensus Workshop Report, Global Strategy for the
Diagnosis, Management, and Prevention of COPD. The
GOLD Expert Panel, a distinguished group of health
professionals from the fields of respiratory medicine,
epidemiology, socioeconomics, public health, and health
education, reviewed existing COPD guidelines, as well as
new information on pathogenic mechanisms of COPD as
they developed a consensus document. Many recommendations
will require additional study and evaluation as
the GOLD program is implemented.
Development of the Workshop Report was supported
through educational grants from Altana, Andi-Ventis,
AstraZeneca, Aventis, Bayer, Boehringer Ingelheim,
Chiesi, GlaxoSmithKline, Merck, Sharp & Dohme,
Mitsubishi Pharma, Nikken Chemicals, Novartis, Pfizer,
Schering-Plough, and Zambon.
Leonardo Fabbri, MD
Modena, Italy
Chair, GOLD Executive Committee
REFERENCES
1. National Heart, Lung, and Blood Institute. Morbidity &
mortality: chartbook on cardiovascular, lung, and blood diseases.
Bethesda, MD: US Department of Health and Human
Services, Public Health Service, National Institutes of Health;
1998. Available from: URL:
www.nhlbi.nih.gov/nhlbi/seiin//other/cht-book/htm
2. Murray CJL, Lopez AD. Evidence-based health
policy-lessons from the Global Burden of Disease Study.
Science 1996; 274:740-3.
A major problem is the incomplete information about the
causes and prevalence of COPD, especially in developing
countries. While cigarette smoking is a major known risk
factor, much remains to be learned about other causes of
this disease. The GOLD Initiative will bring COPD to the
attention of governments, public health officials, health
care workers, and the general public, but a concerted
effort by all involved in health care will be necessary to
control this major public health problem.
I would like to acknowledge the expert panel that prepared
the first workshop report, and the GOLD Science Committee
for its work in preparation of the yearly updated volumes.
We look forward to our continued work with interested
organizations and the GOLD National Leaders to meet
the goals of the GOLD initiative.
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