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Action Plan to Reach the Global Availability of Adrenaline Auto-Injectors

Kase Tanno L1,2,3*, Demoly P2,3, and on behalf of the Joint Allergy Academies**

1Hospital Sírio Libanês, São Paulo, Brazil
2University Hospital of Montpellier, Montpellier, and Sorbonne Universités, UMR-S 1136, IPLESP, Equipe EPAR, 75013, Paris, France
3WHO Collaborating Center for Classification Scientific Support

J Investig Allergol Clin Immunol 2019; Vol. 29(6)
doi: 10.18176/jiaci.0346

Adrenaline is the first-line treatment for anaphylaxis and, therefore, listed as an essential medication for the treatment of anaphylaxis by the World Health Organization (WHO). However, the availability of auto-injector (AAI) forms for use in the first-aid treatment is limited to only 32% of all 195-world countries, mostly high-income countries. The key issues leading to the lack of availability of AAIs include cost but also national regulations, lack of regional evidence about the value of epinephrine and the limited accurate data about the epidemiology of anaphylaxis. For these reasons, regional and international allergy academies support the initiatives to narrow these gaps. Our WHO Collaborating Centre is deeply involved in this process and the purpose of this document is serving as baseline to reach: (I) an adequate access to AAI in affordable cost for all patients/societies and (II) the development of disease/patient-specific approaches. Therefore, we propose a 5 steps action plan (gather accurate anaphylaxis epidemiological data and AAI consumption indicators, confirm partnerships, strengthen awareness and include AAI into the WHO Model List of Essential Medicine), which should be considered in combination. A prioritized research agenda should encapsulate all these steps in the frame a global initiative against anaphylaxis. More than calling for the global availability of AAIs for best management of anaphylaxis, we propose an action plan as baseline of a global initiative against anaphylaxis. We strongly believe the combined efforts are a strong public health and societal move, leading to optimal care of allergic patients and best practice of allergology.

Key words: Anaphylaxis, Adrenaline/Epinephrine Auto-Injectors, Classification, Epidemiology, Essential Medicine, International Classification Of Diseases, Prevention, World Health Organization