Health
Climate Change Drives Respiratory Illness, Push for Low-Carbon Inhalers Grows
As climate change worsens respiratory diseases, doctors and drugmakers are exploring earlier diagnosis and low-carbon inhalers to cut emissions from care and protect patients.
For millions of people worldwide, climate change is already affecting breathing. Rising air pollution, longer pollen seasons, and smoke from wildfires are contributing to asthma attacks, lung damage, and other chronic respiratory illnesses. At the same time, the health systems treating these conditions are themselves contributing to greenhouse gas emissions.
Experts note that over 90 percent of the global population breathe air with particulate levels above World Health Organization recommendations. Climate extremes and poor air quality are increasing the frequency and severity of respiratory diseases, from exacerbations to disease onset. Therese Laperre, head of the respiratory department at University Hospital Antwerp, said changes in particulate matter can trigger emergency visits for asthma and chronic pulmonary diseases days later. A European Environment Agency study estimated that more than a third of chronic respiratory disease deaths in Europe are linked to environmental factors such as pollution, extreme temperatures, wildfire smoke, and allergenic pollen.
Worldwide, an estimated 400 to 500 million adults live with COPD, and over 250 million have asthma. Health care responses come with their own climate cost. Health Care Without Harm estimates global health services generate about five percent of worldwide greenhouse gas emissions, which could rise to six gigatons annually by 2050 if unchecked, equivalent to more than a billion cars on the road. Hospitals, particularly intensive care units, are among the most carbon-intensive, due to high energy use, equipment, and single-use materials.
Respiratory specialists emphasize that early disease control benefits both patients and the environment. Philippe Tieghem from the French respiratory association Sante Respiratoire said early diagnosis allows for better patient care while reducing emissions.
Inhalers, commonly used to treat asthma and COPD, illustrate the challenge. Traditional pressurised metered-dose inhalers (pMDIs) use hydrofluorocarbon propellants, which contribute 16–17 million tonnes of CO₂-equivalent emissions globally each year. The UK’s National Health Service estimates these inhalers account for around three percent of its carbon footprint.
Pharmaceutical companies are developing greener alternatives. AstraZeneca’s reformulated COPD inhaler uses a new propellant, HFO‑1234ze(E), cutting its global warming potential by roughly 99.9 percent compared with older devices. The company has pledged to reduce its emissions by 98 percent by 2026, starting with inhalers. Pfizer and Johnson & Johnson have committed to net-zero targets by 2040 and 2045, respectively.
Pablo Panella, senior vice-president for respiratory diseases at AstraZeneca, told Euronews Health that early detection, diagnosis, and treatment keep patients controlled in the community, reducing hospital admissions and the high-carbon interventions that come with them. Panella also stressed the importance of regulation that supports innovation, allowing low-carbon technologies to reach patients more quickly.
Better disease control, combined with environmentally conscious products, is creating the concept of the “green patient”: someone whose chronic condition is managed well enough to avoid repeated flare-ups, hospital stays, and carbon-intensive treatments.
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Uzbekistan to Launch Nationwide State Medical Insurance System in 2026
Uzbekistan will begin introducing a nationwide state medical insurance system from 2026, part of a broader overhaul of the country’s healthcare financing and service delivery. The reform will introduce digital referrals, a national health insurance fund, and a guaranteed package of essential medical services funded through the state budget. Officials say the changes aim to improve efficiency, expand access, and reduce informal payments.
“State health insurance is a social protection system designed to guarantee access to quality healthcare services,” said Zokhid Ermatov, executive director of the State Health Insurance Fund.
Discussions about state medical insurance in Uzbekistan began in 2017, but implementing such a system required years of preparation. The State Health Insurance Fund was formally established in December 2020, and pilot programmes launched in the Syrdarya region in 2021 tested new financing mechanisms, regulatory frameworks, and digital health systems. In November 2025, the Cabinet of Ministers approved regulations governing how medical care funded through the state budget will be provided in public and private medical institutions, with the rules set to come into force on January 1, 2026.
At the centre of the new model is stronger primary healthcare. Patients will first visit their assigned family clinic, where doctors provide consultations, prescribe tests, and determine whether specialist care is needed. If necessary, patients will receive an electronic referral to hospitals or specialists. Emergency and urgent care will remain available without referrals.
The reform introduces a patient-centred financing model, where healthcare providers are paid by the State Health Insurance Fund based on services delivered. Primary healthcare will be funded through capitation payments, while hospital treatment will follow case-based payments, a structure designed to improve efficiency and treatment outcomes.
A fully digital referral system will allow patients to choose hospitals from a list of institutions contracted with the State Health Insurance Fund using a government portal or mobile app. Referrals will remain valid for 60 days, and waiting lists and hospitalisations will be managed through a unified electronic health information system.
The insurance system guarantees essential healthcare services, including family doctor consultations, diagnostic tests, outpatient treatment, preventive screening, some medicines, hospital care, and certain rehabilitation services. Patients will not be charged additional fees for services included in the approved package.
Funding for the program will come primarily from the state budget, ensuring citizens do not pay direct insurance contributions. Priority access will be given to socially vulnerable groups, including children with disabilities, orphans, pensioners, pregnant women, unemployed citizens, and low-income families. The State Health Insurance Fund will allocate resources across regions to strengthen medical services and reduce inequalities.
International organisations have praised Uzbekistan’s approach, noting that general tax financing and universal coverage can improve financial protection and ensure predictable healthcare funding. Jessika Yin, Health Policy Adviser at the World Health Organization in Uzbekistan, said the reforms align with global trends toward universal health coverage.
If implemented successfully, Uzbekistan’s state medical insurance system could represent a major step toward universal healthcare, ensuring that people receive care without facing financial hardship.
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