Global disparities in adrenaline access: A World Allergy Organization call for equity in anaphylaxis care

Abstract

Anaphylaxis is a medical emergency and can be fatal if not treated immediately.1,2 Adrenaline remains the only effective first-line treatment capable of reversing anaphylaxis in all settings, including in the community,1,2 and should be administered without delay. However, more than a century after the therapeutic effect of adrenaline was first described——and decades after the development of devices for its self-administration——the majority of the world's population still lacks access to these potentially life-saving tools.3,4 Recent global surveys, including those conducted under the auspices of the World Allergy Organization (WAO), reveal an unpleasant reality: only about one-third of countries provide consistent access to any form of adrenaline device for self-administration.3 In the remaining countries, people at risk of anaphylaxis, including children, are forced to rely on improvisation, or worse, be entirely without protection. Even in those countries where adrenaline auto-injectors are available, only 44% of patients have a standardized action plan to guide its use to treat anaphylaxis.5 This situation represents a profound global health inequity, and one that must become an urgent priority for allergy organisations, health authorities, and policymakers worldwide.