[Application of the WHO chronic respiratory diseases programme in Sub-Saharian Africa: problems in Senegal].
BACKGROUND
To prevent and control chronic respiratory diseases, the WHO has outlined a programme to be applied in all the countries. In Sub-Saharan countries like Senegal, its application faces many barriers.


METHODS
This work is a detailed analysis of the main areas of the programme based on the socio-economic, cultural and medical realities present in Sub-Saharan Africa countries, and particularly in Senegal.


RESULTS
There is a lack of political engagement resulting from the precarious socio-economical situation. The demand for care is impaired because of the prevalence of illiteracy and the practice of traditional healing methods which is the first recourse for patients. The inaccessibility and lack of adequate health structures, technical equipment and qualified medical staff, and the high cost of medications for the majority of the population is the cause of this weakness of the healthcare system. These international recommendations are both not compatible with the local realities and not known to the majority of health providers.


CONCLUSIONS
The mobilisation of international and national human and financial resources, the involvement of community-based structures, the adaptation and revision of the recommendations, the introduction of medications advocated by the Bamako Initiative, the training of health providers, the adaptation of regional and continental initiatives against tobacco and the creation of smoking cessation centres are needed if this chronic respiratory diseases programme is to be efficiently implemented.
Service des Maladies Respiratoires, Centre Collaborateur de l'Organisation Mondiale de la Santé pour l'Asthme et la Rhinite, Hôpital Arnaud de Villeneuve, Montpellier, France. drmorndiaye@hotmail.com
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D001249:Asthma / Q000150:complications; D002908:Chronic Disease; D006801:Humans; D008174:Lung Diseases, Parasitic / Q000150:complications; D015397:Program Evaluation; D012120:Respiration Disorders / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D012675:Senegal; D014397:Tuberculosis, Pulmonary / Q000150:complications; D014944:World Health Organization