Asthma represents a great problem for health service all over the world, because it affects each age category and causes a heavy burden of direct an indirect costs. When poorly controlled, asthma may cause limitations in daily life activities and increases the risk of acute exacerbations, with potential fatal consequences.
In order to cope with the dramatic increase in asthma prevalence observed in the late '80s, in 1993 the Global Initiative for Asthma (GINA) published the "Global strategy for asthma management and prevention" document, with the aim to promote dissemination and implementation of guidelines for proper management of asthma. This document has been drawn so that asthma guidelines can be applied in all countries in the world with only minor adaptation, and indeed it has been translated into many languages. It is annually updated, and GINA Guidelines are currently the best known and most used in the world.
In the last 10 years, the main objective of GINA Executive Committee has been to promote the implementation of GINA Guidelines in the world, particularly in the developing countries, where asthma is still increasing in both prevalence and severity and poor health service may prevent from reaching good asthma control in large numbers of patients.
For this reason, GINA International promoted two different regional initiatives (GINA Mesoamerica and GINA Mediterranean) with the aim to create a link among nearby countries with similar tradition and/or culture, in order to favour communication and comparison of different experiences and strategies for the implementation of GINA Guidelines.
GINA Mediterranean was founded in 2005 in Rome, with participating countries of the Mediterranean area: France, Greece, Israel, Italy (Chairmanship), Lebanon, Morocco, Spain, Syria, Tunisia, Turkey. After the first meeting, delegates of each Country tried to create an efficient network in order to compare and discuss the experiences carried out in the different countries involved in the project, and meetings were also held in Morocco, Syria and Turkey.
In April 2010, the second Conference of GINA Mediterranean was organized in Pisa (Italy), with the active participation of 8 countries: Greece, Israel, Italy, Lebanon, Spain, Syria, Tunisia and Turkey. During a full day meeting, data on asthma epidemiology and management, and the level of implementation of GINA guidelines in participating countries have been reported by each delegate and discussed. The results of this meeting have been summarized and represent the basis for the definition of specific programmes for each participating Country.
In June 2011, the third Conference of GINA Mediterranean was held in Istanbul (Turkey), with the aim to discuss implementation plans, either ongoing or in preparation, in the different countries, using the framework proposed by the Implementation Committee of GINA International.