The International Study of Asthma and Allergies in Childhood 20 year anniversary symposium

Firstly it is a privilege to join with you, in this twentieth year anniversary symposium of the international study of asthma and allergies in childhood and I thank you for the invitation.

It makes absolute sense to me, that in my first major speech of this year, it would be in the context of an issue which is so fundamental to the health and wellbeing of our nation – and in particular of our children.

I have been intrigued in listening to the state of the nation addresses presented by the leaders of the two largest political parties over these last two days.

In their addresses to the nation, they have both canvassed various problems and proposals related to national savings, government debt, tax revenue, investment, and other elements of economic performance.

And yet the profound cost of life associated with the prevalence of asthma didn’t even rate a mention.

One leader ended with the statement: “I want to ensure that your children and my children can once again realise the Kiwi dream”; the other with the line, “New Zealanders deserve nothing less”.

And I thought to myself, what bolder aspiration could we have for our nation; what better dream could we live, than to improve early child health; and to protect and nurture the very essence of life?

Surely our children deserve nothing less than the greatest chance in life.

What better investment can we make in our population health and societal wealth, than to significantly improve our treatment and response to asthma and allergies, and in so doing, reduce the burden of disease particularly amongst Maori and Pasifika children?

There is no greater reminder of how critical this conference is, than at the powhiri that opened our day.

And I am thinking, in particular, of the ceremony of hariru – the hongi in which the ha, or breath of life is exchanged and intermingled.

In that one action – the sharing of breath in the touching together of noses – is invested a ritual of great spiritual significance.

It is a process by which we celebrate the link through to our ancestors – the connection which has emerged from the life breathed into those before us.

And in doing so, we think back to the feats of our ancestors which remind us that there was no mountain too high, no sea too far to sail, in the journeys they embarked on.

That same breath of life that we hold with the utmost respect in the ritual of hariru, that same remarkable journey towards progress in health gains, must be seen in the way in which we respond to the admissions, prevalence and deaths related to asthma in New Zealand.

Having mokopuna who suffer from allergies and asthma, I am painfully aware how crippling it can be to spend nights in which the wheezing becomes too severe, and the scratching is unbearable.

This conference focuses on the challenge of asthma – it highlights also the connection with eczema, rhinitis and the environment.

Amongst the offerings at this symposium will be discussion around the impact of climate change and respiratory health; the study of genetics of asthma and allergy; the relationship of farm-living to childhood asthma and allergy, or the link to air pollution.

And I want to take this opportunity to pay tribute to ISAAC – the International Study of Asthma and Allergies in Childhood – as being the largest worldwide collaborative research project ever taken, involving more than 100 countries and nearly two million people.

That is a simply stunning statistic - and I want to honour the fact that since 1992, this global research programme has been led from Aotearoa New Zealand. We can be so proud of the initiative led out of this land, and I want to congratulate all of those involved for their insight.

There are so many issues worthy of intense debate – and particularly related to a focus on the environment, and on disease monitoring. And I want, in this light, to highlight a couple of areas that I have a particular interest in.

It is, of course, well known that there is a recognised link between asthma and smoking, especially maternal smoking. There has been some remarkable progress made in reducing rates of smoking over the last two years. In the first quarter of 2010/11, almost 22,000 hospitalised smokers were offered advice and help to quit – compared to about 2000 in the previous year.

Alongside of that, the increase on all tobacco products that I introduced through the taxation bill passed early last year, will have demonstrable gains in reducing the rates of smoking; as will the increased control measures I have put forward, to take tobacco displays out of sight.

I am really keen to see what difference these measures will make in addressing asthma.

Another area I have a strong interest in is the relationship between Vitamin D deficiency and increased infections, wheezing, eczema and cardiovascular disease.

There was a very interesting study published on 4 January 2011, in the journal Ethnicity and Health, entitled: The risks and benefits of sun exposure: should skin colour or ethnicity be the main variable for communicating health promotion messages in New Zealand?.

The article raises questions around current sun-protection and skin-cancer prevention policies, asking whether they may protect particular ethnic groups from skin cancer but potentially disadvantage other groups that are at risk of vitamin D deficiency or insufficiency.

It suggests that Maori and Pasifika children, have on average, lower vitamin D levels than European children - and that this is assumed to be the result of their higher amounts of melanin, or skin darkness, and lack of exposure to the sun.

In essence, 50% of Maori children are vitamin D deficient – and with respect to sun exposure, people with darker skin pigmentation require longer sun exposure to absorb Vitamin D.

There is, therefore, a debate currently occurring about whether the sunsmart message should differ according to ethnic groups. I am really interested in your thoughts about this issue.

There are many more questions that I am eager to hear your views on, and I hope that in the short time I am here today, there will be a chance to listen and learn from the collected wisdom in this symposium.

All of us must ask the question, what can we do about the fact that one in five Maori children are on medication for asthma; or that one in seven Maori children are on medication for eczema.

How do we take preventive action to reduce the constant flow of hospital admissions related to asthma and eczema?

What are the preventative measures we can take to reduce the risk?

This forum brings together the health professionals, health scientists, medical students and distinguished researchers right across the health sector, to tackle the challenge of asthma and allergies in childhood.

I am deeply committed to doing all that I can to address the root causes of poor health, and to support the solutions that you are already advancing.

I wish you all a productive and stimulating conference, and I thank all of you concerned for the leadership you are bringing together, at this twentieth anniversary symposium.

Thank you, most of all, for cherishing the very breath of life that sustains us all.