National and regional allergy and asthma programs: A comparative analysis and lessons for a German National Action Plan For Allergology.
Köhler Charlotte C, Kalb Birgit B, Becker Sven S, Klimek Ludger L et al.
Allergic diseases impose a substantial public health burden, yet Germany lacks a sustained national framework coordinating allergy-related care, prevention, education, research, and evaluation. We analyzed international allergy and asthma programs to identify principles relevant to a German National Action Plan (NAP) for Allergology. A structured literature and policy review identified national and regional allergy and asthma initiatives through scientific databases, grey literature, and policy documents. Of 13 identified initiatives, 8 were included in the primary comparative analysis. Program characteristics and reported outcomes were descriptively assessed, and structural components were compared across nine analytical domains. The programs differed in scope, implementation, governance, and evaluation. Recurring components included defined priorities, governance and accountability, multidisciplinary stakeholder involvement, integration of evidence-based care, professional and patient education, research and data infrastructure, monitoring, and sustainable resources. Several established programs reported favorable changes in healthcare utilization, disease management, patient quality of life, and healthcare costs. Predominantly observational evaluations, however, limited causal attribution. Eight interrelated strategic objectives were derived for consideration in the development of a German NAP. International programs cannot be directly transferred to Germany. Their recurring structural and implementation principles may nevertheless inform a coordinated national strategy linking unmet needs to measurable objectives, implementation responsibilities, resources, and prospective evaluation. The proposed framework requires further prioritization, operationalization, and stakeholder consensus.