Chronic Obstructive Pulmonary Disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States1, and is projected to rank fifth in 2020 in burden of disease caused worldwide, according to a study published by the World Bank/World Health Organization2. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials.

In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the US National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely from it or its complications.

The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared.

A network of international experts, GOLD National Leaders have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD National Leaders have done on behalf of their patients with COPD.

In spite of the achievements in the five years since the GOLD report was originally published, considerable additional work is ahead of all of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary. We look forward to our continued work with interested organizations and the GOLD National Leaders to meet the goals of this initiative. We are most appreciative of the unrestricted educational grants from Almirall, AstraZeneca, Boehringer Ingelheim, Chiesi, Dey, GlaxoSmithKline, Mitsubishi Tanabe Pharma, Novartis, Nycomed, Pfizer, and Schering-Plough that enabled development of this report.

A. Sonia Buist, MD
Portland, Oregon, USA
Chair, GOLD Executive Committee