Cyprus

Cyprus performs very well in Access and Care Coverage under the GeSY system, which provides universal entitlements to diagnostics, specialist care, medicines, and rehabilitation while maintaining some of the lowest unmet healthcare needs in the EU. However, weak policy foundations, limited COPD-specific monitoring, high tobacco use, and recurring dust-related air pollution continue to constrain outcomes.

Policy Context

35

Access and Care Coverage

87

Health System Characteristics

50

Disease Burden

69

Environment

68

Index Score

62

/100

Rank

32

/45

Overview

Cyprus performs very strongly in Access and Care Coverage. The introduction of GeSY (General Healthcare System) in 2019 has established universal coverage and a structured referral pathway through a gate-keeping model, ensuring access to advanced care. According to the national COPD patient-journey overview, GeSY covers diagnostics, specialist pulmonology visits, medications, nursing care and rehabilitation for COPD patients. Moreover, Cyprus reports one of the lowest levels of unmet healthcare needs in the EU, reinforcing strong access and coverage. Cyprus has a low score in Policy Context as it currently lacks a formal, publicly documented national COPD strategy and dedicated COPD-specific clinical guidelines. The country is, however, in the process of contextualising international guidelines, particularly from NICE, to develop local protocols and indicators for chronic conditions. Occupational exposure policy is relatively strong, supported by the transposition of EU directives on occupational safety and health and their implementation at the national level. The country scores below average in Health System Characteristics. While coverage under GeSY is broad and explicitly includes COPD care, there is a lack of publicly available data on COPD-specific hospitalisation, readmission, or rehabilitation uptake, which limits performance monitoring. However, the country benefits from a comparatively high number of respiratory specialists. In the Disease Burden category, Cyprus performs moderately, slightly above average. COPD contributes to a significant but relatively low societal cost, with disease burden reflected in elevated COPD-related DALYs, and one of the highest adult tobacco use rates. In the Environmental Factors category, performance is mixed. Access to clean household fuels is universal, reducing one major risk factor. However, challenges persist with ambient air quality, particularly from particulate matter and recurrent desert dust events, which can exacerbate COPD.

Performance in each category

Provides further insights into scores across each Index category

Policy Context

Category score

35

35

/29 countries

Access and Care Coverage

Category score

87

1

/29 countries

Health System Characteristics

Category score

50

31

/29 countries

Disease Burden

Category score

69

17

/29 countries

Environmental Factors

Category score

68

50

/29 countries

Takeaways

Data from the COPD Index revealed the following key insights about severe asthma care in this country

Excellent access and coverage, but policy structure is still developing Universal coverage through GeSY ensures broad access to COPD diagnostics, specialist care, medicines, and rehabilitation, but the absence of a formal national COPD strategy or dedicated guidelines limits consistency in referral, treatment, and follow-up.

Broad entitlements but limited COPD-specific performance data Although COPD is fully included in the official patient pathway, routine public reporting does not track COPD-specific admissions, readmissions, or rehabilitation uptake, restricting quality monitoring and system improvement.

Tobacco use and dust-related air quality risks elevate disease burden High adult smoking rates and recurrent desert dust events contribute significantly to COPD progression and exacerbations, highlighting the need for stronger tobacco control and more robust air quality mitigation.

Compare COPD Across Countries

Select different countries to see how they scored across each of the 5 categories and overall

Cyprus

Cyprus performs very well in Access and Care Coverage under the GeSY system, which provides universal entitlements to diagnostics, specialist care, medicines, and rehabilitation while maintaining some of the lowest unmet healthcare needs in the EU. However, weak policy foundations, limited COPD-specific monitoring, high tobacco use, and recurring dust-related air pollution continue to constrain outcomes.

Policy Context

35

Access and Care Coverage

87

Health System Characteristics

50

Disease Burden

69

Environment

68

Index Score

62

/100

Rank

32

/45

Argentina
Australia
Austria
Belgium
Brazil
Canada
Chile
China
Colombia
Costa Rica
Cyprus
Czechia
Denmark
Egypt
Estonia
Finland
France
Germany
Greece
Hungary
India
Ireland
Israel
Italy
Japan
Latvia
Lithuania
Mexico
Netherlands
New Zealand
Norway
Peru
Poland
Portugal
Romania
Saudi Arabia
Slovakia
Slovenia
South Africa
South Korea
Spain
Sweden
Switzerland
United Arab Emirates
United Kingdom
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Select country to compare

Romania

Romania’s strongest performance is in Access and Care Coverage, with broad availability of diagnostics, treatment, rehabilitation, and emerging telemedicine infrastructure, although inequalities and fragmentation limit their overall impact. Policy foundations, system integration, and disease burden challenges remain, driven by the absence of a national COPD strategy, high tobacco use, and comorbidities that continue to elevate risk.

Policy Context

66

Access and Care Coverage

68

Health System Characteristics

57

Disease Burden

87

Environment

61

Index Score

68

/100

Rank

13

/45

Peru

Peru has basic COPD guidelines and a clear understanding of local risk factors, but implementation is extremely limited, with more than 95% of cases undiagnosed and most patients lacking access to essential treatments. COPD in Peru is largely driven by poverty, biomass exposure, and tuberculosis history, while severe access barriers, weak infrastructure, and environmental risks leave the majority of patients without diagnosis or care.

Policy Context

36

Access and Care Coverage

62

Health System Characteristics

52

Disease Burden

70

Environment

67

Index Score

57

/100

Rank

39

/45

United Arab Emirates

The UAE reports good access to telemedicine and remote care, as well as strong conditions for digital therapeutics

Policy Context

33

Access and Care Coverage

72

Health System Characteristics

60

Disease Burden

78

Environment

63

Index Score

61

/100

Rank

33

/45

South Africa

South Africa has solid COPD clinical guidelines and national NCD commitments, with innovative primary-care tools like PACK supporting better practice, but gaps in tobacco control, rehabilitation access, and specialist capacity weaken overall implementation. Persistent inequities, limited reimbursement for key services, and high exposure to environmental and infectious risk factors continue to shape a challenging COPD landscape.

Policy Context

64

Access and Care Coverage

47

Health System Characteristics

32

Disease Burden

57

Environment

68

Index Score

53

/100

Rank

44

/45

India

India has tobacco control policies in place, and greater implementation and monitoring would further improve its overall score

Policy Context

42

Access and Care Coverage

61

Health System Characteristics

41

Disease Burden

62

Environment

44

Index Score

50

/100

Rank

45

/45

Israel

Israel performs well on COPD access, outcomes, and disease burden, supported by universal coverage and publicly funded services, although co-payments and capacity limits reduce full utilisation. Policy and system gaps persist, including the absence of a national COPD strategy, inconsistent guideline implementation, workforce shortages, and environmental risks that continue to influence COPD progression.

Policy Context

45

Access and Care Coverage

75

Health System Characteristics

56

Disease Burden

76

Environment

70

Index Score

64

/100

Rank

25

/45

Mexico

Saudi Arabia scores above average in the Policy Context category, with relatively good adherence to COPD care guidelines and tobacco control policies

Policy Context

52

Access and Care Coverage

78

Health System Characteristics

54

Disease Burden

57

Environment

72

Index Score

63

/100

Rank

30

/45

Saudi Arabia

Saudi Arabia scores above average in the Policy Context category, with relatively good adherence to COPD care guidelines and tobacco control policies

Policy Context

32

Access and Care Coverage

58

Health System Characteristics

52

Disease Burden

68

Environment

71

Index Score

56

/100

Rank

41

/45

Cyprus

Cyprus performs very well in Access and Care Coverage under the GeSY system, which provides universal entitlements to diagnostics, specialist care, medicines, and rehabilitation while maintaining some of the lowest unmet healthcare needs in the EU. However, weak policy foundations, limited COPD-specific monitoring, high tobacco use, and recurring dust-related air pollution continue to constrain outcomes.

Policy Context

35

Access and Care Coverage

87

Health System Characteristics

50

Disease Burden

69

Environment

68

Index Score

62

/100

Rank

32

/45

Egypt

Egypt performs well on COPD disease burden, with comparatively low prevalence and mortality, but this likely reflects under-diagnosis, reporting gaps, and limited access to care rather than a truly low burden. Weak policy foundations, limited access to rehabilitation and cessation support, workforce shortages, and severe air-quality challenges continue to constrain Egypt’s capacity to manage COPD effectively.

Policy Context

36

Access and Care Coverage

56

Health System Characteristics

37

Disease Burden

83

Environment

58

Index Score

54

/100

Rank

42

/45

China

China scores relatively high in the Policy Context category due to a strong national COPD strategy.

Policy Context

75

Access and Care Coverage

51

Health System Characteristics

56

Disease Burden

54

Environment

34

Index Score

54

/100

Rank

43

/45

Colombia

Colombia has a strong regulatory and policy framework for COPD, supported by universal insurance coverage and updated clinical guidelines, but major gaps in implementation, diagnosis, and equitable access limit impact. Underdiagnosis, uneven distribution of specialists and rehabilitation services, and persistent environmental and socioeconomic risk factors continue to drive a substantial COPD burden across the country.

Policy Context

93

Access and Care Coverage

75

Health System Characteristics

49

Disease Burden

79

Environment

71

Index Score

74

/100

Rank

3

/45

Brazil

Relatively good conditions for access to telemedicine, but there remain significant gaps in access to and coverage for COPD diagnosis and care

Policy Context

54

Access and Care Coverage

64

Health System Characteristics

53

Disease Burden

77

Environment

69

Index Score

63

/100

Rank

27

/45

Costa Rica

Costa Rica combines strong tobacco control legislation with universal health coverage, but its COPD response is hindered by extremely high underdiagnosis, limited access to spirometry and specialist care, and the absence of a unified national strategy or clinical guidelines. Growing environmental risks, suboptimal treatment patterns, and urban–rural disparities further undermine disease management and outcomes.

Policy Context

78

Access and Care Coverage

60

Health System Characteristics

53

Disease Burden

82

Environment

73

Index Score

69

/100

Rank

6

/45

Chile

Chile has a strong regulatory and policy framework for COPD, supported by GES coverage, advanced tobacco control, and structured national programmes, which have contributed to declining mortality and smoking rates. However, major gaps persist in early diagnosis, treatment adherence, rehabilitation coverage, and equitable access, particularly in rural areas where spirometry, specialists, and rehabilitation services remain limited.

Policy Context

91

Access and Care Coverage

68

Health System Characteristics

60

Disease Burden

74

Environment

75

Index Score

74

/100

Rank

2

/45

Argentina

Argentina has strong epidemiological data and updated clinical guidelines for COPD, along with access to essential medicines and some leading rehabilitation centres, but system fragmentation and uneven implementation limit impact. High underdiagnosis, poor adherence, and significant environmental and socioeconomic risk factors continue to drive a substantial COPD burden across the country.

Policy Context

53

Access and Care Coverage

66

Health System Characteristics

50

Disease Burden

73

Environment

74

Index Score

63

/100

Rank

29

/45

United Kingdom

The United Kingdom (UK) is the second-highest scorer in the COPD Index, due in large part to its comprehensive implementation of strong tobacco control policies, and a relatively robust strategy for COPD prevention and care.

Policy Context

89

Access and Care Coverage

85

Health System Characteristics

49

Disease Burden

60

Environment

76

Index Score

72

/100

Rank

4

/45

Switzerland

Switzerland presents a slightly above-average score in the COPD Index, attributable to its high score in the Environmental Factors category and good performance in the Access and Care Coverage category.

Policy Context

61

Access and Care Coverage

72

Health System Characteristics

59

Disease Burden

67

Environment

74

Index Score

67

/100

Rank

14

/45

Sweden

Sweden presents the highest score in the Environmental Factors category and a strong Access and Care Coverage category, which contributes to Sweden’s position as the tenth highest-performing country in the COPD Index

Policy Context

55

Access and Care Coverage

75

Health System Characteristics

56

Disease Burden

59

Environment

84

Index Score

66

/100

Rank

21

/45

Spain

Spain is the third highest scorer in the Policy Context category, with strong care guidelines, a robust tobacco policy, and a national COPD strategy.

Policy Context

81

Access and Care Coverage

76

Health System Characteristics

63

Disease Burden

49

Environment

71

Index Score

68

/100

Rank

10

/45

Slovenia

Slovenia has relatively good access to treatment and drugs, good conditions for diagnosis, and robust universal health care service coverage.

Policy Context

39

Access and Care Coverage

68

Health System Characteristics

50

Disease Burden

70

Environment

69

Index Score

59

/100

Rank

38

/45

South Korea

South Korea is among the highest scorers in the Health System Characteristics category, with a low number of annual COPD hospitalizations and good conditions for health data collection and recording.

Policy Context

61

Access and Care Coverage

62

Health System Characteristics

65

Disease Burden

69

Environment

68

Index Score

65

/100

Rank

24

/45

Norway

Norway scores high in the Access and Care Coverage category, mainly due to good conditions for access to diagnosis, treatments, and drugs, as well as high universal health care coverage.

Policy Context

44

Access and Care Coverage

55

Health System Characteristics

49

Disease Burden

86

Environment

65

Index Score

60

/100

Rank

36

/45

Slovakia

Slovakia scores high in the Access and Care Coverage category, mainly due to high access to diagnostic and treatment services, and care referral pathways.

Policy Context

73

Access and Care Coverage

76

Health System Characteristics

55

Disease Burden

71

Environment

71

Index Score

69

/100

Rank

8

/45

Portugal

Portugal has the highest Health System Characteristics score, primarily due to low annual COPD hospitalisations, good conditions for health data collection and reporting, and the highest primary care physician density.

Policy Context

58

Access and Care Coverage

76

Health System Characteristics

46

Disease Burden

59

Environment

68

Index Score

61

/100

Rank

35

/45

Latvia

Latvia scores above average in the Environmental Factors category, with relatively low occupational exposure to COPD risk factors

Policy Context

35

Access and Care Coverage

70

Health System Characteristics

56

Disease Burden

66

Environment

70

Index Score

59

/100

Rank

37

/45

Poland

Poland has a low annual COPD hospitalisation rate, good conditions for health data collection and recording, and a high number of respiratory specialists.

Policy Context

41

Access and Care Coverage

74

Health System Characteristics

70

Disease Burden

64

Environment

71

Index Score

64

/100

Rank

26

/45

New Zealand

New Zealand has the strongest tobacco control policies in the COPD index

Policy Context

66

Access and Care Coverage

82

Health System Characteristics

47

Disease Burden

59

Environment

84

Index Score

68

/100

Rank

12

/45

Netherlands

The Netherlands’ score in the Access and Care Coverage category is high, with good conditions for access to treatment, drugs, and diagnosis

Policy Context

64

Access and Care Coverage

71

Health System Characteristics

48

Disease Burden

67

Environment

81

Index Score

66

/100

Rank

18

/45

Lithuania

Lithuania scores above average in the Health System Characteristics category, with a low number of annual COPD hospitalisations, good conditions for health data collection and reporting, and one of the highest numbers of respiratory specialists.

Policy Context

78

Access and Care Coverage

65

Health System Characteristics

53

Disease Burden

82

Environment

67

Index Score

69

/100

Rank

9

/45

Japan

Japan scores high in the Policy Context category due to strong adherence to COPD guidelines and a well-implemented national strategy

Policy Context

68

Access and Care Coverage

67

Health System Characteristics

55

Disease Burden

67

Environment

71

Index Score

66

/100

Rank

20

/45

Italy

Italy scores very high in Health System Characteristics, mainly due to a low number of annual COPD hospitalisations, a high number of respiratory specialists and good health data reporting. Italy would benefit from slightly more primary care physicians.

Policy Context

57

Access and Care Coverage

73

Health System Characteristics

66

Disease Burden

62

Environment

69

Index Score

65

/100

Rank

22

/45

Ireland

Policy Context

66

Access and Care Coverage

83

Health System Characteristics

45

Disease Burden

63

Environment

77

Index Score

67

/100

Rank

15

/45

Hungary

Hungary scores above average in the Access and Care Coverage category, with good conditions for diagnosis, treatment, and drug access, strong care referral pathways, and telemedicine access.

Policy Context

67

Access and Care Coverage

77

Health System Characteristics

55

Disease Burden

50

Environment

68

Index Score

63

/100

Rank

28

/45

Greece

Greece is among the top scorers in the Health System Characteristics category, with the highest number of respiratory specialists, good conditions for health data recording, and a low 365-day readmission for COPD.

Policy Context

66

Access and Care Coverage

71

Health System Characteristics

68

Disease Burden

62

Environment

73

Index Score

68

/100

Rank

11

/45

Germany

Germany scores above average in the Environmental Factors category, mainly due to good indoor air quality and low occupational exposure to COPD risk factors.

Policy Context

59

Access and Care Coverage

75

Health System Characteristics

53

Disease Burden

54

Environment

71

Index Score

63

/100

Rank

31

/45

France

France scores relatively high in the Health System Characteristics category, mainly due to high-quality health data reporting, an average number of respiratory specialists, and a slightly above-average density of primary care physicians.

Policy Context

51

Access and Care Coverage

78

Health System Characteristics

60

Disease Burden

63

Environment

74

Index Score

65

/100

Rank

23

/45

Finland

Finland has the third highest score in the Environmental Factors category, boasting the highest indoor air quality and the lowest level of environmental exposure to COPD risk factors.

Policy Context

81

Access and Care Coverage

75

Health System Characteristics

56

Disease Burden

63

Environment

80

Index Score

71

/100

Rank

5

/45

Estonia

Estonia is among the top overall scorers in the COPD Index, with strong tobacco control policies, COPD guidelines and practices, and a relatively strong COPD strategy.

Policy Context

78

Access and Care Coverage

70

Health System Characteristics

56

Disease Burden

70

Environment

72

Index Score

69

/100

Rank

7

/45

Denmark

Denmark has the highest score in the Access and Care Coverage category, primarily due to good diagnostic conditions, robust care referral pathways, and access to telemedicine.

Policy Context

73

Access and Care Coverage

84

Health System Characteristics

48

Disease Burden

51

Environment

77

Index Score

67

/100

Rank

16

/45

Czechia

Czechia has the 5th highest score in the Access and Care Coverage category, with good conditions for COPD diagnosis, universal health care coverage, and strong care referral pathways.

Policy Context

59

Access and Care Coverage

78

Health System Characteristics

42

Disease Burden

58

Environment

69

Index Score

61

/100

Rank

34

/45

Canada

Canada scores significantly above average in the Policy Context category, with strong tobacco control policies and relatively strong COPD care guidelines and practices.

Policy Context

66

Access and Care Coverage

71

Health System Characteristics

54

Disease Burden

66

Environment

74

Index Score

66

/100

Rank

17

/45

Belgium

Belgium’s has highly accessible universal health care coverage, treatment and drug access, however it has several gaps in care referral pathways and conditions for COPD diagnosis

Policy Context

34

Access and Care Coverage

61

Health System Characteristics

59

Disease Burden

60

Environment

73

Index Score

57

/100

Rank

40

/45

Austria

Access and Care Coverage in Austria is relatively high, due to strong conditions for COPD diagnosis, universal health care coverage, and telemedicine.

Policy Context

58

Access and Care Coverage

78

Health System Characteristics

57

Disease Burden

64

Environment

72

Index Score

66

/100

Rank

19

/45

Australia

Australia is the second highest scorer in the Policy Context category, due to the implementation of a comprehensive COPD strategy, care guidelines, and tobacco control laws.

Policy Context

87

Access and Care Coverage

80

Health System Characteristics

57

Disease Burden

67

Environment

76

Index Score

74

/100

Rank

1

/45

Argentina
Australia
Austria
Belgium
Brazil
Canada
Chile
China
Colombia
Costa Rica
Cyprus
Czechia
Denmark
Egypt
Estonia
Finland
France
Germany
Greece
Hungary
India
Ireland
Israel
Italy
Japan
Latvia
Lithuania
Mexico
Netherlands
New Zealand
Norway
Peru
Poland
Portugal
Romania
Saudi Arabia
Slovakia
Slovenia
South Africa
South Korea
Spain
Sweden
Switzerland
United Arab Emirates
United Kingdom
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Select country to compare

Romania

Romania’s strongest performance is in Access and Care Coverage, with broad availability of diagnostics, treatment, rehabilitation, and emerging telemedicine infrastructure, although inequalities and fragmentation limit their overall impact. Policy foundations, system integration, and disease burden challenges remain, driven by the absence of a national COPD strategy, high tobacco use, and comorbidities that continue to elevate risk.

Policy Context

66

Access and Care Coverage

68

Health System Characteristics

57

Disease Burden

87

Environment

61

Index Score

68

/100

Rank

13

/45

Peru

Peru has basic COPD guidelines and a clear understanding of local risk factors, but implementation is extremely limited, with more than 95% of cases undiagnosed and most patients lacking access to essential treatments. COPD in Peru is largely driven by poverty, biomass exposure, and tuberculosis history, while severe access barriers, weak infrastructure, and environmental risks leave the majority of patients without diagnosis or care.

Policy Context

36

Access and Care Coverage

62

Health System Characteristics

52

Disease Burden

70

Environment

67

Index Score

57

/100

Rank

39

/45

United Arab Emirates

The UAE reports good access to telemedicine and remote care, as well as strong conditions for digital therapeutics

Policy Context

33

Access and Care Coverage

72

Health System Characteristics

60

Disease Burden

78

Environment

63

Index Score

61

/100

Rank

33

/45

South Africa

South Africa has solid COPD clinical guidelines and national NCD commitments, with innovative primary-care tools like PACK supporting better practice, but gaps in tobacco control, rehabilitation access, and specialist capacity weaken overall implementation. Persistent inequities, limited reimbursement for key services, and high exposure to environmental and infectious risk factors continue to shape a challenging COPD landscape.

Policy Context

64

Access and Care Coverage

47

Health System Characteristics

32

Disease Burden

57

Environment

68

Index Score

53

/100

Rank

44

/45

India

India has tobacco control policies in place, and greater implementation and monitoring would further improve its overall score

Policy Context

42

Access and Care Coverage

61

Health System Characteristics

41

Disease Burden

62

Environment

44

Index Score

50

/100

Rank

45

/45

Israel

Israel performs well on COPD access, outcomes, and disease burden, supported by universal coverage and publicly funded services, although co-payments and capacity limits reduce full utilisation. Policy and system gaps persist, including the absence of a national COPD strategy, inconsistent guideline implementation, workforce shortages, and environmental risks that continue to influence COPD progression.

Policy Context

45

Access and Care Coverage

75

Health System Characteristics

56

Disease Burden

76

Environment

70

Index Score

64

/100

Rank

25

/45

Mexico

Saudi Arabia scores above average in the Policy Context category, with relatively good adherence to COPD care guidelines and tobacco control policies

Policy Context

52

Access and Care Coverage

78

Health System Characteristics

54

Disease Burden

57

Environment

72

Index Score

63

/100

Rank

30

/45

Saudi Arabia

Saudi Arabia scores above average in the Policy Context category, with relatively good adherence to COPD care guidelines and tobacco control policies

Policy Context

32

Access and Care Coverage

58

Health System Characteristics

52

Disease Burden

68

Environment

71

Index Score

56

/100

Rank

41

/45

Cyprus

Cyprus performs very well in Access and Care Coverage under the GeSY system, which provides universal entitlements to diagnostics, specialist care, medicines, and rehabilitation while maintaining some of the lowest unmet healthcare needs in the EU. However, weak policy foundations, limited COPD-specific monitoring, high tobacco use, and recurring dust-related air pollution continue to constrain outcomes.

Policy Context

35

Access and Care Coverage

87

Health System Characteristics

50

Disease Burden

69

Environment

68

Index Score

62

/100

Rank

32

/45

Egypt

Egypt performs well on COPD disease burden, with comparatively low prevalence and mortality, but this likely reflects under-diagnosis, reporting gaps, and limited access to care rather than a truly low burden. Weak policy foundations, limited access to rehabilitation and cessation support, workforce shortages, and severe air-quality challenges continue to constrain Egypt’s capacity to manage COPD effectively.

Policy Context

36

Access and Care Coverage

56

Health System Characteristics

37

Disease Burden

83

Environment

58

Index Score

54

/100

Rank

42

/45

China

China scores relatively high in the Policy Context category due to a strong national COPD strategy.

Policy Context

75

Access and Care Coverage

51

Health System Characteristics

56

Disease Burden

54

Environment

34

Index Score

54

/100

Rank

43

/45

Colombia

Colombia has a strong regulatory and policy framework for COPD, supported by universal insurance coverage and updated clinical guidelines, but major gaps in implementation, diagnosis, and equitable access limit impact. Underdiagnosis, uneven distribution of specialists and rehabilitation services, and persistent environmental and socioeconomic risk factors continue to drive a substantial COPD burden across the country.

Policy Context

93

Access and Care Coverage

75

Health System Characteristics

49

Disease Burden

79

Environment

71

Index Score

74

/100

Rank

3

/45

Brazil

Relatively good conditions for access to telemedicine, but there remain significant gaps in access to and coverage for COPD diagnosis and care

Policy Context

54

Access and Care Coverage

64

Health System Characteristics

53

Disease Burden

77

Environment

69

Index Score

63

/100

Rank

27

/45

Costa Rica

Costa Rica combines strong tobacco control legislation with universal health coverage, but its COPD response is hindered by extremely high underdiagnosis, limited access to spirometry and specialist care, and the absence of a unified national strategy or clinical guidelines. Growing environmental risks, suboptimal treatment patterns, and urban–rural disparities further undermine disease management and outcomes.

Policy Context

78

Access and Care Coverage

60

Health System Characteristics

53

Disease Burden

82

Environment

73

Index Score

69

/100

Rank

6

/45

Chile

Chile has a strong regulatory and policy framework for COPD, supported by GES coverage, advanced tobacco control, and structured national programmes, which have contributed to declining mortality and smoking rates. However, major gaps persist in early diagnosis, treatment adherence, rehabilitation coverage, and equitable access, particularly in rural areas where spirometry, specialists, and rehabilitation services remain limited.

Policy Context

91

Access and Care Coverage

68

Health System Characteristics

60

Disease Burden

74

Environment

75

Index Score

74

/100

Rank

2

/45

Argentina

Argentina has strong epidemiological data and updated clinical guidelines for COPD, along with access to essential medicines and some leading rehabilitation centres, but system fragmentation and uneven implementation limit impact. High underdiagnosis, poor adherence, and significant environmental and socioeconomic risk factors continue to drive a substantial COPD burden across the country.

Policy Context

53

Access and Care Coverage

66

Health System Characteristics

50

Disease Burden

73

Environment

74

Index Score

63

/100

Rank

29

/45

United Kingdom

The United Kingdom (UK) is the second-highest scorer in the COPD Index, due in large part to its comprehensive implementation of strong tobacco control policies, and a relatively robust strategy for COPD prevention and care.

Policy Context

89

Access and Care Coverage

85

Health System Characteristics

49

Disease Burden

60

Environment

76

Index Score

72

/100

Rank

4

/45

Switzerland

Switzerland presents a slightly above-average score in the COPD Index, attributable to its high score in the Environmental Factors category and good performance in the Access and Care Coverage category.

Policy Context

61

Access and Care Coverage

72

Health System Characteristics

59

Disease Burden

67

Environment

74

Index Score

67

/100

Rank

14

/45

Sweden

Sweden presents the highest score in the Environmental Factors category and a strong Access and Care Coverage category, which contributes to Sweden’s position as the tenth highest-performing country in the COPD Index

Policy Context

55

Access and Care Coverage

75

Health System Characteristics

56

Disease Burden

59

Environment

84

Index Score

66

/100

Rank

21

/45

Spain

Spain is the third highest scorer in the Policy Context category, with strong care guidelines, a robust tobacco policy, and a national COPD strategy.

Policy Context

81

Access and Care Coverage

76

Health System Characteristics

63

Disease Burden

49

Environment

71

Index Score

68

/100

Rank

10

/45

Slovenia

Slovenia has relatively good access to treatment and drugs, good conditions for diagnosis, and robust universal health care service coverage.

Policy Context

39

Access and Care Coverage

68

Health System Characteristics

50

Disease Burden

70

Environment

69

Index Score

59

/100

Rank

38

/45

South Korea

South Korea is among the highest scorers in the Health System Characteristics category, with a low number of annual COPD hospitalizations and good conditions for health data collection and recording.

Policy Context

61

Access and Care Coverage

62

Health System Characteristics

65

Disease Burden

69

Environment

68

Index Score

65

/100

Rank

24

/45

Norway

Norway scores high in the Access and Care Coverage category, mainly due to good conditions for access to diagnosis, treatments, and drugs, as well as high universal health care coverage.

Policy Context

44

Access and Care Coverage

55

Health System Characteristics

49

Disease Burden

86

Environment

65

Index Score

60

/100

Rank

36

/45

Slovakia

Slovakia scores high in the Access and Care Coverage category, mainly due to high access to diagnostic and treatment services, and care referral pathways.

Policy Context

73

Access and Care Coverage

76

Health System Characteristics

55

Disease Burden

71

Environment

71

Index Score

69

/100

Rank

8

/45

Portugal

Portugal has the highest Health System Characteristics score, primarily due to low annual COPD hospitalisations, good conditions for health data collection and reporting, and the highest primary care physician density.

Policy Context

58

Access and Care Coverage

76

Health System Characteristics

46

Disease Burden

59

Environment

68

Index Score

61

/100

Rank

35

/45

Latvia

Latvia scores above average in the Environmental Factors category, with relatively low occupational exposure to COPD risk factors

Policy Context

35

Access and Care Coverage

70

Health System Characteristics

56

Disease Burden

66

Environment

70

Index Score

59

/100

Rank

37

/45

Poland

Poland has a low annual COPD hospitalisation rate, good conditions for health data collection and recording, and a high number of respiratory specialists.

Policy Context

41

Access and Care Coverage

74

Health System Characteristics

70

Disease Burden

64

Environment

71

Index Score

64

/100

Rank

26

/45

New Zealand

New Zealand has the strongest tobacco control policies in the COPD index

Policy Context

66

Access and Care Coverage

82

Health System Characteristics

47

Disease Burden

59

Environment

84

Index Score

68

/100

Rank

12

/45

Netherlands

The Netherlands’ score in the Access and Care Coverage category is high, with good conditions for access to treatment, drugs, and diagnosis

Policy Context

64

Access and Care Coverage

71

Health System Characteristics

48

Disease Burden

67

Environment

81

Index Score

66

/100

Rank

18

/45

Lithuania

Lithuania scores above average in the Health System Characteristics category, with a low number of annual COPD hospitalisations, good conditions for health data collection and reporting, and one of the highest numbers of respiratory specialists.

Policy Context

78

Access and Care Coverage

65

Health System Characteristics

53

Disease Burden

82

Environment

67

Index Score

69

/100

Rank

9

/45

Japan

Japan scores high in the Policy Context category due to strong adherence to COPD guidelines and a well-implemented national strategy

Policy Context

68

Access and Care Coverage

67

Health System Characteristics

55

Disease Burden

67

Environment

71

Index Score

66

/100

Rank

20

/45

Italy

Italy scores very high in Health System Characteristics, mainly due to a low number of annual COPD hospitalisations, a high number of respiratory specialists and good health data reporting. Italy would benefit from slightly more primary care physicians.

Policy Context

57

Access and Care Coverage

73

Health System Characteristics

66

Disease Burden

62

Environment

69

Index Score

65

/100

Rank

22

/45

Ireland

Policy Context

66

Access and Care Coverage

83

Health System Characteristics

45

Disease Burden

63

Environment

77

Index Score

67

/100

Rank

15

/45

Hungary

Hungary scores above average in the Access and Care Coverage category, with good conditions for diagnosis, treatment, and drug access, strong care referral pathways, and telemedicine access.

Policy Context

67

Access and Care Coverage

77

Health System Characteristics

55

Disease Burden

50

Environment

68

Index Score

63

/100

Rank

28

/45

Greece

Greece is among the top scorers in the Health System Characteristics category, with the highest number of respiratory specialists, good conditions for health data recording, and a low 365-day readmission for COPD.

Policy Context

66

Access and Care Coverage

71

Health System Characteristics

68

Disease Burden

62

Environment

73

Index Score

68

/100

Rank

11

/45

Germany

Germany scores above average in the Environmental Factors category, mainly due to good indoor air quality and low occupational exposure to COPD risk factors.

Policy Context

59

Access and Care Coverage

75

Health System Characteristics

53

Disease Burden

54

Environment

71

Index Score

63

/100

Rank

31

/45

France

France scores relatively high in the Health System Characteristics category, mainly due to high-quality health data reporting, an average number of respiratory specialists, and a slightly above-average density of primary care physicians.

Policy Context

51

Access and Care Coverage

78

Health System Characteristics

60

Disease Burden

63

Environment

74

Index Score

65

/100

Rank

23

/45

Finland

Finland has the third highest score in the Environmental Factors category, boasting the highest indoor air quality and the lowest level of environmental exposure to COPD risk factors.

Policy Context

81

Access and Care Coverage

75

Health System Characteristics

56

Disease Burden

63

Environment

80

Index Score

71

/100

Rank

5

/45

Estonia

Estonia is among the top overall scorers in the COPD Index, with strong tobacco control policies, COPD guidelines and practices, and a relatively strong COPD strategy.

Policy Context

78

Access and Care Coverage

70

Health System Characteristics

56

Disease Burden

70

Environment

72

Index Score

69

/100

Rank

7

/45

Denmark

Denmark has the highest score in the Access and Care Coverage category, primarily due to good diagnostic conditions, robust care referral pathways, and access to telemedicine.

Policy Context

73

Access and Care Coverage

84

Health System Characteristics

48

Disease Burden

51

Environment

77

Index Score

67

/100

Rank

16

/45

Czechia

Czechia has the 5th highest score in the Access and Care Coverage category, with good conditions for COPD diagnosis, universal health care coverage, and strong care referral pathways.

Policy Context

59

Access and Care Coverage

78

Health System Characteristics

42

Disease Burden

58

Environment

69

Index Score

61

/100

Rank

34

/45

Canada

Canada scores significantly above average in the Policy Context category, with strong tobacco control policies and relatively strong COPD care guidelines and practices.

Policy Context

66

Access and Care Coverage

71

Health System Characteristics

54

Disease Burden

66

Environment

74

Index Score

66

/100

Rank

17

/45

Belgium

Belgium’s has highly accessible universal health care coverage, treatment and drug access, however it has several gaps in care referral pathways and conditions for COPD diagnosis

Policy Context

34

Access and Care Coverage

61

Health System Characteristics

59

Disease Burden

60

Environment

73

Index Score

57

/100

Rank

40

/45

Austria

Access and Care Coverage in Austria is relatively high, due to strong conditions for COPD diagnosis, universal health care coverage, and telemedicine.

Policy Context

58

Access and Care Coverage

78

Health System Characteristics

57

Disease Burden

64

Environment

72

Index Score

66

/100

Rank

19

/45

Australia

Australia is the second highest scorer in the Policy Context category, due to the implementation of a comprehensive COPD strategy, care guidelines, and tobacco control laws.

Policy Context

87

Access and Care Coverage

80

Health System Characteristics

57

Disease Burden

67

Environment

76

Index Score

74

/100

Rank

1

/45