Challenges in management of interstitial lung diseases in resource-poor settings: A review

Abstract

Current approaches to diagnosing and managing interstitial lung disease (ILD) in low-resource settings remain inadequate. Key diagnostic barriers include limited access to high-resolution computed tomography, spirometry, multidisciplinary teams and ILD specialists, leading to delayed recognition and late presentation with irreversible impairment. Treatment is hampered by scarce and unaffordable antifibrotic therapies, inconsistent public health coverage and a lack of lung transplantation and rehabilitation programmes. Fragmented healthcare systems, administrative challenges and distance to referral centres disproportionately affect rural and low-income populations. Patients face significant financial burdens due to high out-of-pocket and indirect costs with inadequate insurance coverage. Policy gaps, such as absent national action plans and strict regulations, further restrict access to specialised care, clinical trials and new therapies. Early integration of palliative care is recommended but often hindered by resource and workforce limitations and regulatory barriers. Promising models in lowand middle-income countries (LMICs) include telemedicine, adapted diagnostic and management algorithms, workforce training and international collaboration. Improving ILD care in LMICs requires coordinated policy, infrastructure investment, broader access to therapies and sustainable region-specific care models.