{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:23:23Z","timestamp":1785461003766,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T00:00:00Z","timestamp":1763596800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cystic fibrosis (CF) is a life\u2010limiting inherited disorder that affects approximately 160,000 people worldwide. While substantial progress has been achieved in high\u2010income countries (HICs) through early diagnosis, multidisciplinary care, and advanced therapies, most people with CF (pwCF) living in low\u2010 and middle\u2010income countries (LMICs) face persistent barriers to diagnosis and treatment, resulting in poor outcomes and reduced survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This manuscript outlines a comprehensive roadmap for advancing global CF care by highlighting the current challenges, successful models of care, and actionable strategies to bridge the gap between HICs and LMICs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We examined the literature and global registries and analyzed outcomes from recent collaborations between CF centers in HICs and LMICs. We identified essential building blocks\u2014including capacity building, training, integration of registries, multidisciplinary clinical care, equitable access to essential medications, and advocacy. The goal for advocacy is to increase awareness about the disease in LMICs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant disparities exist in access to timely diagnosis, specialized care teams, CFTR modulator therapies, and patient registries. Collaboration efforts between HICs and LMICs focused on care team education, local adaptation of international guidelines, cross\u2010training, telemedicine implementation, and family engagement have shown meaningful improvements in CF care in some of the LMICs. Advocacy efforts are critical in increasing access to breakthrough therapies and newborn screening in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CF is a global disease that requires a unified and equitable global response. By fostering strong partnerships, investing in workforce and system development, prioritizing equity and advocacy, the global community can substantially reduce disparities in CF outcomes. Coordinated international efforts will be crucial to ensure every person with CF, regardless of demographics, has access to quality care and the opportunity for improved survival and quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71390","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:11:01Z","timestamp":1763705461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Roadmap to Global Cystic Fibrosis Care"],"prefix":"10.1002","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4124-316X","authenticated-orcid":false,"given":"Samya Z.","family":"Nasr","sequence":"first","affiliation":[{"name":"University of Michigan, Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8629-1889","authenticated-orcid":false,"given":"Salma","family":"Fleifil","sequence":"additional","affiliation":[{"name":"University of Michigan, Michigan Medicine Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4028-3709","authenticated-orcid":false,"given":"Terez B.","family":"Kamel","sequence":"additional","affiliation":[{"name":"Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May F.","family":"Nassar","sequence":"additional","affiliation":[{"name":"Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwa H.","family":"Abdel Hamed","sequence":"additional","affiliation":[{"name":"Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neveen M.","family":"Fouda","sequence":"additional","affiliation":[{"name":"Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eman","family":"Fouda","sequence":"additional","affiliation":[{"name":"Ain Shams University Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,20]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Cystic Fibrosis Foundation Patient Registry 2024 Annual Data Report Bethesda Maryland 2025Cystic Fibrosis Foundation."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30337-6"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf"},{"key":"e_1_2_12_6_1","first-page":"37","article-title":"Cystic Fibrosis in Low and Middle\u2010Income Countries (LMIC): A View From Four Different Regions of the World","volume":"38","author":"Silva L. V. R. F.","year":"2020","journal-title":"Paediatric Respiratory Reviews"},{"issue":"2","key":"e_1_2_12_7_1","first-page":"S35","article-title":"CF Global Care: CF in Egypt: From Zero to Management Through Collaboration Between University of MI and 5 Universities in Egypt, supplement, Presented in a Workshop at the Virtual North American CF Conference (NACF). September 3\u2013October 2, 2021","volume":"20","author":"Nasr S. Z.","journal-title":"Journal of Cystic Fibrosis"},{"key":"e_1_2_12_8_1","unstructured":"ECFSPR Annual Report 2023 https:\/\/www.ecfs.eu\/sites\/default\/files\/general-contentfiles\/working-groups\/ecfs-patientregistry\/ECFSPR_Annual%20Report%202023.pdf."},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000001638"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26041"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2025.03.139"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2006.04.004"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jare.2013.07.005"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cegh.2024.101697"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2018.04.003"},{"key":"e_1_2_12_16_1","unstructured":"WHO Human Genetics Programme. The Molecular Genetic Epidemiology of Cystic Fibrosis: Report of a Joint Meeting of WHO\/IECFTN\/ICF(M)A\/ECFS Genoa Italy 19 June2002. World Health Organization 2004. Pages 1\u201324. Available online:https:\/\/apps.who.int\/iris\/handle\/10665\/68702."},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-024-03506-1"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijns6010018"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2016.12.012"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2007.03.006"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2024.107821"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1569-1993(23)01324-3"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph15092020"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.34197\/ats-scholar.2023-0156BR"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2006.07.002"},{"key":"e_1_2_12_26_1","article-title":"Progression of Cystic Fibrosis Care in Egypt","volume":"24","author":"Nasr S. Z.","year":"2025","journal-title":"Journal of Cystic Fibrosis"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmr.2021.0021"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.71102"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.2165\/11588870-000000000-00000"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2020.05.002"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26954"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2023.1163391"},{"key":"e_1_2_12_33_1","article-title":"Experience of Starting Elexacaftor\/Tezacaftor\/Ivacaftor in Egyptian People With CF (pwCF)","volume":"24","author":"Nasr S. Z.","year":"2025","journal-title":"Journal of Cystic Fibrosis"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/17476348.2022.2090928"},{"issue":"41","key":"e_1_2_12_35_1","first-page":"52","article-title":"Patient Advocacy and Cystic Fibrosis: Political Correctness or a Real Force for Good?","volume":"95","author":"Barnes R.","year":"2002","journal-title":"Journal of the Royal Society of Medicine"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26344"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2023.03.016"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1569-1993"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71390","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71390","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71390","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T09:00:01Z","timestamp":1769590801000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71390"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":37,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/ppul.71390"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71390","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-08-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71390"}}