Aislinn Santoni

Aislinn Santoni

What is bronchiectasis?

23 June 2026

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The devastating lung condition affects millions. Why is it so poorly understood?

Bronchiectasis* is a chronic lung condition that few people recognise by name. But estimates suggest it may affect over 50 million people globally, and it impacts people’s health and their daily lives in ways that can be invisible to others.

Living with the disease can mean dealing with a persistent cough, breathlessness, chest pain, wheezing and overwhelming fatigue. These affect people’s ability to work, attend school or take part in everyday activities. Breathlessness and exhaustion can make even simple tasks difficult and, over time, take a toll on mental health; anxiety and depression are common.

While these symptoms fluctuate, people often experience flare‑ups or chest infections that require antibiotics or even hospital care.

What causes the disease?

Bronchiectasis can be caused by infections, other lung conditions, inflammatory diseases or issues with the immune system; however, for approximately 40% of people with the condition, there is no known cause. And diagnosis frequently occurs late, if at all.

As a result, people may spend years battling chest infections, fatigue and other debilitating symptoms without understanding what is driving the cycle of illness or being referred for the care they need. This can leave them feeling overlooked, deprioritised, and like they have been left to manage the condition on their own.

People with bronchiectasis often experience flare‑ups or chest infections that require antibiotics or even hospital care.

Despite the disease’s prevalence and its debilitating impact, there are no licensed treatments that address the underlying cause. This means that care focuses on managing symptoms, treating infections and slowing its progression. It often involves antibiotics, but mainly focuses on airway clearance techniques: physical exercises that most people with bronchiectasis are required to undertake at least once a day to clear the mucus from their chest and prevent infection. These are mainly breathing techniques but they may be accompanied by physical chest percussion, vibrations or shaking. And there is no break from this routine – to stay as healthy as possible, people with bronchiectasis must perform these activities every day, including when they’re on holiday, when they’re tired or when they’re staying with friends and family.

The effects of stigma and misdiagnosis

The symptoms of bronchiectasis are misunderstood by both medical professionals and the general public. They may mimic symptoms of more common respiratory conditions, such as asthma or chronic obstructive lung disease (COPD), making it easy for the condition to be missed or mistaken for something else. As a result, many people spend over 10 years experiencing symptoms or being treated for the wrong condition – often with steroids, which may come with serious side effects – before receiving an accurate diagnosis. This delays appropriate care and allows symptoms to worsen.

Not only does bronchiectasis take a huge toll on people’s lives; it can be complicated by stigma associated with its main symptoms. Coughing and the need to clear mucus are sometimes mistaken for a contagious illness by members of the public. People may also assume that someone’s cough is due to smoking, and attach blame or judgement.

Experiencing stigma and feelings of judgement can drive people with the condition to isolate, causing loneliness and compounding mental health challenges.

Symptoms – including persistent cough, breathlessness, chest pain, wheezing and fatigue – affect people’s ability to work, attend school or take part in everyday activities.

A lack of data exacerbates the condition’s toll  

Bronchiectasis has received little attention in health policy. One reason for this is a lack of comprehensive, high‑quality data – particularly at a global level. In recent years, registries in parts of Europe and the US have collected large data sets that increase understanding and facilitate research. But in other countries, data are extremely limited.

The lack of data from countries outside of Europe, the US and Australasia is particularly concerning. In low- and middle-income countries, risk factors for bronchiectasis – such as severe lung infections and tuberculosis – are more common. Where data are available, including in India and China, they point to important differences from Western cohorts: age and sex distribution, comorbidities, microbiology and treatment patterns. These mean that data from high-income countries cannot be extrapolated to other settings, and common assumptions about bronchiectasis aetiology and management are not transferable between geographies. Without locally generated data, it is difficult for policymakers to understand the true scale of bronchiectasis, assess its economic and social impact, and plan services.

Making the invisible visible

Better outcomes are possible. Specialist bronchiectasis clinics, multidisciplinary teams, integrated care models and national registries have all demonstrated that coordinated, person-centred approaches can improve quality of life and reduce hospitalisations.

However, better services are not enough. People living with bronchiectasis need access to information about their condition, opportunities to connect with others, and support to advocate for their needs. Feeling informed, supported and understood can make a huge difference to how people manage their health, engage with care and navigate the world.

Raising awareness among the public, healthcare professionals and policymakers is an important first step in making this possible. When a condition is recognised and understood, assumptions can be replaced with empathy, care becomes more proactive, and people living with bronchiectasis are no longer invisible.

 

*Pronounced brong·kee·EK·tuh·siss

The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.
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The Health Policy Partnership. Developing credible resources to help inform policymakers about key health issues across the globe. A range of international healthcare policy change research topics including; Person-centred care, NASH, BRCA, etc. The Health Policy Partnership. Developing credible resources to help inform policymakers about key health issues across the globe. A range of international healthcare policy change research topics including; Person-centred care, NASH, BRCA, etc. International healthcare policy research and policy change consultants.

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