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The most prominent change highlighted in GINA’s 2026 asthma strategy is a set of four acute-asthma flowcharts, organized by age and care setting. The pathways also address severity assessment, anaphylaxis, oxygen use, bronchodilator options, inhaler technique, and reassessment. They are a summary of guidance for clinical use—not individualized treatment instructions.
What is the 2026 GINA Strategy Report?
The Global Strategy for Asthma Management and Prevention is the Global Initiative for Asthma’s (GINA) annually updated strategy document. GINA describes its 2026 report as incorporating recent scientific information reviewed by an international panel of experts on its Science Committee. The organization calls it a practical resource with extensive scientific citations and says it provides a basis for other GINA documents and programs. GINA’s 2026 Strategy Report page
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The report is intended to inform asthma care and policy; its clinical pathways need to be read in their full context and applied with professional judgment and applicable local guidance. GINA’s 2026 Summary Guide is a companion resource.
What changed in the 2026 GINA asthma strategy?
GINA’s key-changes summary foregrounds four new flowcharts for assessment, treatment, and follow-up of acute asthma. They cover two age groupings across two care settings:
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| Age group | Primary care | Acute-care facility or emergency department |
|---|---|---|
| Adults, adolescents, and children aged 6–11 | Flowchart | Flowchart |
| Children aged 5 and younger | Flowchart | Flowchart |
These categories describe the four pathways GINA highlights; they are not a substitute for checking the full pathway for a particular patient or setting. GINA’s 2026 Strategy Report contains the detailed charts.
What’s New in GINA 2026: changes within the acute-care pathways
Severity assessment
The pathways distinguish mild, moderate, severe, and life-threatening presentations. For patients up to age 17, GINA’s summary says it strongly recommends use of a validated clinical score, giving PRAM as an example. The score and the full pathway—not this high-level summary—are needed to guide clinical assessment.
Anaphylaxis and asthma symptoms
When features of anaphylaxis are present, GINA’s summary says the pathways recommend giving epinephrine (adrenaline) first, followed by bronchodilators. This sequence is a report-level summary, not a patient-specific instruction.
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Oxygen thresholds and targets
GINA’s key-changes summary says supplemental oxygen is not recommended unless oxygen saturation is below 92%, and that oxygen targets differ by age group. The threshold belongs to the acute-care context of the report; consult the relevant chart for its full criteria and age-specific targets rather than inferring a target from this summary.
More conservative SABA dosing
The summary describes more conservative recommended doses of short-acting beta2-agonists (SABAs) during acute asthma care. GINA cites concern about overtreatment and possible SABA toxicity, including lactic acidosis. It does not provide dose details in the key-changes summary, so dosing should be taken from the full report rather than inferred here.
ICS-formoterol as an option for some mild exacerbations
GINA says inhaled corticosteroid-formoterol (ICS-formoterol) has been added as an option for adults, adolescents, and children aged 6–11 with a mild exacerbation in primary care or an emergency department, as an alternative to inhaled SABA. The summary does not establish that this option applies to every patient or every regimen; eligibility and use require the full pathway.
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Inhaler technique and response review
The flowcharts add information about tidal breathing with a pressurized metered-dose inhaler (pMDI) and spacer, remind users to shake suspension inhalers before each actuation, and emphasize reviewing the response after initial bronchodilator administration. The operational details belong to the relevant chart and clinical context.
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The 2026 key-changes summary identifies what GINA highlights in this update, but it is not a complete verified comparison with the 2025 report. Do not assume that every item above is entirely new for 2026. For a year-over-year comparison, consult the report’s own tracked changes or “What’s new” section in the full 2026 report.
Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.Where to get the report
GINA provides a free PDF download of the 2026 Strategy Report and offers a paperback option through Amazon. The companion 2026 Summary Guide page also offers a free PDF and a paperback option.
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GINA says its documents are copyright-protected: copies may not be distributed or posted without permission, and additions or changes may not be made. Commercial or promotional use of the Strategy Report, Summary Guide, or Severe Asthma Guide requires GINA approval. Link readers to GINA’s pages rather than reproducing or adapting the material without permission.
Why the annual update matters
GINA says its Science Committee reviews scientific literature and updates its strategy documents, and its May 2026 announcement likewise describes the global strategy as updated annually. In that announcement, GINA attributed an estimate of more than 300 million people worldwide living with asthma to the organization; the announcement does not identify the underlying epidemiological study. GINA’s May 5, 2026 announcement
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