The cost of delivering healthcare is increasing in many countries, while at the same time, populations are ageing and fertility rates falling. These factors are pushing policy-makers to consider alternative strategies for health service delivery. The recent pandemic has confirmed that many of the impacts of acute infectious diseases can be mitigated through vaccination and other forms of prevention and treatment, allowing health leaders to pivot strategic thinking and health systems towards the prevention and cure of non-communicable chronic diseases. Of all chronic conditions, cardiovascular and respiratory diseases are two of societies’ greatest causes of ill-health and early death.

Many chronic diseases of adults have their origins in childhood. For example, increased Body Mass Index, systolic blood pressure, total cholesterol level, triglyceride level and smoking in teenagers are associated with cardiovascular fatality in mid-life.1 Similarly, compared with children without symptoms of wheeze to the age of 7 years, children with severe asthma have significantly higher risk for developing chronic obstructive pulmonary disease.2

Reduced forced expired volume in 1 s (FEV1) identified in childhood is known to track to adult life3 when it confers a poorer prognosis for increased mortality and morbidity. Specific lung function trajectories from childhood are associated with the development of chronic obstructive pulmonary disease.4 However, low lung function is also increasingly being identified as a marker for …