MANILA, July 10 — For the millions of people across Asia living with conditions like rheumatoid arthritis, type 1 diabetes, or lupus, the immune system is not a shield but an adversary. Autoimmune diseases, where the body turns its defenses against its own tissues, affect an estimated 5 to 8 percent of the US population — roughly 24 million Americans. Here in the region, where access to specialists and advanced therapies can be uneven, the burden is often carried quietly.
The numbers paint a stark picture. In the United States alone, rheumatoid arthritis affects 1.3 million adults.
Type 1 diabetes touches 1.6 million Americans. Multiple sclerosis impacts 1 million US adults, and systemic lupus erythematosus affects 200,000 Americans. While these figures are American, the conditions do not respect borders.
For communities across Asia, the same patterns of chronic inflammation, fatigue, and organ damage are a lived reality.
Why women bear the heavier load
One of the most striking facts about autoimmune disease is its gender skew. Women account for 78 percent of all cases. That means for every man diagnosed, more than three women receive the same news.
Researchers have long puzzled over why the female immune system is more prone to this kind of misfire. Hormones, genetics, and even the microbiome are all under investigation.
Closer to home, this disparity means that mothers, daughters, and grandmothers across Filipino and other Asian families are disproportionately affected. The impact on households — where women are often primary caregivers — can be profound. A mother managing lupus while also caring for children and elderly parents is not an abstract scenario; it is a daily negotiation of energy, medication, and hope.
Not all immune problems are the same
The immune system can malfunction in several distinct ways. Beyond autoimmunity, there are allergies — an overreaction to harmless substances like pollen or peanuts, mediated by IgE antibodies. Allergies affect 50 million Americans annually.
Then there are immunodeficiencies, which can be primary, meaning genetic, such as severe combined immunodeficiency (SCID), or secondary, meaning acquired, like HIV/AIDS. HIV, first identified in 1983 by Luc Montagnier and Françoise Barré-Sinoussi — who shared the Nobel Prize in 2008 — infects CD4+ T cells, a critical part of the immune system.
Without treatment, the virus can lead to AIDS. As of 2022, about 1.2 million Americans live with HIV. Treatments include antiretroviral therapy, or ART, which reduces viral load and allows people to live long, healthy lives.
For families across the region, the distinction between these conditions matters. A child with a peanut allergy needs a very different kind of care than an adult with HIV or a grandmother with rheumatoid arthritis.
But all of them share a common thread: a system meant to protect has gone awry.
The hygiene hypothesis and modern life
Why are these conditions becoming more common? One leading explanation is the hygiene hypothesis. The theory suggests that reduced exposure to microbes — a hallmark of modern, sanitized living — may increase the risk of allergies and possibly autoimmune diseases.
For children growing up in cleaner environments, the immune system may not learn to distinguish friend from foe. This hypothesis resonates in rapidly urbanizing parts of Asia, where traditional farming and outdoor living are giving way to high-rise apartments and antibacterial everything.
What it means for people is a question of balance: how to protect children from genuine infections while still letting their immune systems develop normally.
Therapies that offer hope
For those already living with autoimmune disease, treatment has come a long way. Therapies include immunosuppressants like corticosteroids, which broadly dampen the immune response. More targeted are biologics, such as adalimumab, sold under the brand name Humira, which was approved by the US Food and Drug Administration in 2002.
These drugs block specific inflammatory molecules, offering relief to many who previously had few options. But access remains a challenge.
Biologics are expensive, and in many parts of Asia, they are not always covered by public health systems. For families, the cost of a monthly injection can be prohibitive. Research continues, and the hope is that newer, more affordable therapies will reach the patients who need them most.
The science is advancing. The understanding of how the immune system works — and how it can be retrained or calmed — grows deeper every year.
For the millions affected across the region, that progress cannot come soon enough. Consult your doctor for medical advice.
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