 COPD is one of the fastest growing conditions in the world, affecting over 16 million people in the US and over 1 million in Canada and costing society over 23 billion per annum in the US. Its prevalence has risen by 41 since 1982, and the age-adjusted death rate has increased by 17 between 1966 and 1982 in contrast to the decline in the age-adjusted death rates from all other causes during the same time period. By 2020, COPD will become the third leading cause of death currently 4th representing 5 of all deaths worldwide and 5th leading cause of disability currently 12th worldwide. Ironically, despite the rapidly growing public health burden of COPD, it is the most underfunded disease among all major causes of mortality in North America. Despite some progress in the management of COPD over the past two decades, there is still a paucity of efficacious therapies that can effectively modify the natural course of this disease. 