OBJECTIVES: It is expected that chronic diseases will account for 73% of deaths and 60% of the global diseases by 2020. India is experiencing a fast health transition, in 2005 chronic disease contributed to an estimated 53% of deaths and 44% of disability-adjusted life years lost. Chronic diseases are a serious public health issue, particularly because they require long-term therapy. Asthma, a major chronic disease, has become a cause of global concern in terms of its increasing prevalence, morbidity, and economic impact. Improving access to essential medicines and adherence to standard treatment guidelines can decrease the morbidity and mortality. The present scenario of access to essential medicines and treatment behaviour to asthma in India is investigated.  METHODS: Recent studies conducted (2007-2009) on asthma management and adherence to therapy were analysed.  Data on availability and price of two essential medicines for asthma, beclomethasone and salbutamol inhalers was collated from five medicine price studies conducted (2003-04) in five states of India, Haryana, Karnataka, Maharashtra, Rajasthan and Chennai (capital, Tamil Nadu state). RESULTS: Except for Rajasthan no inhalers were on state essential medicine list and were not available in any of the public facility; in Rajasthan these inhalers were available only in public facility of capital city. Results of the asthma management studies indicate poor knowledge regarding treatment of bronchial asthma by prescribers, pharmacists and by patients and asthma is not treated according to standard treatment guidelines. More than 80% patients and/or prescribers are treating acute episodes, rather than focusing on long-term asthma control. Ninety-two percent of patients alter the dose of inhaled corticosteroids after the acute attack. CONCLUSIONS: Since the incidence of chronic diseases are increasing rapidly in India, there is urgent need for improving access to essential medicines, treatment guidelines, policy making, patient & provider education, and resource allocation for chronic diseases, like bronchial asthma.