Standardized and systematic international comparisons of asthma prevalence, such as the International Study of Asthma and Allergies in Childhood (ISAAC) program, will probably contribute to major advances in the understanding of the causes of asthma. The findings from this study provide the basis for investigating the role of different risk factors in the development of asthma. In particular, they show striking international differences in prevalence that do not seem to be explained by currently recognized risk factors or by currently accepted theoretic paradigms for asthma. It is important that both established and novel risk or protective factors are investigated and that new theoretic paradigms are developed.