Global disparities in cystic fibrosis outcomes prior to CFTR modulators: A CF registries cohort study in South Africa and Canada

•Lung function and nutrition prior to CFTR modulator therapy was significantly lower in people with CF in south Africa compared to Canada.•Disparities in outcomes are likely due to different socioeconomic conditions, inferior quality of healthcare in SA and early-life determinants of health.•Global disparities in CF outcomes between high and low to middle income countries are likely to widen in future as CFTR modulators rapidly become standard of care in only high-income countries.