History of the World Allergy Organization: Reflective Recollections of the WAO Presidency, 2010-2011
© World Allergy Organization; licensee BioMed Central Ltd. 2012
Published: 17 February 2012
History of the World Allergy Organization: In 1951, the leaders in allergy from all over the world came together to form the International Association of Allergology and Clinical Immunology (IAACI). For the next 60 years, the allergy world converged at the IAACI triennial meetings, which became biennial in 2003. The international meetings, originally named the International Congress of Allergology and Clinical Immunology (ICACI), are now the World Allergy Congress (WAC) hosted by the World Allergy Organization (WAO). Everyone who has aspired to have worldwide recognition has played a part in IAACI-WAO. The History of the World Allergy Organization traces the global arc of the allergy field over the past 60 years. The current officers of WAO elected to focus on this rich history, inviting prominent leaders who are interested in being part of this history project to write about their time with IAACI-WAO. This series was presented in Cancún, México as part of the XXII World Allergy Congress (December 4-8, 2011). The World Allergy Organization Journal is presenting segments of the History as part of the "Notes of Allergy Watchers Series." Please enjoy.
--Michael A. Kaliner, MD
Historian, and Past President (2006-2007)
World Allergy Organization
The Opportunity to Serve
I have always thought that leadership positions are larger than any one individual who occupies them; they certainly outlast any individual--or at least they should. In other words, I saw being the President of the World Allergy Organization (WAO) as another way of serving the organization, albeit one with enhanced opportunities and challenges, rewards, and responsibilities. Every leadership position, to which I have had the honor of being appointed or elected since I joined the WAO Board in 1997, has provided a unique opportunity to serve the organization.
Formalizing WAO: Revising WAO Bylaws
Working on the WAO Bylaws, as Chair of the Bylaws Committee over the years, showed me the true extent and scope--the scale and complexity--of the issue of representation in a global federation. The committee worked on the Bylaws to ensure that the different regions of the world, as recognized by WAO, were fairly represented on the Board of Directors and to put in place a democratic process for leadership succession. For example, 2 officers (Treasurer and Secretary-General) are elected from within the representative Board of Directors and by the Directors. These 2 officers are eligible to run for the position of President Elect as run-up to becoming the President, and once again the Board votes. All elected individuals are finally ratified by the WAO House of Delegates, the ultimate governing and representative chamber.
Mobilizing WAO: Experiences as Chief Editor of WAO Web Site
Great distances, different time zones, varied languages, and association cultures, not to mention the differences in the field of allergy, asthma, and clinical immunology among regions and countries define the WAO. I became acutely aware of the challenges presented by a global federation while serving as the Chief Editor of the WAO Web site http://www.worldallergy.org for a number of years and chairing the ad hoc Communications Committee (now the Communications Council), which ultimately resulted in the launching of the new online World Allergy Organization Journal (WAO Journal) at http://www.waojournal.org. But being a great believer in communication, and cost-effective communication, the Internet became the perfect means of communicating, sharing information, and remaining in touch to bridge distances and to help build a worldwide allergy community. And, best of all, in a cost-effective manner. Although it was hard work requiring daily attention, it remains one of my favorite and most rewarding duties.
I view the WAO Web site as a leading resource on allergy, asthma, and clinical immunology for both professionals and patients. Unparalleled information is provided by the "Allergic Diseases Resource Center," "Interactive Case Reports," "Expert Interviews," "Clinical Allergy Tips," and "Allergy Quiz," to list some of the available features. While such a major endeavor requires the dedicated work of many contributors, and I salute them all, I would like to mention in particular Connie Katelaris (Australia) for her diligence over several years in providing book reviews, Bob Lanier (the United States) for his unfailing enthusiasm and hard work in preparing interactive case reviews and interviewing fellow doctors, and Juan Carlos Ivancevich (Argentina) for successfully taking over the medical literature reviews and enhancing them in his role as the Web Editor-in-Chief.
The monthly WAO News and Notes electronic newsletter was introduced not only to bring allergists/immunologists worldwide up to date with WAO's activities but also to outline the most important scientific literature over the previous month. A successful monthly literature review, of the most recent and relevant publications in the field of allergy and immunology, WAO Reviews, is posted so that busy clinicians can quickly click online to obtain a comprehensive review of the previous month's major journals. The WAO Reviews is now translated into 7 languages by individuals from member societies. Yehia El-Gamal, WAO Board Member from Egypt, and his colleagues have been exemplary in their timely and accurate translations of WAO Reviews into Arabic every month.
The WAO Web site has also become a means of delivering easy-to-access, free, online education via didactic and interactive modules, webinars, podcasts, and other online learning modalities. One of the more recent additions to this growing online repository of educational materials is the series of modules on "Asthma and Allergic Rhinitis: WAO Online Lecture Series," a project jointly chaired by Hae Sim Park (South Korea) and Motohiro Ebisawa (Japan). Michael Blaiss (the United States) did an outstanding job in his contributions to the module content and in helping to coordinate the project.
As President, I have been keen to promote the use of Web-based technology for teaching, and, where possible, WAO has taken the opportunity to organize a webinar rather than send a WAO speaker halfway across the world to deliver a lecture. I was delighted to be able to present a lecture, from Tampa, Florida, at the Annual Meeting of the Georgian Association of Allergology and Clinical Immunology in Tbilisi via Web link in October 2010, and I found this to be an enjoyable, cost-effective, and time-saving way to interact with a WAO Member Society. And this live webinar is now archived on the WAO Web site to be accessed by anyone at any time. It is my opinion that online learning and continuing medical education are increasingly intimately related. The day and age of physicians and other healthcare professionals being able to afford to travel long distances to scientific meetings for such education is limited.
The WAO Web site has become a repository for a tremendous amount of information, both for physicians and trainees. The fellows-in-training at the University of South Florida in Tampa regularly access this site. On assuming the presidential role, this major task was turned over to the present editor, Juan Carlos Ivancevich. He has done an exceptional job and continues to expand the WAO Web site and WAO's social media presence. Along with him, Sofia Dorsano, of the WAO Executive Staff, has also been extremely instrumental in making the WAO Web site such a huge success.
Scientific Credibility: Developing the WAO Journal
The World Allergy Organization Journal (WAO Journal), an online-only journal with monthly postings that is free to individual members of WAO Member Societies, was the result of the work of the Communications Council that was charged with evaluating and proposing the best option for a scientific, flagship WAO periodical. Starting with the first electronic issue or "posting" in January 2008, under the direction of Johannes Ring as Editor-in-Chief, the WAO Journal has been published every month since--no small feat by any means. With the WAO Journal, WAO demonstrated that it was ahead of the curve in recognizing the primacy of electronic media in the creation and dissemination of knowledge, as it did so by embracing online education. Electronic media and the Internet help WAO to fulfill its mission as a global federation of true accessibility and real representation. Now, under the current leadership of Lanny Rosenwasser as Editor-in-Chief, the WAO Journal continues to expand its influence on a worldwide basis.
Effective Governance: Empowering the WAO Board
WAO does a good job of electing a Board that represents the national and regional diversity of its member societies. One of my major presidential goals was to work with a Board that was "actively" representative, fully engaged, and involved, that is, to turn WAO into a Board-driven rather than a presidential-driven organization. The WAO has an extraordinarily talented Board of Directors that has worldwide recognition for its expertise and leadership skills, and I wanted to ensure that both its knowledge and skills would be harnessed toward advancing the mission of the WAO.
A World Federation of Allergy, Asthma, and Immunology Societies and its Activities
To help direct WAO activities (education, research, publications, scientific meetings, etc) toward strengthening the specialty, a strategic planning session was held in New Orleans, February 2010, with the Executive Committee and another meeting in London, June 2010, with the entire Board, giving WAO leaders opportunities to consider WAO's changing role in the global allergy community and to determine areas of growth and development. These strategy sessions led to several projects and proposals arising from the individual and collective thinking of the Board, an engaged involvement that continued when every board member assumed leadership individually or collectively of seeing the projects to fruition.
As anyone who manages a personal budget knows, an organization also must spend judiciously--balancing smart spending and investment with wise savings--and continue to explore new sources of revenue. These new initiatives, of course, would need to advance WAO's mission and help secure the financial viability of the organization and balance its budget. One such initiative arose directly from WAO's educational philosophy. To raise awareness, improve patient care, and advance research, WAO holds that continuing education for physicians must occur as repetitive learning through program activities that are cumulative, complementary, and constant.
Thus, a very valuable initiative that resulted from these brainstorming sessions was the introduction of disease-specific, multipartner, multiyear and multiactivity projects, each with its own dedicated area on the WAO Web site. These projects are global in scope, in terms of both expert representation and approach to the disease. WAO now overseas 3 such Working Groups on Small Airways chaired by Lanny Rosenwasser (the United States), Hereditary Angioedema chaired by Timothy Craig (the United States), and Allergic Rhinitis chaired by Sandra González-Díaz (Mexico). Similar Working Groups on Specific Immunotherapy and Anaphylaxis are in the process of being developed, and others on Biological Products and Food Allergy are to be discussed by the Board for future consideration.
One of the ways in which WAO has most effectively fulfilled its role as a global federation is by leading the creation of "WAO Position Papers and Statements". These publications, providing global perspective and international consensus, critically help in defining and harmonizing the field worldwide. Among the more recent publications, WAO has published on these subjects:
Sublingual Immunotherapy (SLIT) spearheaded by G. Walter Canonica (Italy) and completed during his presidency (2008 and 2009).
Cow's Milk Allergy Guidelines led by Alessandro Fiocchi (Italy) under the aegis of President Canonica and completed in 2011. Alessandro Fiocchi is currently working on a similar publication on probiotics.
Anaphylaxis led by Estelle Simons (Canada), the culmination of a 3-year project including 2 worldwide surveys.
There are several such key publications and global projects underway currently, including Urticaria and Angioedema led by Mario Sánchez-Borges (Venezuela).
Testing for IgE Sensitization and Interpreting Results headed up by Ignacio Ansotegui (Spain) and Tari Haahtela (Finland).
Biodiversity headed by Tari Haahtela (Finland).
Risks and Safety Requirements for Diagnostic and Therapeutic Procedures in Allergy spearheaded by Marek Kowalski (Poland).
Grading Local Side Effects of Sublingual Immunotherapy: Speaking the Same Language headed by Gianni Passalacqua (Italy).
A recent WAO publication that fully captures the organization's role as a global federation and advances its mission is the WAO White Book on Allergy. The WAO White Book on Allergy, published in early 2011, was edited by Ruby Pawankar, Stephen Holgate, G. Walter Canonica, and Richard F. Lockey and coauthored by 79 international allergy experts. This landmark publication, which can be downloaded free of charge from the WAO Web site, has set the scene for the need for allergy services worldwide to be enhanced to meet the growing burden of allergic disease. It clearly explains the nature and burden of allergic diseases in a format that makes it widely accessible. The WAO White Book on Allergy is being provided to all WAO Member Societies with advice on how to use it as an advocacy tool. Sixty-one member societies took up the invitation to submit a report on the state of allergy in their countries, and these make very fascinating reading. Translations of the "Executive Summary" of the WAO White Book on Allergy are already available in Russian, Czech, Japanese, Polish, and Spanish, and they can be accessed at http://www.worldallergy.org.
WAO is uniquely positioned to lead projects that, in being globally representative, are able to address the differences in practice among countries while providing harmonizing guidelines for research, practice, and care of patients. Several projects, closely reflective of my vision, have been evolving over the last 2 years, and I look forward to their launch under the presidency of Ruby Pawankar (2012-2013). The first project, conceived and led by Tari Haahtela and inspired by a similar program in Finland, is the Global Allergy Plan, which seeks to reduce the burden of allergic diseases by equipping individual points of care (hospitals, clinics, universities, etc) all over the world with measurement and assessment tools that will help toward improved management of disease and create awareness of preventive strategies. The second project is the creation of WAO Centers of Collaboration and/or Excellence toward expanding the capacity of institutions and individuals to interact and collaborate with WAO in carrying out educational programs in their own country and region. The proposed "WAO-Primary Care Physicians International Initiative" will reach out to primary care physicians, informing them about the clinical science of diagnosing and treating allergic diseases. Too often, allergy and immunology specialists talk to one another but do not talk to their colleagues in internal medicine, pediatrics, and general medicine. A fourth initiative is to try to solicit the support of patients and patient groups to be advocates for the specialty. All specialties need advocates, not only to support the training of specialists but also to support and advocate for research, appropriate patient care, access to care, and reimbursement for care. The field of allergy and immunology is not unlike others in this regard.
There can be no sustainable global outreach to strengthen our field without strong and robust global collaboration. To that end, a number of initiatives with Regional Member Societies are in discussion and various stages of development. A series of global consensus documents (International Consensus ON, or ICONs), first proposed by Jan Lötvall (Sweden), are being produced as a result of collaboration among the WAO, the American Academy of Allergy, Asthma and Immunology (AAAAI), the European Academy of Allergy and Clinical Immunology, and the American College of Allergy, Asthma and Immunology. The ICONs will be part of a larger collaborative, the International Collaborative on Asthma, Allergy, and Immunology (iCAALL), created to help with joint communication strategies for WAO and the major regional societies aimed at promoting and strengthening the specialty worldwide.
A Global Federation and its Global Outreach
Joining the ESP in 2011 to strengthen WAO's global outreach are 2 new initiatives. The WAO Junior Members Group was successfully launched in March of this year, with a Steering Committee of enthusiastic junior allergists meeting for the first time in San Francisco to start to plan activities. The Junior Members are already contributing to the WAO News and Notes monthly electronic newsletter along with other educational and editorial projects (eg, they are contributing to the online elements of the activities of the Working Groups on Small Airways and Allergic Rhinitis), and they held an excellent scientific session in Cancún. Their goals, leadership, and structure were established at the first in-person meeting of the group's steering committee during the XXII World Allergy Congress, and we are greatly looking forward to their participation in WAO over the coming years. The WAO Junior Members Group is overseen by the Specialty and Training Council, chaired by Paul Potter (South Africa). Ignacio Ansotegui (Spain) has taken responsibility as liaison between the Council and Junior Members Group.
The year 2011 also saw the celebration of World Allergy Day extend to a World Allergy Week, whose launch in April 2011 was overseen by Marek Kowalski, Chair of the Communications Council with a Steering Committee guiding regional activities. It was felt that a designated Week, rather than a Day, would give member societies much more flexibility to organize media and promotional activities around the theme of allergy, organized on various days to suit local needs and circumstances. The first World Allergy Week was celebrated in April 2011, and picking up on the launch of the WAO White Book on Allergy, the theme of "Allergy as a Global Health Concern" was the major focus.
Reflecting on the Past for Present Understanding and Future Growth: History of the WAO
This overview of my presidency is part of the WAO History project that is being overseen by the WAO Historian and Past President, Michael Kaliner. He has worked with Karen Henley, WAO's Global Projects Director on staff for the last 13 years; their extensive network of personal connections and collective knowledge of the work of the organization has helped us put together a superb history of the past 60 years since the organization was inaugurated. The WAO History project was one of the earliest of my 2 years as President. I could not have chosen a better leader for this huge and most important job. Since he took on this project, Michael Kaliner has worked tirelessly and with great initiative. His contribution to strengthening the identity of WAO is indeed historical.
As President of WAO, my biggest history lesson concerned the economic health of the organization and the fiscal stewardship provided by the Board and President. Thus, I would like to note that along with the many initiatives begun in 2010, the first year of my presidential duties, 2010 also marked the first time since 2002 that the WAO recorded a balanced budget and a net profit in a non-Congress year. Balancing the budget is the single most important responsibility of the Board of any nonprofit organization, including WAO. The World Allergy Congress in Cancún in 2011 was a financial success thus; for 2 years in a row, WAO has made a profit, an unusual occurrence in WAO's history. I am very thankful for the Board's assistance in making this possible.
Capstone Activities: WAO and its Scientific Meetings
Every congress builds on the ones that preceded it, and it is the same for WAC 2011, which included several new and improved features. In addition to improving and expanding on the concept of the Sister Society Symposia, the congress in Cancún offered university training programs in allergy/immunology, the opportunity to collaborate on scientific sessions. The process for including Sister Society and collaborative sessions in the scientific program was a competitive one, and the final selection greatly enhanced the scope and quality of the programming.
WAC 2011 also featured the first WAO Allied Health Session in collaboration with the AAAAI. The Allied Health program took place over a 2-day period and concentrated on 2 themes that are critical to the knowledge base of all health care professionals who provide care to people with allergy, asthma, and immunologic diseases: "Asthma, Diagnosis, Management and Education" and "Allergic Disorders: Snapshots of a Worldly View."
The winners of the Junior Abstract Awards were:
Top Junior Oral Abstracts:
Juan Manuel Leyva Castillo
Top Junior Poster Abstracts:
Barbara Cases (top poster presenter winner)
Arelis Mas Quintero
Ivan Lopez-Exposito (top poster presenter winner)
Jeong-Eun Kim (top poster presenter winner)
Oussama Abou Chakra
Gisoo Ghaffari (top poster presenter winner)
Freya Helena Campos Romero
Nelva Lizbeth Guillen Rocha
Jun Lu (top poster presenter winner)
Raul Lazaro Castro Almarales (top poster presenter winner)
Mayra Alondra Lievano Perez
David Alexander Morales Marin
Pavel Samoylikov (top poster presenter winner)
The WAO's ESP hosted its seventh WATS with participants from 8 Latin American countries. The main purpose of WATS is to help strengthen a country's core allergy base by assisting in expanding and better mobilizing already existing knowledge, competence, experience, and skills in the field of allergy, asthma, and immunology. Faculty from around the world covered a variety of topics from "Basic Mechanisms in Allergic Diseases" to "Immunotherapy" to "Food Allergy." As mentioned earlier, the ESP WATSs are a joint program of the WAO and the ACAAI. A critical part of WAO's mission is outreach, and this program has become a successful vehicle for achieving outreach goals.
In 2011, WAO reached its 60th anniversary as an organization, and WAC 2011 celebrated these years of growth and achievement in a special WAO History display and in the Presidential Symposium. Along with the display, past presidents, congress organizers, and other WAO leaders have contributed personal recollections to the WAO Journal, recording their experiences in WAO and observations of the evolving field of allergy/immunology. A bibliography of WAO History articles is available at http://www.worldallergy.org/wao_societies/history_project.php
During WAC 2011, the WAO House of Delegates approved the joint World Allergy Congress and AAAAI Annual Meeting of 2018 to be held in Orlando, Florida, the United States. The vote was an historical one for WAO because this will be the first WAO and AAAAI joint meeting. I look forward to it and to the next World Allergy Congress to be held jointly with the European Academy of Allergy and Clinical Immunology in Milan in 2013 and in Seoul, South Korea, in 2015, with the Korean Academy of Asthma, Allergy and Clinical Immunology.
In summary, the WAO is a world organization with worldclass people working on projects that positively influence the specialty and improve the quality of life of individuals all over the world who suffer from allergic diseases, asthma, and clinical immunological problems. I am honored to have represented 89 member societies and their members as the WAO President for 2010 and 2011. Thank you for this great privilege.
I especially wish to thank the Board members who served during my term and Gunnar Johansson, Allen Kaplan, Michael Kaliner, Carlos Baena-Cagnani, and Walter Canonica, past presidents under whom I have served. I also wish to thank Charu Malik, past Executive Director of WAO, who has been instrumental and essential in advancing WAO to its current prominent status, and the staff at WAO who have been instrumental in making these last 2 years a successful and pleasurable experience. They are Ande Rowe (Senior Manager, Meetings and Programs), Becky Anderson (Web Assistant), Jennie Smazik (Executive Director), Karen Henley (past Global Project Director), Kate Kirchner (past Project Coordinator), Katie Vande Zande (Associate Director of Meetings), Marechiel Santos-Long (past Director of Meetings), Sofia Dorsano (Director, Publications, Education & Communication, and Managing Editor, WAO Journal), Tahira Chaudary (Project Coordinator), and Kay Whalen (EDI Consulting Partner).
In addition, I thank my fellow faculty members and staff in the Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida College of Medicine, Tampa, Florida, for their support. They include Roger Fox, Mark Glaum, Narasaiah Kolliputi, Dennis Ledford, Michael Teng, and Jia-Wang Wang; the Division's clinical faculty members, Rosa Codina, Enrique Fernandez-Caldas, Mary Jelks, Dennis Kim, Monroe King, Brett Stanaland, Ed Stewart, Glenn Whelan, and Hugh Windom; and past faculty members Gerald A. Bucholtz, Rama Ganguly, Shyam S. Mohapatra, Srinivas Nagaraj, Robert P. Nelson, the late John J. Stablein, and the late Andor Szentivanyi.
Thank you also to the Pediatric Division of Allergy and Immunology headed by John Sleasman and consisting of Noorbibi Day-Good, Morna Dorsey, Soichi Haraguchi, Gary Litman, Elena Perez, Panida Sriaroon, Mandel Sher, and Nathan Tang. I also thank my support staff, which includes Rebecca Carter, Geeta Gehi, Peggy Hales, Dawn McCrery, Diana Miller, Dona Shearer, and Michelle Singleton, and all the MDs, PhDs, and postgraduate trainees from throughout the world. Last and most important, I thank my wife, Carol; sons, Keith and Brian; Brian's wife, Chiara, and their family; and my siblings, Stephen, Jim, Doris, and their spouses and families, the late Samuel C. Bukantz and his wife Jewell, and the late Robert A. Good. Sam was my mentor and dear friend. Bob Good was my counterpart and dear friend in the Paediatric Division of Allergy and Immunology at the University of South Florida. These 2 men were perhaps the brightest physician friends with whom I have associated.
I am honored to have been your president. I greatly enjoyed my last 2 years and look forward to my new position as a Past President of the WAO. I am sure that WAO will continue to enhance the specialty and ultimately provide optimal care for patients with allergic diseases, asthma, and clinical immunology problems throughout the world.
Dedicated to my late parents, Stephen D. Lockey, MD, and Anna F. Lockey. The author has no funding or conflicts of interest to disclose.
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