History of the World Allergy Organization: Personal Reflections of a Board Member, Vice President, Congress Organizer, and Journal Editor

Abstract

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 will be presented in Cancún, México, as part of the XXII World Allergy Congress (December 4-8, 2011). Leading up to the Congress in Cancún, 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

A 60th birthday is a good occasion to look back trying to understand the basis from where we look forward. This organization, "World Allergy Organization" (WAO), founded as the International Association of Allergology and Clinical Immunology (IAACI), has good reasons to be proud. The history of this organization is somehow highlighting the progress of the discipline in the second half of the 20th century and the beginning of our millennium. My humble task is just to reflect on the years where I had the chance to participate in the development of this organization.

Congresses

"International Congress of Allergology and Clinical Immunology"--"World Allergy Congress"

As a matter of fact, my first contact with IAACI was in 1973 when I wanted to attend the International Congress of Allergology and Clinical Immunology (ICACI) in Tokyo; in those days I, was working in experimental immunology trying to prevent organ transplant rejection with horse antihuman lymphocyte globulin in the group of Walter Brendel in Munich and trying to induce immunological tolerance against horse IgG in patients to prevent the quite serious side reactions as anaphylaxis and serum sickness. Unfortunately, I did not get a travel grant, and in those days, this was a problem. So only a colleague of mine went there, told me about the event, and brought back an interesting abstract volume motivating me for allergy.

The first ICACI congress I attended was in 1982 in London and from then on I attended all of them. The program became increasingly richer, and the number of abstracts increased considerably, as well as the quality. However, what really stays in my memory are not only excellent plenary lectures but also the social events, which make the difference and make the memory of such a congress unique.

I recall the big tent on the "mall" in Washington, DC, 1985; I still have the red scarf we got. Michael Kaliner did a great job.

From 1988, in Montreux, we will not forget the outstanding evening with the candle light dinners in the various castles around Lake Geneva where I first met Tomio Tada, the great immunologist. The other event was the big circus "Knie" where Professor Alain de Weck made me enter the stage and try to cope with the professional clowns. An outstanding satellite meeting was dedicated to Alain de Weck's 60th birthday. The many friendly helpers were carrying bright red scarves and shirts; we called them "red brigades," which was not really appreciated by our Italian colleagues. The whole spirit of the meeting was reflecting the organizational and human skills of Alain and Christine de Weck.

In 1991, during Professor Terumasa Miyamoto's congress in Kyoto, the highlight was Tomio Tada's "No" play with the ghost of a transplant donor in dialogue with the recipient of his heart. Needless to say, the beautiful city of Kyoto is an unforgettable imprint in the memory of the participants.

In 1994, in Stockholm, Gunnar Johansson managed to bring together the European Academy of Allergology and Clinical Immunology (EAACI) and the IAACI for one event, and everybody was enjoying the beautiful evening in the open amusement park in Skansen.

In 1997, under President Alberto Oehling, and the excellent organization by José Huerta-López, it was amazing how crowded the lecture halls were, despite the beautiful beaches in Cancún, and the tropical night with the Maya pyramids is unforgettable.

In 2000, in Sydney, Connie Katelaris led the allergists along the path of the Paralympics, and we had an outstanding evening in the Olympic Stadium just after the big millennium event.

In 2003, Michael Kaliner and Estelle Simons organized the congress in Vancouver with North American perfection, and everybody will remember the beautiful bay area with the airplanes landing on the water and the evening in the stadium.

In 2005, I had the big honor to organize the first World Allergy Congress (WAC) in Munich, again in a joint effort with the EAACI (Figure 1). When you want to become a congress organizer (in analogy to Olympic Games), you sometimes have to perform not only once; it means that you cannot always win at the first bid. When we first proposed Munich as the congress site--this was in 1997 in Cancún with posters and compact discs with Bavarian music as well as ties--we had to compete with Madrid and Vancouver, and we became second choice. Three years later, we prepared things better and received the approval in Sidney, Australia, to host the WAC in Munich in 2005.

Figure 1

Promotional material for the XIX World Allergy Congress (WAC 2005) Munich.

For the presentation of Munich at national and international congresses, we organized a booth in the exhibit hall of large congresses with leaflets, information material, buttons, flyers, and the like. As a special small gift, we had a typical Bavarian sample of "snuff tobacco" in nice ceramic bottles with the Bavarian emblem and the inscription "topical nasal immunotherapy." We offered this at the Vancouver congress with great success and wanted to do the same the following year at the congress of the American Academy of Allergy, Asthma and Immunology (AAAAI). But to my surprise, the package of 500 bottles never arrived because we had underestimated the strict American laws for the introduction of narcotics. So it happened that our beautiful little gifts from Bavaria were regarded almost like cocaine by the customs officers in the United States and were annihilated by fire. It was then that I learned that the United States and Canada are indeed different countries.

In Munich, we had the President's dinner in the "Kaisersaal" of the Munich castle upon invitation by the Bavarian government and the Bavarian evening in the Löwenbräu beer hall where I could find a playground for my crazy fantasies in putting on stage the allergomusical "L'Allergica Commedia" following Dante Alighieri (Figure 2). The "comedy of allergy" was a modest attempt to illustrate the weaknesses of human ambition in research and clinics together with some pitfalls in allergy diagnosis and treatment on the stage performed by our co-workers from the Dermatology Department and Heidrun Behrendt's ZAUM-Center for Allergy and Environment. I think that the song "Allergy, oh allergy - I'm so sensitive to you" or the mast cell granule's song "Please release me, let me go" are still somewhere in the heads of the participants. We had a good time, and it was hard work and fun at the same time!

Figure 2

Title page of the booklet accompanying the "Allergo-Musical," "L'allergica commedia - The Comedy of Allergy", performed in Munich, 2005.

In 2007, Pakit Vichyanond was able to invite the participants to a private audience with a member of the royal dynasty of Thailand, together with the beautiful and romantic farewell evening with candles swimming on the lake--this was unforgettable.

In 2009, the congress organized by Carlos Baena-Cagnani brought Argentine temper, tango, and beef in the beautiful city of Buenos Aires.

Now, we all look forward to a second time in Cancún in December 2011.

I personally think that a 3-year interval between the congresses is better for such large events because there is not a lot of news every year. However, the meetings were and are successful and people come, so the proponents of a 2-year interval are justified.

The Executive Committee--Board of Directors

My first appearance in this famous committee was in 1983 on the occasion of a meeting at the AAAAI (but in those days only triple A-I) where I was permitted to step in for the German Executive Committee member Erich Fuchs, who was not able to travel due to his poliomyelitis. The Executive Committee and the officers were kind enough to allow this, and thus several times I had the duty and honor to participate in these meetings when they were in the United States and I had the opportunity to meet the very famous allergists, such as Professor Jack Pepys, Max Samter, Oskar Frick, Terumasa Miyamoto, and many others.

When Alain de Weck became president, he invited me to a presidential advisory committee where one could actively bring forward ideas. Thus, the organization began to change from a purely congress-organizing group to an active platform of worldwide allergy. One of the first activities of President de Weck was the introduction of a house dust mite committee chaired by Tom Platts-Mills and an epidemiology committee which I had the honor to chair and which finally was included in the ISAAC project (The International Study of Allergies and Asthma in Children). One of the major achievements was the introduction of the allergen standardization committee in a joint venture with the World Health Organization and the International Union of Immunological Societies (IUIS), which was only possible due to the excellent personal connections of Alain de Weck who has been one of the very few individuals serving as president of both the IUIS and the IAACI. This committee with Henning Løwenstein and many others really made a difference in allergy history and our specialty!

In 1988, I was elected as a member of the Executive Committee where I stayed until 2005 in various roles, slowly working up the way from third to second up to first Vice President, historian, and finally journal editor.

The more political the organization became, the more emotional were the discussions, especially with regard to statutes.

It was President Gunnar Johansson who changed the character of this organization tremendously by the introduction of new statutes, which were not easily accepted. I still recall night-long hours of hot discussions between the North American friends with their philosophy of statutes and allergists from other parts of the world with a slightly different and more diverse culture of democracy. Yet, as mostly, the American way of life won and a big credit goes to our acting president Richard Lockey for his unbelievable commitment! During the turmoils of statute change, some personal careers went unexpected ways. So Mario Ricci from Florence, one of the first proponents of the Th1/Th2 paradigm in allergy who normally was supposed to become the next president after having served as first vice-president, all of a sudden found himself no longer on the list. There were intense telephone calls and discussions. But, the new President Allen Kaplan was able to reconcile the various fractions in the Board of Directors.

It was on the occasion of Gunnar Johansson's 60th birthday in 1998 in Uppsala, where a decisive "strategic planning meeting" took place, the name "WAO" was born. As in every success story, there are various fathers who claim to have participated in the "ignition," among them Gunnar Johansson, Robert Davies, Johannes Ring, maybe also the unforgettable Rick Iber who then was--almost in a one-man show--manager of the organization as head of the "Executive Director" group (EDI). It seems appropriate to remember Rick Iber whom I met first in 1988 in Montreux where he, together with Christine and Alain de Weck, organized an outstanding congress with very little bureaucracy and a tremendous talent to acquire sponsorship. WAO can be happy that after Rick Iber left in 2000, he was followed by a well-functioning group under the leadership of Kay Whalen and an increasing enthusiastic crowd of EDI people, just to name Charu Malik in particular.

The presidents Carlos Baena-Cagnani, Michael Kaliner, and Walter Canonica further contributed to strengthen the organization and increase the visibility beyond congresses through educational programs and development of WAO guidelines.

Journal Editor

In 1989, Alain de Weck had founded Allergy and Clinical Immunology News (ACI News) as the official journal of the IAACI, thus transforming the newsletter "Horizons", edited by Max Samter over many years, into an official and scientific journal. Alain de Weck served as chief editor until 1998 and was followed by Allen Kaplan until 2004. I became chief editor from 2004 to 2007.

As a young allergist, I had enjoyed the Horizon", attending the international congresses and meeting so many enthusiastic people. The Executive Committee of the IAACI I witnessed the birth of the new journal that was proposed by Alain de Weck in 1988 with the aim to edit an attractive medium for practicing allergists, unconventional in appearance, and focusing on research trends, international communication and current news from the societies.

With Hogrefe and Huber Publishers we found an ideal partner willing to walk unconventional paths. This journal had colored pictures which did not cost extra money. The journal also had cartoons printed among serious scientific articles, gossip from societies, interviews and congress reports. Being a member of the Editorial Board, I was often asked by Alain de Weck to send a contribution, so one of my most exciting case reports, the "white sausage anaphylaxis," actually appeared in ACI News.

As attractive as it was, this journal never found the love and appreciation of the people behind Index Medicus. There must be someone who dislikes colorful pictures and who thinks that the appearance of a scientific journal has to be somewhat boring. Our journal--for these people--did not look "scientific" enough, but rather like a "magazine," although it was full of excellent articles, both reviews and original papers, case reports, of course written in perfect English with abstracts, peer review process, and everything. But, it never made it to an "impact factor."

The scientific manuscripts published over the years came from 45 countries; all in all 590 scientific articles appeared in 19 volumes. The journal acquired a large readership around the world with a maximum distribution of 17,000 at its peak! This is a real impact. From time to time, there were non-English editions of the journal in the Japanese and Russian languages. The Japanese edition went with a circulation of 5000 between 1998 and 2005, under the editorship of Terumasa Miyamoto and Ruby Pawankar, thus reaching the largest national allergy society in the world. The Russian edition edited by Revas Sepiashvili reached a circulation of 1000 in 2006 and 2007.

It was a great honor for me in 2004 to become chief editor of Allergy and Clinical Immunology International--Journal of the World Allergy Organization, as it was then called.

With mixed feelings and some emotion--a weeping and a smiling eye--I experienced the big change not only of publishers after a long and controversial discussion in the Board of Directors but also from a paper journal to the online-only type at the end of 2007. In this context, I want to express my sincere gratitude and respect to Christine Hogrefe and Robert Dimbleby from Hogrefe Huber Publishers for their tremendous help, enthusiasm, and input for more than 19 years for this journal!

In January 2008, I became founding editor of the new World Allergy Organization Journal (WAO Journal), published by Lippincott Williams and Wilkins in Philadelphia (now part of the Wolters Kluwer publishing family), together with co-editor Lanny Rosenwasser. It was a tough experience at the beginning. Both of us, the publisher and the editors, had to learn; it was a new experience to edit an electronic-only journal. There was a tremendous fluctuation in friendly coworkers at the publisher's house; the newly developed software "Editorial Manager" in those days was suffering from a lot of "childhood diseases", so that Lanny and I had no easy time.

With the electronic-only WAO Journal, our organization grasped the chance to reach more than 30,000 allergists worldwide directly online. It was planned to be available free of charge during the first years for all individual members of national allergy societies as well as non-member subscribers. The new journal was supposed to keep the direct tradition that had grown with "Allergy and Clinical Immunology International." The decision for this new type of journal reflected the new philosophy of publication, concentrating on the electronic way with many advantages, starting with the speed with which articles can be accepted, reviewed and published; decreased costs; and the opportunity for digital content, including videos and animation, finally easy searching of contents and independence from postal services, just to name a few.

As it happens with all new journals, the first years are hard work. The editors have to attract manuscripts by their personal charisma or obstinacy on the telephone. The same holds true for putting pressure on the reviewers to finally come up with an opinion.

In 2009, I handed over the "baby" to the present Editor-in-Chief Lanny Rosenwasser and withdrew to my position as "Founding Editor" after having served for 5 years for WAO as chief editor. I am convinced that the WAO Journal will be a big success, will get an impact factor, and will explode and revolutionize our philosophy of written education programs.

Conclusions

WAO is the platform for allergists all over the world; it is a great organization, the congresses are highlights, not only because of scientific content and social events but also--and the older I get, the more I appreciate this--as a place to meet friends. It is an old human experience that sometimes friendship is easier to gain and keep over some distance, and it is wonderful to have friends all over the world. Interestingly, also the relationship to your fellow countrymen is much more relaxed when you meet them abroad and enjoy a wonderful evening on the beach in Cancún, as compared with a bureaucratic meeting at the Health Ministry in Berlin.

So, let us support WAO, let us support the idea of a global family of allergists, and let us work together in friendship and motivate our young colleagues to become enthusiastic for these big endeavors, too! I wish the President-Elect, Ruby Pawankar, all the best and good luck for her presidency 2012 to 2013!