A New Focus of International Rheumatology

Healthcare is global, and rheumatology is no exception. In fact, the international implications of our activities have become a recurring theme at ACR Board of Directors discussions over the past year. Whether discussing education, research, or practice issues, ACR board members are consistently reminded of the importance of breaking down traditional silos (geographic and otherwise) and of rheumatologists joining forces not only across the country but around the world as we pursue solutions to our common challenges.

The ACR has always encouraged and nurtured a large international membership, and the ACR Annual Scientific Meeting has always been the gathering place for the international rheumatology community. In recent years, however, the ACR has visibly stepped up its international activities. Our newly established collaboration with the European League Against Rheumatism (EULAR) represents a landmark achievement for both organizations. This historic alliance has not only strengthened the links between the American and European rheumatology communities, but has also resulted in more robust classification and response criteria representing a broader perspective from a wide variety of rheumatologists across two continents. I believe the synergy between these two rheumatology world powers will continue to benefit rheumatologists and their patients around the world.

A central motivation underlying the growing interest in international collaboration in rheumatology is the emerging evidence of major inequalities in healthcare for rheumatic and other chronic diseases, both within and among countries. The ACR recognizes its responsibility to help advance rheumatology in areas of the world that suffer disproportionately from such inequities. Together with leaders of the African League Against Rheumatism (AFLAR), the Asia Pacific League of Associations for Rheumatology (APLAR), EULAR, and the Panamerican League of Associations for Rheumatology (PANLAR), the ACR has led an initiative to restructure and reinvigorate the International League of Associations for Rheumatology (ILAR). The new ILAR now has a more focused mission to advance rheumatology in developing countries. The ACR provides administrative and management support to the new ILAR at no charge. The new ILAR Executive Committee consists of the presidents and presidents-elect of the ACR, AFLAR, APLAR, EULAR, and PANLAR.

Renewed Enthusiasm for ILAR’s Mission

The collaboration among the leaders of these international organizations demonstrates a renewed commitment to support programs that advance the clinical practice and education of rheumatology in countries where there is an exceptional need. As someone who was born and grew up in one such country, Egypt, this mission has personal resonance for me.

Over the past year, in my role as ACR president-elect, I have participated in the ILAR Executive Committee meetings and have personally witnessed the genuine enthusiasm and deep commitment to advance rheumatology in the neediest countries of the world. ILAR’s new Executive Committee held its first meeting at the ACR Annual Scientific Meeting in Boston in November 2007. During this first meeting, the committee members unanimously endorsed the ILAR mission and resolved governance issues. At ILAR’s second Executive Committee meeting, held in June 2008 in conjunction with the EULAR Congress in Paris, we launched a new program to fund ILAR projects aimed at improving rheumatology care in countries represented by PANLAR, APLAR, and AFLAR. Given ILAR’s limited budget, only $100,000 could be committed to these projects in 2009. A call for proposals was issued indicating that priority would be given to projects focused specifically on improvements in rheumatology education or clinical practice, as opposed to research.

The ILAR Executive Committee was delighted, and somewhat surprised, to receive 61 applications in response to their call for proposals. This overwhelming response clearly indicated strong interest among the ILAR community from all over the world. Because there were many more outstanding ideas than funds available, a substantial portion of the third ILAR Executive Committee meeting—held in October 2008 in conjunction with the ACR annual meeting in San Francisco—was devoted to brainstorming about ways to support as many projects as possible and to work together to pursue new funding mechanisms to support others. Ten projects will receive ILAR funding in 2009. In addition, the ACR agreed to provide educational materials, at no charge, to support several of these projects.

Even though the initial round of ILAR projects is complete, I encourage you to reach out to the ACR throughout the year with ideas for ways that we can encourage progress in rheumatology throughout the world. Please do not hesitate to contact me personally at [email protected] with your ideas. Supporting and improving rheumatology care worldwide is an important goal that will have a positive impact on patient care globally, so I welcome your ideas and encourage your participation.

In leading the effort to create a renewed ILAR, the ACR has embraced its responsibility as a global world citizen. Through its commitment to ILAR, the ACR has taken the initial steps to breaking down the geographic barriers that superficially divide the rheumatology community and impede progress toward our common goal of creating a strong and unified global specialty. I have been privileged to be a part of this remarkable effort. Sitting around the table with the leaders in the international community and working together to promote the specialty has been a uniquely rewarding experience. It is only through our collective efforts that we can begin to address healthcare inequalities in the rheumatic diseases./p>

Dr. Gabriel is president of the ACR. Contact her via e-mail at [email protected].