for clinician and healthcare professionals training in allergy are to: • Produce graduates equipped to further their careers in healthcare and in particular to enhance the number of individuals trained in the mechanisms and management of allergic diseases. • Develop an understanding of the processes involved in improving the management of patients with allergic disease. • Develop new areas of teaching in response to the advance of scholarship and the needs of vocational training. • Provide a training in research skills. • Develop skills and understanding of the more complex components of allergic disease encountered in specific areas of practice. The Cost-Effectiveness of Consulting an Allergist • Allergic diseases are chronic conditions with systemic involvement that can affect multiple organs and systems throughout the lifespan of atopic (allergic) subjects. • In assessing the economic burden of allergic diseases, the costs of several organ-specific diseases need to be aggregated, including the nose (allergic rhinitis), sinuses (rhinosinusitis); lungs (asthma); skin (atopic eczema); and others. • Cost-effective analyses (CEA) assess the comparative effects of one health care intervention over another, under the premise that there is a need to maximize the effectiveness relative to its cost. • A cost-effective intervention could, if incorrectly used, generate unnecessary costs, provide no benefit and even cause harm. • The allergist is an expert in tailoring therapy to the individual patient and adjusting treatment dosages in more severe or complex cases. The main defining characteristics of allergists are their appreciation of the importance of external triggers in causing diverse diseases; their expertise in both the diagnosis and treatments of multiple system disorders, including the use of allergen avoidance and the selection of appropriate drug and/or immunological therapies; and their knowledge of allergen specific immunotherapy practices. • Misinterpretation of the results of diagnostic tests by nonspecialists can lead to over-diagnosis and inappropriate management which can be harmful for the patient. It may lead to over-prescription of therapy and costly and unnecessary allergen avoidance measures, including exclusion diets that can lead to nutritional deficiency and secondary morbidity. Conversely, the under-appreciation of the severity of asthma can lead to life-endangering under-treatment or the lack of potentially life-altering immunotherapy. • The cost-effectiveness of allergist consultation will be demonstrated by improved patient outcomes and experiences together with a reduction in unnecessary expenditure by payer, society or patient/family. WAO White Book on Allergy 2 1 Copyright 2011 World Allergy Organization Declaration of the World Allergy Organization DECLARATION In its role as an umbrella organization of national and regional allergy, asthma and clinical immunology societies worldwide, the World Allergy Organization invited all 84 of its member societies to contribute to the White Book by participating in an online survey on the current status and needs of the specialty in their respective country or region. The responses from the Member Societies along with the scientific reviews which are included in the White Book form the basis of the World Allergy Organization Declaration. I. Epidemiological Studies Of Allergic Diseases Identified Need: In several parts of the world, there is a paucity of published epidemiological information about the overall prevalence of allergic diseases and, in particular, about specific diseases. For example, there is little or no information about severe asthma; anaphylaxis; food allergy; insect allergy; drug allergy; and complex cases of multi-organ allergic disease. Data concerning some of these disorders are available in a few countries, but only for certain age groups. Recommendation: Every country should undertake epidemiological studies to establish the true burden of allergic diseases; asthma; and primary and secondary immunodeficiency diseases. This is the first essential step in ensuring the provision of adequate physician and healthcare professional services to meet both current and future needs. II. Allergens And Environmental Pollutants Identified Need: