Evidence-based information about the major indoor and outdoor allergens and pollutants responsible for causing or exacerbating allergic diseases and asthma is either lacking or, when available, is not always universally accessible. Recommendation: Local indoor and outdoor allergens and pollutants which cause and exacerbate allergic diseases should be identified and, where possible, mapped and quantified. Appropriate environmental and occupational preventative measures should be implemented where none exist or as necessary. Strategies proven to be effective in disease prevention should also be implemented. III. Availability Of Allergy, Asthma And Clinical Immunology Services (Allergists) And Appropriate Medications Identified Need: There is an increasing need for more allergy specialists and for the existence of local and regional allergy diagnostic and treatment centers in order to facilitate timely referrals for patients with complex allergic diseases. Accessibility to affordable and costeffective therapy and to novel therapies is needed. For example, adrenaline auto-injectors for patients at risk of anaphylaxis; new and more effective medications to treat severe asthma; and access to allergen immunotherapy are lacking in some parts of the world. Recommendation: Public health officials should provide for adequate allergy/ clinical immunology services, including access to specialists and diagnostic and treatment centers. Allergists should be able to prescribe the most cost-effective medication to manage a patient’s disease. Examples include adrenaline auto-injectors to treat anaphylaxis; anti-IgE for severe asthma; a variety of very effective medications to treat chronic urticaria and angioedema, hereditary angioedema, rhinitis, conjunctivitis and asthma. INTRODUCTION AND EXECUTIVE SUMMARY CHAPTER 3 CHAPTER 1 CHAPTER 4 CHAPTER 6 CHAPTER 2 CHAPTER 5 MEMBER SOCIETY SURVEY REPORT 2 2 Pawankar, Canonica, Holgate and Lockey Copyright 2011 World Allergy Organization Allergen-specific immunotherapy is effective in preventing the onset of asthma and is the only available treatment to prevent anaphylaxis and death from bee, wasp, yellow jacket, hornet and ant induced anaphylaxis. Consultations with allergists, timely diagnosis and treatment are necessary to improve longterm patient outcomes and quality of life and to reduce the unnecessary direct and indirect costs to the patient, payer and society. IV. Undergraduate And Postgraduate Education For Primary Care Physicians And Pediatricians Identified Need: There is a need for undergraduate and postgraduate training in allergy, asthma and clinical immunology for general practitioners and pediatricians such that primary care physicians and pediatricians may appropriately assist patients with allergic diseases. Recommendation: Allergic diseases are a major cause of morbidity and mortality. Suitable undergraduate and postgraduate training for medical students, physicians, pediatricians and other healthcare professionals will prepare them to recognize allergy as the underlying cause of many common diseases. It will also enable them to manage mild, uncomplicated allergic disorders by targeting the underlying inflammatory mechanisms associated with these diseases. They will learn when and how to refer the more complicated cases for a specialist consultation. Such education at the general practice level is of paramount importance since the vast majority of patients with allergic diseases are cared for by primary care physicians and pediatricians. These clinicians will also be required to comanage such patients with an allergy specialist and should be aware of the role of the allergist/clinical immunologist in investigating, managing and caring for patients with complex allergic problems. V. Recognition Of The Specialty And Training Programs Identified Need: Globally, medical education providers need to recognize allergy / clinical immunology as a specialty or sub-specialty, resulting in adequate training programs for optimal patient care. Recommendation: Expertise in allergy and clinical immunology should be an integral part of the care provided by all specialty clinics. Where allergy/clinical immunology