I was fascinated by the smart forum opened by the article of Nikos Papadopoulos and then lightened by the elegant thoughts of Kalliopi Kontou-Fili.

I was tempted to put some Latin into this Greek dispute. However, I finally decided to omit any semantic consideration to avoid that my opinion is just considered as a part of an intellectual game for old academy members with time enough to think to history and semantics, but not open enough to progress and development.

On the contrary, as EAACI Past-President and as an old EAACI member who has long taken part in the development of EAACI and in changes made to its Constitution, I feel obliged to call attention of members on some considerations, before they democratically vote in the General Assembly an important (change as a change in the name and constitution of a society is).

After having said that “Allergology” is correct, while “allergy” is more direct (and I prefer to be correct), let’s start from A (i.e. the extra A).

Adding an A for Asthma to EAACI is not a new issue. It has been discussed on several occasions.

I am not in favour of this change.

Again, I should like to omit any semantic issue (Allergology and Clinical Immunology are disciplines, Asthma is a disease). Let me make more relevant considerations:

1. Important Societies deal with disciplines not with diseases, which are left to Sections or small societies. Combining the two is not an effective trick, since the name of a Society must clearly state its primary field of action and influence. Is there any Society of Cardiology and Infarction or Endocrinology and Thyroid Diseases or Infectious Diseases and SARS? On the other hand – you may object – there are important societies dealing with diseases (Diabetes, AIDS). However, in these cases the relevance of the society is only justified by a multi-specialistic approach. Has EAACI among members enough genetists, pathologists, physiologists, pharmacologists, etc. to deal with asthma in such a multi-specialistic approach?

2. The possibility of survival for our discipline is to reinforce some concepts: a) to be a transversal specialty; b) to show cost-effectiveness and value for the patient through an olistic approach to co-morbidities; c) to be potentially involved in a wide range of diseases, including immunodeficencies, autoimmune diseases, immune-modulation, immunity to infections, immunological aspects of transplantation and cancer, environmental health. You may object that this is not our actual field. I agree, and this is – form my point-of-view – a mistake. But the prevalent area of interest of a society may change with time, people or structure of individual national health services. Why to restrict the area? There is no doubt that the additional A does not extend our field of action but furtherly characterises us as skin-testers in respiratory allergy. Constitutional changes should look to the future and cannot be guided by extemporary marketing issues.

3. It will be claimed that other societies (i.e. AAAAI) added an additional A to their name. This is not a good reason to follow a fashion. Which, anyway, appears at present out of fashion since the asthma business is almost over, replaced in the respiratory area by the growing interest for COPD. Which are the drugs in the pipelines of major pharmaceutical companies to push us to fight for asthma (with relevant competitors!). Therefore, I think that adding an A is not even timely. And when the fashion will be completely over, shall we take out the A and put a C for Conjunctivitis or a R for Rhinitis or even a NAR for Non Allergic Rhinitis?

4. Let’s keep our name and just look to the future to explore and include new areas of interest which might justify the cost of an A&CI specialist in most national services. We cannot think that claiming to deal with asthma will increase the possibility for us to have services since any politician will say “we have already a pulmonary department”.
I do not like marketing considerations but should we look at them, then we should look for areas where the business has developed and will develop, i.e. biological drugs for instance. To look at skin tests we missed the trains of anti-IgE, anti TNF-alfa, immune modulators, etc.

5. The few countries where A&CI is a specialty have a well defined curriculum for it. The additional A will not fit with the name and the new European curriculum of A&CI specialization schools. And what about our members? Will ENT doctors, dermatologists, ophthalmologists be happy to have asthma on the stage or will they leave their section and EAACI?

Any marketing decision needs a marketing survey. Perhaps it would be wise to ask firstly EAACI members and then sponsors about their feelings through a well-conducted professional survey. Or anyway opening a debate among members. This forum in the EAACI Newsletter might certainly help the Executive Committee to guide the Assembly to a wise decision.

Sergio Bonini
Former EAACI Past-President