Notes from ICARA Meeting, Lisbon 29-30 September, 2012 Attendee’s Rebecca McKetin Rebecca.McKetin@anu.edu.au APSAD (Australia) Ted Cicero cicerot@psychiatry.wustl.edu, CPDD (USA) Elisardo Becoña elisardo.becona@usc.es Socidrogalcohol (Spain) Ralph Hingson (rhingson@mail.nih.gov NIAAA (USA) Franca Beccaria beccaria@eclectica.it Kettil Bruun Society for Social and Epidemiological Research on alcohol (Int.) Raul Caetano raul.caetano@utsouthwestern.edu , ABEAD, (Brazil) Karl Mann Karl.Mann@zi-mannheim.de , ISBRA and EUFAS (Int. and European) Amador Calafat calafat@adicciones.es, Socidrogalcohol (Spain) Katariina Warpenius, Katariina.warpenius@thl.fi Finnish Association of Alcohol and Drugs Researchers (AHTS). (Finland) Maristela Monteiro, Monteiro, Dra. Maristela (WDC) monteirm@paho.org, PAHO (Panamerica) Sungsoo Chun, , chss97@syu.ac.kr, Korean alcohol research association (Korea) Bruce WheeJer, bwheeler@reesgroupinc.com, SRNT (int.) Jacques Le Houezec, Jacques.lehouezec@amzer-glas.com, SRNT (Europe) Tom Babor babor@nso.uchc.edu, ISAJE Kerstin Stenius kerstin.stenius@thl.fi (ISAJE) (Int.) Isidore Obot (CRISA), (Nigeria), obotis@gmail.com Alison Ritter (ISSDP), (Int.) a.ritter@unsw.edu.au Jean Bernard Daeppen jean-bernard.daeppen@chuv.ch (SFA), (France), Roland Simon roland.simon@emcdda.europa . EU, EMCDDA (Europa) David Ndetei, dmndetei@amhf.or.ke, African Mental Health Foundation, Nairobi, Kenya Andrea Mitchell , amitchell@salis.org , SALIS, (Int) Day 1: 29th September, 2012 1. Introductions Each of the participants introduced themselves, the organizations they are affiliated with, and the nature, size and focus of the organization. The 21 participants were affiliated with 9 national societies, 6 international societies, 2 research institutes and 1 public health organization. According to one participant’s rough estimate, approximately 12,000 addiction professionals were represented across the delegates/societies present at the meeting. It was noted that there are a number of societies not represented, for example RSA, ESBRA, European network prevention, INEBRIA, European SPR, Thai health promotion, Korean Society for AOD Research, Int Society for the study of history of AOD, American PH Association, WHO, ICAA, SSA, IHRA etc… It would be very helpful for ICARA to have a full list of all professional societies – this needs to be generated from those present. Tom Babor gave a brief overview of ICARA (See Tom’s slides) ACTIONS: - All to contribute other organisation names to the full list. - Please send to Kerstin Stenius – Acronym, full name, contact person 2. How to keep a Research Society flourishing? Presentations from 5 society representatives: 1 APSAD –Rebecca McKetin - Engagement with members through annual conference and the journal - Newsletter – communication with members - Growth of role as an advocate, for evidence-based practice (disseminate info on best practice) - Example of challenge re different disciplines: Addiction Medicine Specialist (doctors) – want greater role in APSAD AHTS- Katariina Warpenius - Issue of consensus – temperance vs. researchers Consensus not able to be achieved, so perhaps should not be an aim - Wide membership (ca 250 members), multiple actors Connection between research and practice is important - Scientific seminars (3-4 p.a.) free for members Eager, young researchers organise these voluntarily (no conference fees – because seminars are free) - Yearbook, since 2002 Bibliography attached to yearbook funded by Alcohol Monopoly originally, then Health Department Funding has ended – looking for new collaborators each year (Coalitions) (Collections of articles on selected topics – no longer a yearbook and bibliography) CPDD – Ted Cicero - Large endowment built over the years and NIDA annual grant - Membership fee kept low, to encourage as many to join as possible - Conference (1500 delegates). Turns a profit - Journal (Drug and Alcohol Dependence) not a money maker, although costs are minimal - Requests to provide advice to Congress and Senate and ask for more research money. Advice to NIDA and how to assist them on non-controversial issues. - Very broad range of disciplines and research – animal, brain, clinical… Shifts in priorities of CPDD – from animal models to applied sciences/epidemiology International Narcotics Research – splinter group - Balancing diverse constituency – a key challenge - Conference abstract submission does drive the agenda of the conference/focus of the conference - Emergence of more specialist societies, to better meet members’ needs - Risk = loss of focus for a society - Consensus on issues not necessarily possible - Funding sources a challenge - Journal reputation is really important – but takes time to build a high impact journal Yes – research societies need to have a journal - Quality of the conference is essential CRISA – Isadore Obot - Actually a Centre, rather than Research Society, to bring people together - Conference (every 2 years) break even, grants for the conference - Grown to attract more countries and delegates - Journal – “quite a success” Forum for studies that would not have been otherwise published - 2012 formally starting a society - Membership criteria – e.g. issue of law enforcement people as members ISSDP – Alison Ritter - New societies vs. old societies - Why join? Altruism - Journals may no longer be the way of the future. 2 - Importance of creating a network and annual scientific meeting – as a place for bringing people together. Discussion Following the five presentations, there was group discussion about how to keep a research society flourishing. Discussion surrounded the issue of members, how many members, how to keep members, along with maintaining communications and networks of researchers, society funding and journals. A summary of the points raised is provided here: General points: - Goals of the society (mission) – e.g. some examples of diverse missions: - Research, scholarly focus - Clinical workforce development focus – practitioner focussed - Policy influence, advocacy for evidence-based policy, etc. - Disseminate information - It’s essential that mission is clear/focussed and this is what members want to belong to - Importance of a “network” (e.g. development of WHO’s international Framework Convention on Tobacco Control was facilitated by professional societies). Exchange ideas - on a daily basis via list serves, emails, etc. - ISAJE as an example of sharing information (i.e., about publisher arrangements, which strengthens the negotiating position of the society and the editor) - KBS list serv – eg of network of researchers… Ask questions, share information etc. - Visibility for your work – as a key motivator for a society - Conferences as places to meet many people (e.g. AIDS conference, tobacco conference). Go to learn the full range and to meet senior scientists Membership: - SRNT has had debates about what different members (basic sciences, clinical, policy) were getting for their dues, with some being more privileged than others - One solution: to have conference with 3 tracks so everyone has their own stream (streamed conferences) - Setting up ‘networks’ within SRNT – as per interest groups notion. Gives each group a sense of their home within the larger organisation - Changes within the USA have highlighted issues for different interest groups within societies: NIDA vs. NIAAA – (and whether tobacco should move from NIDA to the Cancer institute. - Example of issue re SRNT had to take a stand even tho membership was split. Discussion paper and survey created opportunities to discuss a controversial issue. Then board revised their position. Importance of giving the members a place to talk/a voice in the process - Staffing: Association Planning Company (where each Association can draw on relevant expertise) - Bigger societies – federated models more common with committees, interest groups, etc. – to ensure that all have peers that are homogeneous - Societies in developing countries – have few permanent members - Organise meetings for the non-members (as this is where most people will come from) - For smaller societies –keep focused, rather than getting too broad e.g. KBS focuses on social sciences - Focus/specialisation vs. very broad constituency that covers the whole gamut of addictions. Different models for large vs. small societies - Depends on the goals of the society – workforce development, e.g. of very broad constituency and hence have a conference that is very broad. And possibly making streams 3 - Developing countries: less likely to split Alcohol, Drug & Tobacco. Looking at developed country models – and trying to apply them. E.g. of meetings/conferences which allow all to attend: not just researchers, for example - Developing countries – hard to maintain membership when there are many other society options - A society with no members? Most discussion considered this a poor idea: some reasons: - Problem with who your constituency is - Problem with status and reputation – need to be seen as powerful - Need to have decision – makers - Altruism – engagement is important - Gives collective voice to members/stakeholders What do members get? (societies get more from members than members get from the society)? - Confer prestige and legitimacy A scientific mtg organised for various stakeholders e.g. special conference for young scholars - Reduced conference fees - Journal access - Feeling of belonging – invisible/visible college - Voting privileges - Can serve on the board - Why join? Because there is a tradition Question about membership criteria – must have them to meet the “prestige” criterion Developing countries – less notion of a research career – researchers come from clinicians/practitioners who then become active in research… Research career differences will meant that societies in developing countries will need different approaches. Funding: - Funding is a problem-funds are dwindling - Long history of some societies – means they have built up legacy funds - Sponsorship (e.g. NIDA, NIAAA, good supporters) - Research funds that cover costs for conference attendance – NIDA, NIAAA, expect that investigators will present research findings - Volunteers’ time – boards, planning committees, etc., etc. - Societies may not need much money - Developing, low income countries – no funds. Must innovate. One way is to. get others interested in what the society does – donate time - E.G. engaging employers (universities) - E.g. partnerships with high income countries including research partnerships on specific studies - Small amounts of funds make a huge difference in LAMI - Costs of running an office. US $250,000 to maintain central office – all volunteer time - Universities – need to appreciate that these roles are prestigious: universities benefit from academics having roles in societies - North/South issue – things may be quite different in 10 years. New societies being formed in LAMI. Increasing affluence in Asia, Latin America etc. will drive consumption of alcohol and other drugs. They will need more research support, etc. - ICARA could compile a list of funding opportunities on the national and international levels - Use of new technologies – webinars, Skype, etc. etc. to reduce costs 3. Industry sponsorship of meetings 4 Presentations KBS – Franca Beccaria - KBS is concerned with alcohol research – so no dealing with the alcohol industry. - Issue raised frequently - Main concern = alcohol industry representatives attending KBS meetings – meetings are open, so a small handful from industry register each year - June 2012 unanimous decision – we are for open communication of science, so we should not restrict attendance and it’hs difficult to regulate. Participation = come to listen, not to present papers. Concern was that new research, yet to be completed – will have access to this. But overall agreed. - By-laws of society means industry reps can’t be members of society so that problem did not exist - Disclosures of interest for each meeting paper. But yet to implement it - No history of alcohol industry sponsoring KBS meeting but past example of pharmaceutical sponsorship for meeting - Own thoughts – pharmaceutical much more complicated than alcohol, tobacco (e.g. Italy, buprenorphine, Reckitts paid for meeting, education sessions etc. for opinion leaders) - Journal – advertising by pharmaceutical industry (but not alcohol) - Sponsorship re keynote speakers – not a good idea. General costs to meeting OK, but not specific speakers - Need to also consider government funding. Eg of govt commissioned research, where govt prohibited publication of the results (and wrote letter to newspaper saying research was not scientific!) SRNT – Bruce Wheeler - Two industry groups: tobacco and pharmaceuticals - One produces something that kills people, one produces something that helps people - Three areas where they intersect (membership, meeting and journal): - Membership: prohibit tobacco industry workers/as per WHO definition of industry - Meeting: o attendance: open to all (note: SRNT Europe doesn’t allow industry to the meeting) o presentations: do allow pharmaceuticals and tobacco to submit then it’s peerreviewed. Declarations of interest required. Trying not to pre-judge quality of science based on funder/author o sponsorship: - no tobacco industry - pharma o Strict policy no organisation names to be put on any sessions (e.g. Pfizer opening session with logo) this is due to perception of influence. Applies to everyone including government and NIDA. No names allowed. o General donations only o Thank X, Y, Z to support the mission of SRNT (not to support the conference) - Journal: allow pharma/tobacco submissions but all peer reviewed. No advertisements. - SRNT logo cannot be in proximity of any other logos - Very specific policies - Address perceptions - Clear firewalls SRNT Europe – Jacques le Houezec - Slightly different and more strict regulation - Not allowed to come to the conference (but partly b/c of local condition, Helsinki) - SRNT Europe: same position as above re journal 5 o Good science + peer reviewed o Declaration of funding - Pressure to bar tobacco industry from the meeting (due to strategic advantage) Spanish Society – Elisardo Becona - No pressure from industry (alcohol, tobacco); no lobbying (they don’t perceive us as important/not afraid of us) - Clear understanding that we don’t want them, but we don’t do anything about it - Pharma o Special symposia that they pay for o They pay for registrations o E.g. buprenorphine lobbied for by the society itself Government sponsorship not without risk, e.g. re lobbying role Pharma in Spain, very open market, 30% of budget on propaganda o EUFAS – Karen Mann - EUFAS yet to have a position on all this (but given no conference and no journal will be less of a problem) - German society: o no money from alcohol industry o can come to meeting o as above for tobacco, gambling industry - Pharma industry – do have products that harm people but other products which are good - Scientific program committee review all. Pharmaceutical companies can submit abstracts. Pre-meeting workshops/satellites. Also peer reviewed - Tendency to ban pharma associations in these meetings - ISBRA no alcohol industry Pharma can donate to support “mission” of org but not conf per se. (As per SRNT) ABMRF - Ralph Hingson - Alcoholic Beverage Medical Research Foundation (name has changed to The Foundation for Alcohol Research) hypotheticated tax. Focus on young scientists. Small grants. Ralph never saw ABMRF misuse their role - Alco-many industries involved…some good, some bad - Cautionary principle - Need to judge on a case-by-case basis ABEAD – Raul Caetano - Firm position re alcohol industry – no engagement - Pharma sponsorship for meeting/organise satellites and have lunchtime sessions, etc. - Incident : member of society left due to alcohol industry money - Developing nations – weak regulating system for all kinds of drugs, alcohol (and other industries). Laws may exist but regulation not enforced - Many professional societies therefore have a more NB role as part of the regulatory system? Can we turn a blind eye given this context? CRISA – Isidore Obot - Alcohol industry doesn’t recognise we are there. Not concerned with us, eg: No approach from industry to sponsor our conferences - Government very keen to build membership and alcohol and tobacco industry’s - Personal level: do have contacts with tobacco industry who want Obot to be an expert witness. No. 6 - ICAP (International Centre for Alcohol Policy) – funded by Alcohol Industry (“beautiful face of industry”) Personal decision no re: ICAP African M.H. Foundation – David Ndetei - Illicit alcohol industry – beers & spirits – very affordable - Cause many problems in the community Discussion Following the presentations, general discussion about society industry sponsorship. The following points were made: - - - - - Clear that there are a variety of views, opinions, experiences and society policies Situation is changing/evolving. Industry behaviour is also changing Many ill-defined areas here and blurred distinction between harmful/nonharmful products PAHO is discussing industry sponsorship together with the food industry: McDonald’s, Nestle, etc. There is no black and white: Electronic cigarettes, as e.g., will tobacco companies that produce these less harmful products then become the good guys Need for guidelines and/or advice re accepting $ from alcohol industry for research WHO 2006 issued Expert Committee Report that recommended no collaboration with alcohol industry Should governments consider research sponsored by industry? Will it always be bad? Has WHO ever cited alcohol industry research? ISAJE has reviewed the literature on conflict of interest research, bias, industry funding. Quite a wealth of research now which shows the bias and influence. ISAJE has this bibliography on its website. The bibliography can be found at www.isaje.net “Treattobacco.net” as an example – because treatment doesn’t accept pharmaceutical money, only public money Framework convention on tobacco control Article 14 – not sponsored by pharmaceutical industry money Wolf can be disguised as a sheep. Don’t necessarily know what’s going on/where money comes from. Don’t necessarily know where the money comes from – laundered, third party bodies. It’s not transparent ISAJE has a list of third party organisations. Can share this with ICARA members Illusion of control when entering into relationships with industry There is sometimes reliance on alcohol industry data, e.g. sales data, required for analysis Provision of free drugs donated by industry for clinical trials Increasingly industries are becoming more diverse, e.g. energy drinks Government needs to be considered as potential conflict also o vested interest in industry o Constraints on publishing Come back to the principles of conflict of interest – rather than decide on industry type per se Line in sand gets washed away continuously Case by case situation. Transparency is essential Guidelines would be very helpful Can look to other specialty areas – transparency is clearly the preferred option Moral hazard, risk of reputation damage We could easily agree that societies don’t accept as members industry. But after that it gets complicated. Extensive discussion about public funds, in KBS, e.g. countries with government owned alcohol monopolies. Any guidelines must include role of public money, not just industry. General guidelines helpful, but each society must judge for itself 7 - Need to disseminate info about this and the issues – and how the situation changes. Need to keep up-to-date with cases. Global network is required ACTION: ICARA – small working group on this issue documentation of the variety of arrangements model protocols re industry sponsorship ICARA working group to collect and disseminate existing guidelines. Start to develop protocol – voluntary for org’s – as a prototype. ICARA to collect case examples (from member organisations’ experiences) 4. Strengthening ATOD Research in countries with little resources Presentations PAHD – Maristela Monteiro - Support of WHO and PAHO – part of the role of PAHO - Funding opportunities: International Drug Research Centre, LAMI alcohol research by having a network, can disseminate funding announcements and then put together collaborative grant applications. This has been successful. - Trainee Fellowships for Young Investigators, e.g. Humphries Fellowships. (application thru the USA Embassies in every country) African M.H. Foundation – David Ndetei - List of all funding agencies – could be maintained by ICARA and circulated regularly - Calls for funding announcements – could be distributed by ICARA - Encourage high income country members to look out for collaborations with LAMI - Developing training materials on methodologies for SUD research – available to LAMI for free. LAMI missing expertise in research in this area. - Technology – make it accessible as possible (No reason for not using the training/protocols, etc.). - Create critical mass in local settings – so don’t have to travel to USA - Develop curriculum - Bloomberg Initiative – money available – research in LAMI re tobacco. Also have a curriculum re tobacco research, e-learning, already available. One from University of Sydney, Australia and another elsewhere. (points to importance of sharing what is already developed and available) - EMCDDA – graduating students from Universities (Italy and Denmark) - SALIS librarians’ network could also collect curricula - Side-effect of exposure abroad – “brain drain” (leaving LAMI countries +moving to developed countries) - ISAJE – e-learning for publishing addiction sciences ABEAD – Paul Caetano - 3 needs: Organise, congregate and train - Will vary by countries - ICARA needs to communicate with these countries and associated societies helping people organise and congregate. And one way of organising and congregating is through training/education 8 - Training/education: either in person, or on-line. E.g. Pittsburgh has existing courses in multiple languages. PAHO also has an organised course on P.H. Policy online in Spanish and English. Will be available shortly. - USA Uni’s looking to international studies, on-line, in home country - ICARA can provide role models, especially in low prestige areas such as ‘Addiction’ need to see successful Addictions Scientists. - Pool of potential mentors… facilitated by ICARA - Connect up students across the globe – peer student network peer mentorship could be very powerful. Linking students NIAAA – Ralph Hingson - Alco & Traffic Safety Area – as an example of what can be done. Global program (1.2m traffic deaths each year, 80% in LAMI countries) - Special sessions in meetings for LAMI presentations - Working groups, e.g., on standardised measurement - Conferencing using Skype - WHO should be encouraged to improve data systems (given that data systems can lead to better knowledge about the problem and trends, etc.) including key alcohol indicators and policy approaches. Begin simply. Standardization of measurement enables international research - Engage professional societies to get involved in standardizing measurement and to encourage countries where the data are not collected. Discussion Following the presentations, general discussion occurred. The following points were raised: - In many cases there are things/materials/activities already available, but what’s required is dissemination and much broader exposure to what’s out there - ICARA website creation: which has links to all of these things (ACTION) - ICARA facilitate working groups that is, working group members recruited from outside ICARA – ICARA as a facilitation role in bringing people together - Robert West’s son: Internet specialist. Will set up a website for ICARA plus make this as a prototype website for all societies. Could work together with Nairobi person (via David) - Website as a portal. Clearinghouse role - ICARA could engage in mentoring programs, like the ISAJE mentoring program – to identify and match students/junior investigations with journal editors (all via ISAJE website) - Providing expertise for conferences – to hold conferences in LAMI countries. Where expertise is required, SRNT want to be able to help and have a depth of experience in putting together conferences - ICARA as potentially facilitating this and linking SRNT with local conference group (if SRNT has members in those locales) - ICARA as clearinghouse function, including helping find relevant speakers for training/conferences in LAMI - Seed-funding for network establishment - Code of ethics re not having cheap labour for LAMI scholars - ICARA will need sources of funding for all the above - ?Role for ICARA to talk to LAMI governments about their practices, research conditions, etc. and a further problem is that research findings are not implemented (governments reluctant to implement – against current policy) 9 Day 2: 30th September, 2012 ICARA Mission and by-laws ICARA and EUFAS mission statement: synergies EUFAS: - see website EUFAS.net n=34 societies as members. - When started 3-4 years ago, about same time as idea for ICARA, did a “gap analysis”. - We have enough conferences, enough societies - But we need something that brings things together - EUFAS = limited to Europe only (incl. Russia, Baltic States) - Not enough $ to addictions, especially in context of the social costs of the problem. And harms to others - Role=influence governments to put more money into research. To nation state governments (e.g. Lithuania, Ireland) How? - First meeting in Paris, 2 years ago - Registered in Austria (small country) - 2 meetings per annum (linked to a national conference – 1 business meeting, also linked to an existing meeting) - Education/benchmarking: providing resources available across multiple countries - Collaboration between EUFAS and ICARA as well as EUFAS being a conduit to European Societies for ICARA - Editorial in Addiction (2012) describing rationale for EUFAS etc. ICARA comparison: - global outlook - Focus on LAMI (especially given USA, Australia, Canada, New Zealand and UK domination) - Parallel between SRNT and SRNT Europe Presentation of the ICARA mission; objectives (n=5), activities (n=3) At this point, the delegates worked through the draft ICARA by-laws – track changes and comments function have been used to document the discussions that were held. Some general points were made about the By-Laws: - It should be as non-specific as possible with less detail rather than more. Policies and procedures should provide the accompanying detail, as developed by the first ICARA Board. - Try not to lock into too much eg board composition re continents, etc – have these as things to aim for (eg spread of continents represented on the Board) rather than as insisting upon them. Some specific points were discussed: Registration of ICARA: - It was agreed that ICARA should be registered in Finland. KS to pursue. Scope of ICARA member organisations: - There was discussion about the extent to which ICARA represented only research/scholarly societies, or also professional societies who support practitioners (via journal and conference). Broad agreement that it should not be limited to research societies alone – but that members 10 needed to have research as one of its activities/foci.(hence words re research societies changed in the by-laws. Fees: - Sliding scale, based on: economy (developed vs. developing) and size of the organisation SRNT: as an example Fee waiver: at board’s discretion Affiliate: as above – sliding scales, waiver as above. The board can create other membership categories as appropriate Conflict of interest: - Much discussion about this, finally agreed that members must have no conflicts in relation to the objects of ICARA but otherwise members would not be barred from certain groups. - Declaration of Interest for both full and affiliate members is required - Board needs to set the membership policy ICARA activities and funding discussion How can ICARA work with major groups, such as: o NIDA o NIAAA o WHO o EMCDDA o UNODC These organisations need professional research associations to do their job and disseminate their work. How can ICARA maximise these opportunities, given the symbiosis? - What do these organisations need help with? NIAAA- justifying international research spend WHO – comment on global strategies and help implementing them UNODC – network of researchers as a pool of potential researchers, consultants. Conduit to access latest scientific findings - Seed money – this is what ICARA needs - Mechanism by which federal agencies can give money – likely that need to contract specific pieces of work (Along with confirmed grants, etc.) - Philanthropy - Through national/state governments – who want to do more in their global region - Awards as a platform ACTIONS ARISING Working groups established at the Sept meeting: Working group on ICARA establishment and next meeting: Kerstin Stenius, Tom Babor, Alison Ritter, Isidore Obot Working group on ICARA website: David Ndetei, Andrea Mitchell, Jacques Le Houezec, , Ted Cicero (? I am a bit uncertain) (Robert West to donate model) 11 Working group on sponsorship guidelines: Franca Beccaria, Bruce Wheeler, Tom Babor, Rebecca McKetin , Raul Caetano , Amador Calafat Other ACTIONS - Newsletter: press release to member journals, short editorial - Potential membership list: All to contribute organisation names to the full list. (Please send to Kerstin Stenius – Acronym, full name, contact person). 12