International Confederation of ATODResearch Associations (ICARA):

Summary of a Planning Meeting

Executive Summary

This document summarizes the results of a meeting to consider the feasibility of establishing an International Confederation of ATOD Research Associations (ICARA), where “ATOD” stands for alcohol, tobacco and other drugs. The meeting was held on 13th-14th September, 2011 at Hilton Head, South Carolina, with partial funding from the Norwegian Ministry for Health and Social Care, the Finnish National Institute for Health and Welfare and IOGT- International in Sweden, a nongovernmental organization working in the field of temperance. The meeting consisted of formal presentations, panel discussions and work group recommendations devoted to the drafting of a mission statement and a plan to prepare for a subsequent (inaugural) meeting where interested individuals, sponsors and organisations can formally establish an international confederation.

Rationale and background

There are today at least 30 national, regional and international societies, aiming to bring ATODresearchers together for exchange of knowledge and experience, to promote the interest of ATODresearch and to disseminate research results, through conferences and other professional development activities.

With the acknowledgement of the importance of ATOD misuse and its consequences for public health and social welfare, and the growing emphasis on evidence-based measures to meet the emerging problems, basic, clinical and social research has an increasingly important role to play in the shaping of health policies at the national and international levels.This is not always recognised in terms of research funding. Further, although ATOD science has become more and more international in its character, important cultural, economic and linguistic barriers to research collaboration and the dissemination of research results still exist. At the same time, the alcohol, gambling and tobacco industries have internationalized their marketing activities and are expanding in developing countries and emerging economies, often opposing evidence-based policies promoted by the World Health Organization and other organizations that advocate in the public interest.

In the context of these developments, there is a pressing need for researchers involved in the management of ATOD research societies to keep abreast of new international developments in the dissemination of research results, in translational science as well as in organizational management, financing, and fund raising. A decade ago the rapid developments in the area of scientific publishing led to the formation of the International Society of Addiction Journal Editors (ISAJE), which has served as a valuable forum for the world’s addiction speciality journals, many of which are owned and managed by professional societies (see for more information about ISAJE).

Research societies have been able to play a critical role in the professional development and scientific identity of ATODresearch professionals. They have been instrumental inshaping national, regional and international policy responses. Some of the existing societies are international in character, but do not reach across scientific fields and thus do not derive full benefit from interdisciplinary contacts. National or regional organizations are much more prevalent in the economically advanced countries (i.e., Europe, North America, Australia), where the scientific infrastructure and the health and welfare systems are relatively well developed. In other parts of the world, where these kinds of organization could play a particularly important role, they are not yet established.

There is a wealth of experience and knowledge in the existing research organizations that could be sharedamong the established societies and used to support the establishment of new organizations in the developing world, where such organizations are needed. What is missing is a forum for information exchange and mutual support and a means to support development at the national and international levels that are likely to influence the future of addiction science. For these reasons, ISAJE agreed to host a meeting of individuals who currently hold elected positions within ATOD societies across the globe along with interested parties from national (e.g., NIAAA, NIDA), international (e.g., WHO), and regional organizations (e.g., EMCDDA) to discuss the possible establishment of a network or confederationof research societies.The meeting was held on 13th-14th Sept, 2011 at Hilton Head, South Carolina. This document summarises the outcomes from that initial meeting.

First Day of the Meeting

The meeting to discuss the formation of ICARA was divided into two half days. The first was attended also by members of ISAJE. On the first of these days, both groups listened to presentations about international research cooperation and brief comments from representatives of a number of research societies, on their views on international cooperation and their thoughts about opportunities and challenges to the formation of an international confederation. On the morning of the second day, a smaller group of participants continued discussion of the feasibility of the confederation[1].

The ICARA meeting was opened by a short presentation by Prof. Thomas Babor, Immediate Past President of ISAJE. In his “Introduction to the Addiction Research Confederation Idea,” he described the steady growth of ATODscience during the past 50 years, including specialty journals and research societies. Historical precedents for confederations like ICARA were noted, especially the formation of ISAJE and, recently, the European Federation of Addiction Societies. Possible roles of the proposed confederation were described (e.g., information exchange, mentoring new society leaders, nurturing new societies, professional education, training to promote research integrity, inter-organizational collaboration, support for evidence-based addiction research and policy). In closing, the audience was challenged to consider two questions regarding ICARA: Is it a feasible idea? If so, what should be its mission?

The second presentation was given by Prof. Mike Daube, who is associated with the World Federation of Public Health Associations (WFPHA). The topic was “Global Cooperation: The Key to Progress.” Prof. Daube, described the importance of international collaboration in public health, the work of WFPHA and similar organisations, and the role of advocacy in the advancement of evidence-based health policy. Using the example of tobacco, he described how the tobacco industry misused science and opposed meaningful legislation designed to protect public health. He also pointed to similarities among the tactics of the tobacco, alcohol and gambling industries. He noted that medical journals and professional organizations were instrumental in the adoption of the WHO Framework Convention on Tobacco Control, which has begun to reverse the global epidemic of tobacco-related diseases. His closing message was that “Global problems need global action.”

The next presentation was delivered via Skype by Dr. Vladimir Poznyak, representing the World Health Organization. Dr. Poznyak said that from the perspective of the WHO Secretariat, a global research network or association of research societies would facilitate collaboration and communication (using as an example a forthcomingWHO meeting with NGOs and professional associations on 12th December 2011 in Geneva). Dr. Poznyak described the goals of the 2010 WHO strategy on research for health, which challenges the world scientific community to pay more attention to the research needs of low-income countries, and to work with WHO in areas such as technology transfer, research workforce and infrastructure development . Within this context, Dr. Poznyak reviewed the WHO Global Strategy to Reduce the Harmful Use of Alcohol (2010), and emphasized the need for collaboration with international network(s) of scientists to promote research on alcohol and health. He noted that WHO is committed to working with the relevant partners to shape the international research agenda on alcohol and health, build capacity for research, and support international research networks and projects to generate and disseminate data to inform policy and program development.

The next presentation was given by Dr. Steven Gust, who directs the international program at the US National Institute on Drug Abuse (NIDA). Dr. Gust outlined the potential benefits of a confederation including development of a global constituency, harmonization of research goals, and better coordination to deal with economic realities affecting alcohol and drug research. According to Dr. Gust, ICARA would benefit a research funding organization like NIDA by identifying ‘unique opportunities’ (e.g., interventions to reduce drug-related HIV transmission), providing a forum for coordination among research funding organizations, helping to promote NIDA’s international programs, fostering NIDA’s international collaborations and serving as hosting organization for NIDA’s International Forum, which attracts over 300 investigators from as many as 50 countries annually.

The next presentation was given by Prof. Ralph Hingson, Director, Division of Epidemiology and Prevention Research, US National Institute on Alcohol Abuse and Alcoholism. Prof. Hingson described three research priorities that he thought were relevant to the proposed confederation: alcohol, drugs, and driving; alcohol, drugs, and poisoning; and integrated alcohol and drug screening and brief intervention. He suggested that the international research community could be instrumental in standardizing reporting procedures and advocating for drug testing of fatally injured drivers.

Next, Dr. Linda Bosma, Chair, Alcohol Tobacco & Other Drugs (ATOD) Section of the American Public Health Association (APHA), talked about the benefits and challenges of cooperation and exchange across substances. The ATOD section includes more than 1000 researchers and practitioners. Its main functions are to plan the section’s program at the APHA annual meeting (approximately 450 individual oral and poster presentations), propose APHA policy positions and respond to current issues in the field. Dr. Bosma said the benefits of working across substances include synergy (people who work on one substance can learn from people working in other areas), breaking down the ‘silos’ between substance areas, bringing more people into the section, and increasing the opportunities to network across multiple substances. On the negative side, she indicated that people working in the three substance areas do not always see national issues the same way.

The final program item for the first day’s agenda consisted of two panel discussions on the needs and the perceived benefits of international collaboration. In the first panel, comments were provided by leaders of national societies: Prof. Mark Goldman (Research Society on Alcoholism, USA), Dr. Sungsoo Chun (Korean Society for Alcohol Research), Prof. Eric Strain (College on Problems of Drug Dependence, USA), Dr. Tuukka Tammi (Finnish Alcohol and Drug Research Society), Prof. Alison Ritter (Australasian Professional Society on Alcohol and Drugs Australia) , Dr. Jean-Bernard Daeppen (Société Francaise d’ Alcoologie) and Prof. Isidor Obot (Center for Research and Intervention on Substance Abuse, Nigeria). In the second panel Prof. Alison Ritter, Dr. Kate Graham, Dr. Donald Zeigler and Prof. Peter Miller, gave their views based on their experience with a variety of international organizations in the drug and alcohol field, including the International Society for the Study of Drug Policy , Kettil Bruun Society for Social and Epidemiological Research on Alcohol and Drugs, the World Medical Association, the International Society for the Study of Drug Policy, and ISAJE.

Although the panel participants provided many examples of how their organizations would benefit from greater international collaboration, there were also questions about the scope, mission and functioning of the proposed confederation. Some suggested that their organizations’ governing boards might be concerned about the confederation’s travel and membership costs. Others wondered about the benefits that would accrue to their organizations’ constituents, and the possibility that the confederation might engage in advocacy on topics that individual societies would not agree with. Another issue was the name of the proposed confederation (ICARA), which could suggest that the main focus was addiction rather than the larger area of drug, alcohol, tobacco and gambling. It was noted that many of the same concerns were expressed at the time ISAJE

was formed in 2000, and these issues had never become serious concerns to its members during the past decade.

At the end of the day Prof. Gerhard Buehringer provided a summary of the ICARA presentations and panel discussions. He suggested the following course of action for the meeting attendees to consider: appoint a Working Group to draft a meeting report, revise the draft mission statement (distributed prior to the meeting), review criteria for membership, make preparations for another ICARA planning meeting to be held in conjunction with ISAJE next year, and explore options for funding support.

Second Day of Meeting

A smaller group of meeting participants (Kerstin Stenius, Alison Ritter, Sungsoo Chun, Kate Graham, Mark Goldman, Isidor Obot, Tom Babor, Margareta Nilson, Jean-Bernard Daeppen, Tuukka Tammi, Linda Bosma, Gerhard Buehringer, Peter Miller), representing a diverse group of addiction societies and constituencies, met on the second day to review the draft mission statement and attend to other matters related to the first day’s proceedings.

The following points summarize the main conclusions of the discussions:

  • ICARA was considered a good acronym, in that it means “friends” in Gaelic and also refers to a cushion protecting a woman’s head in one of the languages spoken in Nigeria.
  • Advocacy for specific policies is problematic for many, but for others very important (e.g., the Australian professional society, Korean and Nigerian societies). The concept of “promotion”was discussed. In the end a consensus was reached that advocacy for evidence based policy could be acceptable for all.
  • It was agreed that acceptance of funding from the tobacco, alcohol, gambling and pharmaceutical industries was in some cases and to some extent not acceptable but that as long as the organization could adopt a transparency (disclosure) policy the receipt of some industry funding would not preclude membership in ICARA. It was suggested that a membership committee would decide on when industry funding becomes a barrier to the independence of member organizations.
  • It was agreed that a 1-2 year process would be needed to set up the organization, with annual meetings initially to keep interest up.
  • No decision was made regarding headquarters, staff, affiliations (e.g., NIAAA, NIDA; EMCDDA; WHO; UNODC), but the potential involvement of these organizations was considered crucial to the success of ICARA.

The mission statement was revised (see attachments for the draft statement) and the group supported the idea of continuing to plan for the establishment of an international confederation. Special thanks were expressed to Kerstin Stenius for her leadership in planning and coordinating the ICARA meeting. A working-group (Alison Ritter, Isidore Obot, Jean-Bernard Daeppen, Thomas Babor and Kerstin Stenius) was appointed to draft the paperwork and prepare for a subsequent (inaugural) meeting where the organization could become formally established, pending interest and commitment from research societies once they have reviewed the documentation associated with this meeting report.

The working group was asked to prepare the meeting report, establish a schedule for teleconferences, and plan for the next meeting. They were also asked to draft a description of possible activities that ICARA would engage in, including:

-Relations between research scientists and the media and decision-makers

-A review of the pros and cons of merging alcohol and drug research in different countries

-Exchange of information about research training and quality standards for training

-Possibly education and workforce development

-How to get support for interdisciplinary and transnational research

Once agreement has been reached as to the above mission, objectives, activities and membership requirements, by-laws will be drafted consistent with a not-for-profit association and consideration will be given to possible registration of the confederation in an appropriate country.

Appendices

List of ICARA meeting participants and their institutional affiliations

Draft mission statement and by-laws

DRAFT MISSION STATEMENT AND BY-LAWS

Name

The name of the Confederation will be the “International Confederation of Addiction[2] Research[3] Associations” (ICARA) NOTE: Subsequent to the close of the meeting, the planning committee changed the proposed name of the confederation from International Confederation of Addiction Research Associations to International Confederation of ATOD Research Associations.

Mission and objectives

The International Confederation of Addiction Research Associations (ICARA) is an international, nongovernmental, multidisciplinary and civil society organization bringing together research societies to promote addiction[4] science through professional exchange, collaboration and action.

The purpose of ICARA is to create an international network of research societies in order to promote, support and enhance addiction research, nationally and internationally.

The ICARA objectives are:

a) To create avenues for collaboration between addiction research societiesand serve as a forum for exchange of information related to the management of scientific organizations (e.g., fund raising, relations to government authorities/media/industry, management, training, sponsorship of scientific journals, etc.)

b) To promote the development of addiction research societies in low or middle income countries as well as countries with emerging addiction problems.

c) To promote national and international, interdisciplinary and comparative research on addiction and support activities that promote scientific integrity.

d).To articulate global visions for the role of scientific inquiry in the prevention and treatment of addiction problems.

e) To advocate on both national and international levels for the use of scientific evidence in public policy and clinical practice.

Activities

ICARAis an organisation for mutual support among addiction research societies. Its biannual meetings will provide an international forum. The priority areas, activities and program of the meetings will be based on the needs and suggestions of the member organisations. Between meetings, exchange between members will be coordinated through a website.