- Email: [email protected]
Organising a World Congress of Epidemiology (WCE): Reflections and lessons from the XIX WCE, Scotland
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Available online at www.sciencedirect.com
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Retrospect
Organising a World Congress of Epidemiology (WCE): Reflections and lessons from the XIX WCE, Scotland R.S. Bhopal a,*, W.C. Smith b, J. McEwen c, G. MacFarlane b, A. McCallum d, D. Pattison e, N. Bhala f, R. Peto f, J.P. Pell g, on behalf of the Management Executive Committee a
Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK School of Medicine and Dentistry, University of, Aberdeen, Polwarth Building, Foresterhill, Aberdeen c Public Health, University of Glasgow, UK d Public Health, NHS Lothian, Deaconess House, 128 The Pleasance, Edinburgh e International Development, NHS Health Scotland, Woodburn House, Canaan Lane, Edinburgh f Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Richard Doll Building, Oxford g Institute of Health and Wellbeing, Public Health, University of Glasgow, 1 Lilybank Gardens, Glasgow b
summary Keywords:
The 3-yearly World Congress of Epidemiology is the premier, international, scientific
Conference
conference organised under the auspices of the International Epidemiological Association
Organisation
(in open competition). This paper explores the justification for seeking to host the Congress
Epidemiology
and reflects on the structures and processes adopted in making the XIXth Congress in
Public health
Scotland happen.
International
Preparing the bid was invaluable for forming collaborations, generating scientific ideas, and garnering opinion. After the bid was accepted, we formed a local organising committee, named the Management Executive Committee to signal its decision making authority; and scientific, fundraising, marketing, international and social subcommittees. There was uncertainty about critical matters such as delegate numbers, costs and the total budget. Early decisions had to be made on, for example, the fee and fundraising target (£250,000), despite financial risks. Development of the scientific programme was a critical step that underpinned fundraising and marketing and permitted involvement of the international committee. Overall the 2011 WCE succeeded. The key ingredients to success were: a large collaboration of institutions and individuals; early pledges of financial support mostly from the UK; the valuable and relevant experience of the professional conference organisers; unstinting support and advice from IEA; and the effectiveness of the committee structure. The educational and professional development benefits of this WCE will reach a worldwide community and not just delegates, because of video, PowerPoint and textual accounts being open access on the Internet. This reach is unprecedented for IEA’s World
* Corresponding author. Tel.: þ44 131 650 3216; fax: þ44 131 650 6909. E-mail address: [email protected] (R.S. Bhopal). 0033-3506/$ e see front matter ª 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.puhe.2012.01.024
266
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Congresses. We anticipate that the Congress will translate into better public health practice, better future Congresses, advances in epidemiology and improved population health. ª 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Why hold a World Congress of Epidemiology? Weighing up the costs and benefits of making a bid to be the host The World Congress of Epidemiology (WCE) is the premier international scientific conference in the discipline and is organised locally and independently, under the auspices of the International Epidemiological Association (IEA, http:// www.ieaweb.org/)1 It is now established on a 3-yearly cycle, with the 19th Congress held in Edinburgh in August 2011. Potential organisers will consider why global meetings are still needed, despite their financial and environmental costs, especially in times of austerity. When a group of Scottish academics convened by the lead author, Raj Bhopal (RSB), discussed in 2004 e before the current financial crisis e whether to bid for WCE 2008, among the perceived answers to this ‘why’ question were the following: 1. Epidemiology as a science and practice across the world has sufficient commonality and mutual interest to warrant a global meeting. This commonality is both conceptual and methodological e.g. confounding, study design, and subject matter related e.g. the causes of disease and the interrelationship of epidemiology and health inequalities2,3; 2. There are many health issues that can only, apparently, be solved by international action and cooperation. This applies both to communicable diseases that rapidly cross international borders e.g. avian influenza and threats to health created by global companies e.g. the tobacco industry;4 3. Even given other means of communication (in 2004) a live interaction would be more likely to spark intellectual development of the discipline and its practitioners. Early career researchers and practitioners, in particular, are likely to benefit from face-to-face contact, which is an important prerequisite to more remote communication methods; 4. The potential benefits to Scotland of hosting the event would be great, particularly the opportunity to enable early career researchers and practitioners to learn from, debate with, and be inspired by global leaders. This, in turn might help to forge both long-term commitment and career directions. Long-term professional relationships and collaborations would, foreseeably, have scientific and public health benefits both locally and internationally; 5. Importantly, international conferences provide a boost for the economy. The Edinburgh Convention Centre estimated that the economic value of the WCE 2008, calculated in 2004 assuming 1000 participants, was £1 million pounds. The estimate of the economic benefits of the Congress in 2011 (1471 participants) stands at £2.9 million.
In summary, we expected long-term public health and scientific benefits to accrue both internationally and (especially) to Scotland. This was the main motivation, though the economic reasons were also a modest spur. These and other reasons for making a bid needed to be offset against the challenges of organising the event. The choice of location of WCE’s is part of the competitive process. The bid is scrutinised by the IEA Council (twice) and by the IEA membership at the AGM. We also had to consider the substantial workload consequences of winning the bid. For the XIXth Congress we went through a number of stages before deciding to bid: 1. Discussion with senior colleagues across Scotland on the potential merits and difficulties with proceeding. The merits were recognised but the workload was seen as a problem, particularly as a potential distraction from research. In particular, there was recognition that the role of leader of the Congress could be as much as 6-months equivalent of full-time work. (In retrospect, that assessment was reasonable); 2. Clarification of the specific roles of the Edinburgh Convention Bureau (agreed as financial and administrative), which initiated the dialogue with RSB, and of the academic staff (agreed as scientific); 3. Creation of a collaboration across the four medical schoolbased departments of epidemiology and/or public health. NHS Health Scotland was later included as the 5th responsible organisation; and 4. Leaders of Scottish Universities, NHS organisations, local government offices, the Scottish Government’s Health Department, and leading UK based research organisations and charities were informed by letter of the planned bid and invited to: (a) express general support and/or (b) to pledge financial support. General support was virtually unanimous and financial pledges of about £50K were made. An ‘ad-hoc’ short term advisory committee developed the scientific themes and specific ideas for the bid. (These deliberations gave the Scientific Committee a platform to develop the programme e see below.) At the end of this process we had achieved near-consensus to proceed to a formal bid for the WCE. The three key components for the bid were: (a) the academic case that outlined Scotland’s history of epidemiology and public health, the strengths of its current institutions, the combined strength of the four partnership universities making the bid, and the main theme and sub-themes the WCE would cover;
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(b) the quality of the venue, the facilities for delegates and the amenities and attractions of the city of Edinburgh; and (c) the budget and most importantly the delegate fee. The IEA Council wanted the fee to be low so low-income country delegates would come, and also wanted subsidised places for low-income countries’ early career researchers. These expectations would need sponsorship, so the financial pledges already in place were crucial to IEA Council’s support. The bid was presented in 2004 to the IEA Council, and following feedback, again in 2005. After this we presented to the IEA AGM at the XVIIth WCE in Bangkok in 2005 where the IEA Council invited us to host the XIXth WCE (2011), an offer that was accepted, but only after further consultation with partners in Scotland. This was to ensure ongoing commitment to the next stage of development. The challenges after the bid is accepted are organisational with the goal of achieving the predicted benefits while minimising risks and costs. In the next section we describe and reflect on our approach as a way of helping other public health academics and practitioners aiming to host similar large Congresses.
Organising the XIXth WCE in Edinburgh Setting up the infrastructure to host the WCE: the local organising/management executive committee The first priority was to recognise the Congress as a complex process that merited a strong infrastructure. The key early actions were to book the conference centre, negotiate rates and hold accommodation in hotels, and hire a professional conference organiser. We set up a local organising committee, which we named the Management Executive Committee to recognise its function and clarify its authority as the ultimate decision making body. Scientific, Marketing, Fundraising, Social and International Committees were established and a treasurer nominated. The Management Executive Committee held full responsibility, the subcommittees and IEA Council being advisory. NHS Health Scotland e which is the national agency for Health Improvement in Scotland and a WHO Collaborating Centre e was given full partner status alongside the four Universities. A limited company was formed with four directors, one from each of the four Universities involved. The processes followed by each of the above subcommittees are described below.
Developing the scientific programme and evaluating submissions: The scientific committee The scientific committee is, clearly, at the heart of the congress and for creativity it needs to be quasi-independent though decision making is still subject to approval by Management Executive Committee. We identified three key elements to success e careful selection of members and clarification of their functions; the development of an overarching Congress theme with coherent sub-themes; and robust processes of peer review of submissions and related
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decision making. The members’ commitments were exploring ideas, contacting potential speakers, helping organise and chair specific sessions, reviewing abstracts and helping make key strategic recommendations to Management Executive Committee. An early face-to-face meeting was useful to address the main issues, explore ideas and for members to get to know each other; later most business was by telephone, teleconferencing, email etc. Congress theme and sub-themes were chosen to be coherent and reasonably broad. The Scientific Committee consulted widely on these themes, built on the themes developed at the bid stage and was aware of themes adopted by previous congresses. These themes provided the framework for inviting plenary speakers and deciding their topics, organising workshops or symposia and inviting abstract submissions for free paper and poster sessions. The demand on the scientific programme was high and predictably exceeded capacity. In fact, our Congress attracted nearly 2000 abstracts for oral presentation/posters (about 1000 spaces available) and about 40 proposals for proposed workshops (eight spaces available). Workload was, therefore, about double that originally expected and planned for. Speakers want to be invited to give plenary lectures which are a mark of peer esteem and customarily come with travel and other support from the Congress. Investigators want their abstracts accepted, preferably as oral presentations rather than posters, as their funding often depends on it. There will be disappointed people, many influential and/or vocal, so it is essential that robust peer review processes are in place. Excepting invited plenary speakers and invited workshops on Congress themes, submissions need to be peer reviewed e whether abstracts, or workshop and symposia proposals. The panel of reviewers needs to review abstracts in a narrow time window. Committee members need to plan ahead to fulfil their commitments. Transparent scoring systems and an electronic system to manage the process are essential. In our Congress each abstract offered for oral presentation was independently scored by three reviewers.
Fundraising and the fundraising committee Fundraising is essential to international meeting such as WCEs as otherwise attendance from, in particular but not exclusively so, many of the lower-income countries will be negligible. Fundraising is a long, slow process that involves a great deal of administration, and this is worse in a period of financial austerity. It needs to begin when the Congress is first under discussion. We were fortunate that the preliminary contacts made in 2004 led to financial pledges. This greatly facilitated future contacts with potential donors, though the changed circumstances meant that some pledges were not honoured, and others required prolonged renegotiation. Agreement on fundraising from the Management Executive Committee was required on key policy issues. These included which sources of funding were acceptable. While it is normal practice in epidemiology and public health not to accept money from the tobacco industry, we agreed that funding would also not be sought from the alcohol industry, as this might send mixed messages about alcohol as a public health problem and might have ruled out funding from health
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service organisations in Scotland. We agreed that fundraising should start with public health and other health services in Scotland, as support from them would then make it easier to approach others having shown good initial support from our own constituency. Indeed, in the end they provided a major part of the total funding. Setting a target was essential e in our case £250,000. This target, on our projections, permitted the WCE budget to balance with 900 paying delegates and with a commitment of 100 bursaries (of £1000 each). There were two main strands to the funding-raising: first, general support for the Congress and, second, bursaries for younger researchers from lowincome countries. Our aim to provide bursaries was vital and the 250 or so mostly strong applications (64 offered) indicated a large need. (The process of selection is described on the Congress website.) Letters were supported by brochures detailing the actual opportunities provided in return for sponsorship. The letter emphasised that our purpose was to hold a congress that would be reasonably priced so delegates from all countries of the world might be able to attend. The letter emphasised the international nature of the congress, its prestige, the contribution of epidemiology, the need for research, the outstanding programme, the learning opportunities for delegates, the honour to Scotland (and the UK for appropriate funders), and the benefits to supporters.
Marketing and the work of the committee Congresses are in intense competition for delegates. The IEA’s North American Congress of Epidemiology took place in June 2011 and a major conference on international public health took place in London in September 2011. We were competing with these and many other Conferences. There was a clear outcome measure of how successful the marketing subcommittee was in its task i.e. how many persons attended the conference. Management Executive Committee’s judged that the minimum acceptable number was 900 as fewer than that would have put the Congress in financial jeopardy, the expected number was 1200 (achieved by the Montre´al Congress in 2002), and 1500 would be a major success. We achieved 1471 participants. Information from previous conferences, unsurprisingly, demonstrated that the single largest number of delegates would come from the host country and with the United Kingdom’s rich traditions in epidemiology we knew that we could rely on strong home support. However this was a world congress and it would only be considered successful in that context if we attracted a truly international mix of delegates. Our most important marketing tool throughout was our website: www.epidemiology2011.com. This initially informed delegates of the congress dates. It then evolved to providing details of the committees involved, programme information including biographies of plenary speakers, deadline dates for submission of abstracts and registration, information about the venue, social activities, sponsorship and exhibition opportunities and links to other sites of interest. The information changed with time to provide updates and to highlight the relevant approaching deadlines. We also used Facebook and Twitter, particularly to reach a younger audience.
To spread information internationally we relied on IEA regional councillors and our international committee to identify relevant contacts in their countries (including national societies) who could help advertise the congress. We also identified all major congresses relevant to epidemiology which were scheduled to be held prior to the World Congress. We identified whether any of the executive or marketing committees or other contacts were attending these congresses and could take flyers or posters to display at the meeting. If not we used local contacts to do the same. At some IEA regional meetings we secured “plenary” slots for a short presentation about the congress and its themes and also played a short video of Edinburgh. We used publications to help us “spread the word”. We advertised in the IEA house journal and wrote an editorial in IJE, which was reprinted in Public Health5and a commentary in the Lancet6 to feature the discipline of epidemiology, the coming congress and its themes, plenary speakers and wider attractions of the host city. We provided periodic newsletters to IEA members, and those registering an interest on our website or registering as delegates, as preparations for the congress progressed. Epimonitor (http://www.epimonitor.net/) was enthusiastic about helping us to promote the conference and we were able to use themed features to highlight speakers, workshops and social activities of the conference. The Supercourse team in Pittsburgh, USA, were wonderfully enthusiastic about helping to publicise the event through their extensive international contacts (http://www.pitt.edu/wsuper1/). The host Universities advertised to their staff and we used our national society, the Society for Social Medicine, through newsletters and congresses to advertise to its members (http://www. socsocmed.org.uk/). We contacted heads of relevant academic and NHS departments throughout the United Kingdom. Marketing needed to be well established by the close of abstract submission early in 2011 e since most delegates coming would only do so if they were presenting at the conference. Our final total of 1471 delegates from 82 countries around the world ensured a truly international gathering e and the countries with the highest number of attendees (outside the United Kingdom) were, in order, Brazil, Japan, United States and Australia. As only 441 people were from the UK, 70% were from overseas.
Social committee and social programme While the central component of any congress is the scientific programme, without a social programme opportunities to develop, renew and maintain the relationships so important to personal development and our scientific endeavours are lost. The social committee had local knowledge and contacts, vital to its success. The timing of the event is important. The Edinburgh congress began at the start of the largest arts festival in the world, the Edinburgh International Fringe. This reduced the availability, and increased the cost, of accommodation. (In part compensation the Congress venue was obtained at 50% of the usual price because of the Festival so helping to minimise the delegate fee.) The committee’s budget was minimal for two reasons: first, financial governance of a Congress requires that spending does not exceed income, which depends on registrations and
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fundraising, which cannot be predicted. Secondly, the priority for the budget was the scientific programme, closely followed by the commitment to provide bursaries. The lack of a significant budget encouraged creative thinking of fun and stimulating events ranging from jogging groups to a historical exhibition of publications charting the history of epidemiology, held in the impressive environment of The Royal College of Physicians of Edinburgh (see Last).7 We deliberately chose a small but focused social programme rather than a large expensive programme which could be misrepresented as extravagant and out of tune with the public health agenda. The Congress website directed potential delegates to a wide range of social, cultural and generic tourist information. Congress lunches and dinner are surprisingly important to the success of a Congress: intellectual nourishment is not enough! Is the dinner a social, business or mixed event? Are speeches and entertainment required? Social dinners are unlikely to attract ethical sponsorship. While business dinners may attract sponsorship, costs are likely to be higher because of the increased formality. Religious and cultural issues also need to be considered. The Scottish congress was held in August during Ramadan when Muslims fast during daylight hours. Dawn in Edinburgh was approximately 05.30 and sunset was approximately 21.00. This had implications for when Muslim delegates can eat and drink. Our choices, given these issues, were a healthy boxed lunch and a conference party with a buffet supper (costing the Congress £35 per head, and subsidised for delegates at £25 per head), rather than a ‘gala’ dinner (cost closer to £70 per head).
International advisory committee (IAC) An international advisory committee is customary for international conferences including the WCE and the potential benefits are multiple e.g. constructive expert feedback from across the world, and access to a wide range of perspectives and networks. The role of the IAC was to offer high level strategic advice on the directions proposed by the other committees. It also encouraged people to participate both as speakers and as delegates. In 2009 RSB and Richard Peto (RP, chair of this committee) started by proposing members to the Management Executive. This is no small task, as membership should span the globe, and include the disciplines relevant to the science and practice of epidemiology. It was initially suggested that the IAC would comprise about 20 members, but following recommendations from the IEA it was expanded to broaden the breadth and depth of fields covered. In total, there were 41 members from 28 countries covering six continents, and encompassing the major fields in epidemiology. The IAC was active in advising on the scientific programme, fundraising and marketing. Some IAC members wanted more involvement, so were co-opted to other conference committees as well. Many IAC members spoke or chaired sessions at the World Congress. The IAC was, in retrospect, very important to the success of the WCE.
Budget management Congresses that lose money are failing irrespective of other achievements. IEA Council is clear: the full financial
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responsibility lies with the conference organisers. Tight financial management is necessary especially as decisions on expenditures need to be made before either sponsorship or delegate fees are secured. The professional conference organisers (PCO) controlled budgetary matters with the treasurer (JP). The PCO’s knowledge, contacts and negotiating skills were essential in securing value for money. A detailed spreadsheet was devised at the outset, and populated with both fixed and variable costs. Using this as a financial modelling tool, we were able to readily see the potential impact of changes in the numbers of delegates and sponsorship raised, as well as the effects of changing registration fees, the numbers of bursaries offered, and the quality of meals and other facilities. We used this spreadsheet tool to classify areas of expenditure as either essential or desirable, and we determined the latest dates on which decisions could be taken regarding the inclusion of desirable items, such as additions to the social programme and higher quality catering. Desirable items were only included when the projected income allowed. Similarly an indicative amount was initially allocated for the provision of bursaries with the actual amount determined at a later date once we had a clearer understanding of the level of sponsorship.
Reflections and lessons Reflecting on what has been learnt in any exercise or area of work is an essential part of personal development, but it is also important in the dissemination of knowledge for the benefit of future organisers and future conferences. We have selected a few of the many lessons learnt. Absolute clarity is essential on who is ultimately responsible for decision making. Recommendations, often strongly worded, are likely to come from multiple directions, e.g. the IEA Council, subcommittees, professional conference organiser, governmental agencies and interested individuals, possibly those very senior in the field. A single, crystal-clear route for decision making needs to be established early and made widely known. In our case every decision required to be ratified by the Management Executive Committee, or by “chairman’s action” when this was not practical. As tensions are inevitable, especially in resolving differences in opinion on the best way to achieve agreed goals, usually in the face of uncertainty, this kind of clarity, though not a totally perfect remedy, was vital. It is important to appoint qualified and committed members to the committees, especially the Scientific Committee, and check that those accepting membership recognise fully their obligations and responsibilities. Membership is not a right associated with seniority or status; rather it is a demanding role requiring considerable commitment of time and energy. The committees should not be too large so as to be unmanageable or for members to have little sense of their specific responsibilities, but not too small to be unable to handle the workload or be unrepresentative or elitist. The Committees, especially the scientific one, needs a balance of age groups, gender, geography and disciplines relevant to epidemiology and public health. This is important as decisions may be criticised and will need to be defended. An unbalanced, small committee will be vulnerable to criticism.
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Committees need to assume that what can go wrong, will go wrong and plan ahead. The scientific committee, especially, needs to be flexible, responsive and versatile in coping with challenges e.g. last minute withdrawals of speakers, poster presenters, and chairs. A series of reserves ready and willing to fill the gaps is advisable. The preparation of materials for fundraising and marketing, and their distribution, was a huge task and could not have been done without the professional conference organisers. The marketing and fundraising committees, working with the management executive committee were able to produce ideas, prepare drafts and make personal contacts, but not to undertake the voluminous day-to-day tasks. Very few organisations that did not have a direct link to public health provided financial support. Few international organisations gave support. Many organisations did not respond to communications by the fundraising committee. Personal contact by a member of the fundraising committee, usually by telephone, proved to be a good way to follow up the emailed material. Looking back much of the effort produced little, but this was not predictable at the time. Marketing was, in contrast to fundraising, a relatively smooth process. There is much goodwill from organisations to promote (freely) the Congress. Also with multiple electronic media now available the work can be done quickly, reaching large numbers of people at low cost. While an international committee is customary, it is easy to see it as convened to provide (largely) moral support. Our approach was to request limited but specific help. We informed the committee that we would restrict their work to responding to three communications (on the draft scientific programme, the fundraising strategy, and the marketing strategy). This approach seemed to strike the right balance, with most members making input to these key matters, and those wishing to do so becoming more actively engaged by joining other committees. Initially, there was uncertainty about many things such as delegate numbers, costs and the total budget. Estimates had to be made as to what would be a reasonable fee and what fundraising target was feasible (£250,000). We had periods of anxiety over many issues, and much debate over the planning process. We raised a little more than £180,000, a fine performance but as it was short of target, the dual challenge was to attract more delegates and reduce the number of bursaries. The budgetary uncertainty affected the social and catering aspects of the Congress most, as here there was most room for discretionary spending.
Conclusions This article was written to give insights into the justification for the Congress coming to Scotland, the structures and processes adopted, and the experience gained, so that it might be helpful to future organisers of WCEs, or indeed any similar, large scale international conference. The organisation of a WCE is an enormous responsibility but a potentially rewarding one if it works out well i.e. the science and social programme is good, delegates come, and the budget balances while providing value for money. The key ingredients for us
were a large and willing collaboration of institutions and individuals; financial support mostly from Scotland or other UK sources; the valuable and relevant experience of the professional conference organisers; ongoing and unstinting support and advice from IEA, including a site visit to Edinburgh; and the effectiveness of the committee structure, which worked well notwithstanding its apparent complexity. Overall the 2011 WCE was a success. The scientific programme was ambitious, especially the large number of plenary lectures, but it worked as shown by the delegate feedback (see summary statistics on the Congress Website). The marketing was also successful as we exceeded our target of 1200 participants. While we did not achieve our fundraising target of £250,000, this was probably because the target was set prior to the financial crisis. We raised about 70% of the target but this took far more work and persistence than we foresaw. Funding uncertainties forced us to make difficult decisions such as restricting the number of bursaries and keeping the subsidy on the conference party to a modest £10 per head. The benefits of this WCE will be enjoyed by a worldwide community and not just delegates. In addition to the papers presented in this edition of Public Health, the plenary lectures were videoed and can be watched on the Congress website (http://www.savav.co.uk/webcasts/ieaepidemiology/index. html); and many of the PowerPoint slides are on the Supercourse Website (http://www.pitt.edu/wsuper1/globalhealth/ IEA2011.htm), the abstracts and programme were published and are available on the website of the Journal of Epidemiology and Community Health (http://jech.bmj.com/content/ 65/Suppl_1.toc). This reach, beyond the immediate participants, is unprecedented for IEA’s World Congresses. While no effectiveness or cost-effectiveness data are available, on the basis of delegate feedback and personal judgement, we judge the XIXth World Congress of Epidemiology to have given benefits fully commensurate with the costs. In the longerterm, we hope that these benefits, and our documentation of the Congress, will translate into better public health practice, better future Congresses, and improved population health.
references
1. Bhopal RS, Macfarlane GJ, Smith WC, Victora CG. World congress of epidemiology. International Journal of Epidemiology 2011;40:3e4. 2. Venkatapuram S, Marmot M. Epidemiology and social justice in light of social determinants of health research. Bioethics 2009;23:79e89. 3. Morabia Ae. A history of epidemiologic methods and concepts. Basel: Birkha¨user Verlag; 2004. 4. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367:1747e57. 5. Bhopal RS, Macfarlane GJ, Cairns Smith W, Victora CG. XIXth IEA world congress of epidemiology, Edinburgh: august 7the11th 2011. Public Health 2011;125(7):482e3. 6. Bhopal R, Macfarlane GJ, Smith WC, West R. What is the future of epidemiology? Lancet 2011;378:464e5. 7. Last J. The people’s library of epidemiology. Public Health 2012;126(3):262e4.
Available online at www.sciencedirect.com
Public Health journal homepage: www.elsevier.com/puhe
Retrospect
Organising a World Congress of Epidemiology (WCE): Reflections and lessons from the XIX WCE, Scotland R.S. Bhopal a,*, W.C. Smith b, J. McEwen c, G. MacFarlane b, A. McCallum d, D. Pattison e, N. Bhala f, R. Peto f, J.P. Pell g, on behalf of the Management Executive Committee a
Centre for Population Health Sciences, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK School of Medicine and Dentistry, University of, Aberdeen, Polwarth Building, Foresterhill, Aberdeen c Public Health, University of Glasgow, UK d Public Health, NHS Lothian, Deaconess House, 128 The Pleasance, Edinburgh e International Development, NHS Health Scotland, Woodburn House, Canaan Lane, Edinburgh f Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford, Richard Doll Building, Oxford g Institute of Health and Wellbeing, Public Health, University of Glasgow, 1 Lilybank Gardens, Glasgow b
summary Keywords:
The 3-yearly World Congress of Epidemiology is the premier, international, scientific
Conference
conference organised under the auspices of the International Epidemiological Association
Organisation
(in open competition). This paper explores the justification for seeking to host the Congress
Epidemiology
and reflects on the structures and processes adopted in making the XIXth Congress in
Public health
Scotland happen.
International
Preparing the bid was invaluable for forming collaborations, generating scientific ideas, and garnering opinion. After the bid was accepted, we formed a local organising committee, named the Management Executive Committee to signal its decision making authority; and scientific, fundraising, marketing, international and social subcommittees. There was uncertainty about critical matters such as delegate numbers, costs and the total budget. Early decisions had to be made on, for example, the fee and fundraising target (£250,000), despite financial risks. Development of the scientific programme was a critical step that underpinned fundraising and marketing and permitted involvement of the international committee. Overall the 2011 WCE succeeded. The key ingredients to success were: a large collaboration of institutions and individuals; early pledges of financial support mostly from the UK; the valuable and relevant experience of the professional conference organisers; unstinting support and advice from IEA; and the effectiveness of the committee structure. The educational and professional development benefits of this WCE will reach a worldwide community and not just delegates, because of video, PowerPoint and textual accounts being open access on the Internet. This reach is unprecedented for IEA’s World
* Corresponding author. Tel.: þ44 131 650 3216; fax: þ44 131 650 6909. E-mail address: [email protected] (R.S. Bhopal). 0033-3506/$ e see front matter ª 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.puhe.2012.01.024
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Congresses. We anticipate that the Congress will translate into better public health practice, better future Congresses, advances in epidemiology and improved population health. ª 2012 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
Why hold a World Congress of Epidemiology? Weighing up the costs and benefits of making a bid to be the host The World Congress of Epidemiology (WCE) is the premier international scientific conference in the discipline and is organised locally and independently, under the auspices of the International Epidemiological Association (IEA, http:// www.ieaweb.org/)1 It is now established on a 3-yearly cycle, with the 19th Congress held in Edinburgh in August 2011. Potential organisers will consider why global meetings are still needed, despite their financial and environmental costs, especially in times of austerity. When a group of Scottish academics convened by the lead author, Raj Bhopal (RSB), discussed in 2004 e before the current financial crisis e whether to bid for WCE 2008, among the perceived answers to this ‘why’ question were the following: 1. Epidemiology as a science and practice across the world has sufficient commonality and mutual interest to warrant a global meeting. This commonality is both conceptual and methodological e.g. confounding, study design, and subject matter related e.g. the causes of disease and the interrelationship of epidemiology and health inequalities2,3; 2. There are many health issues that can only, apparently, be solved by international action and cooperation. This applies both to communicable diseases that rapidly cross international borders e.g. avian influenza and threats to health created by global companies e.g. the tobacco industry;4 3. Even given other means of communication (in 2004) a live interaction would be more likely to spark intellectual development of the discipline and its practitioners. Early career researchers and practitioners, in particular, are likely to benefit from face-to-face contact, which is an important prerequisite to more remote communication methods; 4. The potential benefits to Scotland of hosting the event would be great, particularly the opportunity to enable early career researchers and practitioners to learn from, debate with, and be inspired by global leaders. This, in turn might help to forge both long-term commitment and career directions. Long-term professional relationships and collaborations would, foreseeably, have scientific and public health benefits both locally and internationally; 5. Importantly, international conferences provide a boost for the economy. The Edinburgh Convention Centre estimated that the economic value of the WCE 2008, calculated in 2004 assuming 1000 participants, was £1 million pounds. The estimate of the economic benefits of the Congress in 2011 (1471 participants) stands at £2.9 million.
In summary, we expected long-term public health and scientific benefits to accrue both internationally and (especially) to Scotland. This was the main motivation, though the economic reasons were also a modest spur. These and other reasons for making a bid needed to be offset against the challenges of organising the event. The choice of location of WCE’s is part of the competitive process. The bid is scrutinised by the IEA Council (twice) and by the IEA membership at the AGM. We also had to consider the substantial workload consequences of winning the bid. For the XIXth Congress we went through a number of stages before deciding to bid: 1. Discussion with senior colleagues across Scotland on the potential merits and difficulties with proceeding. The merits were recognised but the workload was seen as a problem, particularly as a potential distraction from research. In particular, there was recognition that the role of leader of the Congress could be as much as 6-months equivalent of full-time work. (In retrospect, that assessment was reasonable); 2. Clarification of the specific roles of the Edinburgh Convention Bureau (agreed as financial and administrative), which initiated the dialogue with RSB, and of the academic staff (agreed as scientific); 3. Creation of a collaboration across the four medical schoolbased departments of epidemiology and/or public health. NHS Health Scotland was later included as the 5th responsible organisation; and 4. Leaders of Scottish Universities, NHS organisations, local government offices, the Scottish Government’s Health Department, and leading UK based research organisations and charities were informed by letter of the planned bid and invited to: (a) express general support and/or (b) to pledge financial support. General support was virtually unanimous and financial pledges of about £50K were made. An ‘ad-hoc’ short term advisory committee developed the scientific themes and specific ideas for the bid. (These deliberations gave the Scientific Committee a platform to develop the programme e see below.) At the end of this process we had achieved near-consensus to proceed to a formal bid for the WCE. The three key components for the bid were: (a) the academic case that outlined Scotland’s history of epidemiology and public health, the strengths of its current institutions, the combined strength of the four partnership universities making the bid, and the main theme and sub-themes the WCE would cover;
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(b) the quality of the venue, the facilities for delegates and the amenities and attractions of the city of Edinburgh; and (c) the budget and most importantly the delegate fee. The IEA Council wanted the fee to be low so low-income country delegates would come, and also wanted subsidised places for low-income countries’ early career researchers. These expectations would need sponsorship, so the financial pledges already in place were crucial to IEA Council’s support. The bid was presented in 2004 to the IEA Council, and following feedback, again in 2005. After this we presented to the IEA AGM at the XVIIth WCE in Bangkok in 2005 where the IEA Council invited us to host the XIXth WCE (2011), an offer that was accepted, but only after further consultation with partners in Scotland. This was to ensure ongoing commitment to the next stage of development. The challenges after the bid is accepted are organisational with the goal of achieving the predicted benefits while minimising risks and costs. In the next section we describe and reflect on our approach as a way of helping other public health academics and practitioners aiming to host similar large Congresses.
Organising the XIXth WCE in Edinburgh Setting up the infrastructure to host the WCE: the local organising/management executive committee The first priority was to recognise the Congress as a complex process that merited a strong infrastructure. The key early actions were to book the conference centre, negotiate rates and hold accommodation in hotels, and hire a professional conference organiser. We set up a local organising committee, which we named the Management Executive Committee to recognise its function and clarify its authority as the ultimate decision making body. Scientific, Marketing, Fundraising, Social and International Committees were established and a treasurer nominated. The Management Executive Committee held full responsibility, the subcommittees and IEA Council being advisory. NHS Health Scotland e which is the national agency for Health Improvement in Scotland and a WHO Collaborating Centre e was given full partner status alongside the four Universities. A limited company was formed with four directors, one from each of the four Universities involved. The processes followed by each of the above subcommittees are described below.
Developing the scientific programme and evaluating submissions: The scientific committee The scientific committee is, clearly, at the heart of the congress and for creativity it needs to be quasi-independent though decision making is still subject to approval by Management Executive Committee. We identified three key elements to success e careful selection of members and clarification of their functions; the development of an overarching Congress theme with coherent sub-themes; and robust processes of peer review of submissions and related
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decision making. The members’ commitments were exploring ideas, contacting potential speakers, helping organise and chair specific sessions, reviewing abstracts and helping make key strategic recommendations to Management Executive Committee. An early face-to-face meeting was useful to address the main issues, explore ideas and for members to get to know each other; later most business was by telephone, teleconferencing, email etc. Congress theme and sub-themes were chosen to be coherent and reasonably broad. The Scientific Committee consulted widely on these themes, built on the themes developed at the bid stage and was aware of themes adopted by previous congresses. These themes provided the framework for inviting plenary speakers and deciding their topics, organising workshops or symposia and inviting abstract submissions for free paper and poster sessions. The demand on the scientific programme was high and predictably exceeded capacity. In fact, our Congress attracted nearly 2000 abstracts for oral presentation/posters (about 1000 spaces available) and about 40 proposals for proposed workshops (eight spaces available). Workload was, therefore, about double that originally expected and planned for. Speakers want to be invited to give plenary lectures which are a mark of peer esteem and customarily come with travel and other support from the Congress. Investigators want their abstracts accepted, preferably as oral presentations rather than posters, as their funding often depends on it. There will be disappointed people, many influential and/or vocal, so it is essential that robust peer review processes are in place. Excepting invited plenary speakers and invited workshops on Congress themes, submissions need to be peer reviewed e whether abstracts, or workshop and symposia proposals. The panel of reviewers needs to review abstracts in a narrow time window. Committee members need to plan ahead to fulfil their commitments. Transparent scoring systems and an electronic system to manage the process are essential. In our Congress each abstract offered for oral presentation was independently scored by three reviewers.
Fundraising and the fundraising committee Fundraising is essential to international meeting such as WCEs as otherwise attendance from, in particular but not exclusively so, many of the lower-income countries will be negligible. Fundraising is a long, slow process that involves a great deal of administration, and this is worse in a period of financial austerity. It needs to begin when the Congress is first under discussion. We were fortunate that the preliminary contacts made in 2004 led to financial pledges. This greatly facilitated future contacts with potential donors, though the changed circumstances meant that some pledges were not honoured, and others required prolonged renegotiation. Agreement on fundraising from the Management Executive Committee was required on key policy issues. These included which sources of funding were acceptable. While it is normal practice in epidemiology and public health not to accept money from the tobacco industry, we agreed that funding would also not be sought from the alcohol industry, as this might send mixed messages about alcohol as a public health problem and might have ruled out funding from health
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service organisations in Scotland. We agreed that fundraising should start with public health and other health services in Scotland, as support from them would then make it easier to approach others having shown good initial support from our own constituency. Indeed, in the end they provided a major part of the total funding. Setting a target was essential e in our case £250,000. This target, on our projections, permitted the WCE budget to balance with 900 paying delegates and with a commitment of 100 bursaries (of £1000 each). There were two main strands to the funding-raising: first, general support for the Congress and, second, bursaries for younger researchers from lowincome countries. Our aim to provide bursaries was vital and the 250 or so mostly strong applications (64 offered) indicated a large need. (The process of selection is described on the Congress website.) Letters were supported by brochures detailing the actual opportunities provided in return for sponsorship. The letter emphasised that our purpose was to hold a congress that would be reasonably priced so delegates from all countries of the world might be able to attend. The letter emphasised the international nature of the congress, its prestige, the contribution of epidemiology, the need for research, the outstanding programme, the learning opportunities for delegates, the honour to Scotland (and the UK for appropriate funders), and the benefits to supporters.
Marketing and the work of the committee Congresses are in intense competition for delegates. The IEA’s North American Congress of Epidemiology took place in June 2011 and a major conference on international public health took place in London in September 2011. We were competing with these and many other Conferences. There was a clear outcome measure of how successful the marketing subcommittee was in its task i.e. how many persons attended the conference. Management Executive Committee’s judged that the minimum acceptable number was 900 as fewer than that would have put the Congress in financial jeopardy, the expected number was 1200 (achieved by the Montre´al Congress in 2002), and 1500 would be a major success. We achieved 1471 participants. Information from previous conferences, unsurprisingly, demonstrated that the single largest number of delegates would come from the host country and with the United Kingdom’s rich traditions in epidemiology we knew that we could rely on strong home support. However this was a world congress and it would only be considered successful in that context if we attracted a truly international mix of delegates. Our most important marketing tool throughout was our website: www.epidemiology2011.com. This initially informed delegates of the congress dates. It then evolved to providing details of the committees involved, programme information including biographies of plenary speakers, deadline dates for submission of abstracts and registration, information about the venue, social activities, sponsorship and exhibition opportunities and links to other sites of interest. The information changed with time to provide updates and to highlight the relevant approaching deadlines. We also used Facebook and Twitter, particularly to reach a younger audience.
To spread information internationally we relied on IEA regional councillors and our international committee to identify relevant contacts in their countries (including national societies) who could help advertise the congress. We also identified all major congresses relevant to epidemiology which were scheduled to be held prior to the World Congress. We identified whether any of the executive or marketing committees or other contacts were attending these congresses and could take flyers or posters to display at the meeting. If not we used local contacts to do the same. At some IEA regional meetings we secured “plenary” slots for a short presentation about the congress and its themes and also played a short video of Edinburgh. We used publications to help us “spread the word”. We advertised in the IEA house journal and wrote an editorial in IJE, which was reprinted in Public Health5and a commentary in the Lancet6 to feature the discipline of epidemiology, the coming congress and its themes, plenary speakers and wider attractions of the host city. We provided periodic newsletters to IEA members, and those registering an interest on our website or registering as delegates, as preparations for the congress progressed. Epimonitor (http://www.epimonitor.net/) was enthusiastic about helping us to promote the conference and we were able to use themed features to highlight speakers, workshops and social activities of the conference. The Supercourse team in Pittsburgh, USA, were wonderfully enthusiastic about helping to publicise the event through their extensive international contacts (http://www.pitt.edu/wsuper1/). The host Universities advertised to their staff and we used our national society, the Society for Social Medicine, through newsletters and congresses to advertise to its members (http://www. socsocmed.org.uk/). We contacted heads of relevant academic and NHS departments throughout the United Kingdom. Marketing needed to be well established by the close of abstract submission early in 2011 e since most delegates coming would only do so if they were presenting at the conference. Our final total of 1471 delegates from 82 countries around the world ensured a truly international gathering e and the countries with the highest number of attendees (outside the United Kingdom) were, in order, Brazil, Japan, United States and Australia. As only 441 people were from the UK, 70% were from overseas.
Social committee and social programme While the central component of any congress is the scientific programme, without a social programme opportunities to develop, renew and maintain the relationships so important to personal development and our scientific endeavours are lost. The social committee had local knowledge and contacts, vital to its success. The timing of the event is important. The Edinburgh congress began at the start of the largest arts festival in the world, the Edinburgh International Fringe. This reduced the availability, and increased the cost, of accommodation. (In part compensation the Congress venue was obtained at 50% of the usual price because of the Festival so helping to minimise the delegate fee.) The committee’s budget was minimal for two reasons: first, financial governance of a Congress requires that spending does not exceed income, which depends on registrations and
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fundraising, which cannot be predicted. Secondly, the priority for the budget was the scientific programme, closely followed by the commitment to provide bursaries. The lack of a significant budget encouraged creative thinking of fun and stimulating events ranging from jogging groups to a historical exhibition of publications charting the history of epidemiology, held in the impressive environment of The Royal College of Physicians of Edinburgh (see Last).7 We deliberately chose a small but focused social programme rather than a large expensive programme which could be misrepresented as extravagant and out of tune with the public health agenda. The Congress website directed potential delegates to a wide range of social, cultural and generic tourist information. Congress lunches and dinner are surprisingly important to the success of a Congress: intellectual nourishment is not enough! Is the dinner a social, business or mixed event? Are speeches and entertainment required? Social dinners are unlikely to attract ethical sponsorship. While business dinners may attract sponsorship, costs are likely to be higher because of the increased formality. Religious and cultural issues also need to be considered. The Scottish congress was held in August during Ramadan when Muslims fast during daylight hours. Dawn in Edinburgh was approximately 05.30 and sunset was approximately 21.00. This had implications for when Muslim delegates can eat and drink. Our choices, given these issues, were a healthy boxed lunch and a conference party with a buffet supper (costing the Congress £35 per head, and subsidised for delegates at £25 per head), rather than a ‘gala’ dinner (cost closer to £70 per head).
International advisory committee (IAC) An international advisory committee is customary for international conferences including the WCE and the potential benefits are multiple e.g. constructive expert feedback from across the world, and access to a wide range of perspectives and networks. The role of the IAC was to offer high level strategic advice on the directions proposed by the other committees. It also encouraged people to participate both as speakers and as delegates. In 2009 RSB and Richard Peto (RP, chair of this committee) started by proposing members to the Management Executive. This is no small task, as membership should span the globe, and include the disciplines relevant to the science and practice of epidemiology. It was initially suggested that the IAC would comprise about 20 members, but following recommendations from the IEA it was expanded to broaden the breadth and depth of fields covered. In total, there were 41 members from 28 countries covering six continents, and encompassing the major fields in epidemiology. The IAC was active in advising on the scientific programme, fundraising and marketing. Some IAC members wanted more involvement, so were co-opted to other conference committees as well. Many IAC members spoke or chaired sessions at the World Congress. The IAC was, in retrospect, very important to the success of the WCE.
Budget management Congresses that lose money are failing irrespective of other achievements. IEA Council is clear: the full financial
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responsibility lies with the conference organisers. Tight financial management is necessary especially as decisions on expenditures need to be made before either sponsorship or delegate fees are secured. The professional conference organisers (PCO) controlled budgetary matters with the treasurer (JP). The PCO’s knowledge, contacts and negotiating skills were essential in securing value for money. A detailed spreadsheet was devised at the outset, and populated with both fixed and variable costs. Using this as a financial modelling tool, we were able to readily see the potential impact of changes in the numbers of delegates and sponsorship raised, as well as the effects of changing registration fees, the numbers of bursaries offered, and the quality of meals and other facilities. We used this spreadsheet tool to classify areas of expenditure as either essential or desirable, and we determined the latest dates on which decisions could be taken regarding the inclusion of desirable items, such as additions to the social programme and higher quality catering. Desirable items were only included when the projected income allowed. Similarly an indicative amount was initially allocated for the provision of bursaries with the actual amount determined at a later date once we had a clearer understanding of the level of sponsorship.
Reflections and lessons Reflecting on what has been learnt in any exercise or area of work is an essential part of personal development, but it is also important in the dissemination of knowledge for the benefit of future organisers and future conferences. We have selected a few of the many lessons learnt. Absolute clarity is essential on who is ultimately responsible for decision making. Recommendations, often strongly worded, are likely to come from multiple directions, e.g. the IEA Council, subcommittees, professional conference organiser, governmental agencies and interested individuals, possibly those very senior in the field. A single, crystal-clear route for decision making needs to be established early and made widely known. In our case every decision required to be ratified by the Management Executive Committee, or by “chairman’s action” when this was not practical. As tensions are inevitable, especially in resolving differences in opinion on the best way to achieve agreed goals, usually in the face of uncertainty, this kind of clarity, though not a totally perfect remedy, was vital. It is important to appoint qualified and committed members to the committees, especially the Scientific Committee, and check that those accepting membership recognise fully their obligations and responsibilities. Membership is not a right associated with seniority or status; rather it is a demanding role requiring considerable commitment of time and energy. The committees should not be too large so as to be unmanageable or for members to have little sense of their specific responsibilities, but not too small to be unable to handle the workload or be unrepresentative or elitist. The Committees, especially the scientific one, needs a balance of age groups, gender, geography and disciplines relevant to epidemiology and public health. This is important as decisions may be criticised and will need to be defended. An unbalanced, small committee will be vulnerable to criticism.
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Committees need to assume that what can go wrong, will go wrong and plan ahead. The scientific committee, especially, needs to be flexible, responsive and versatile in coping with challenges e.g. last minute withdrawals of speakers, poster presenters, and chairs. A series of reserves ready and willing to fill the gaps is advisable. The preparation of materials for fundraising and marketing, and their distribution, was a huge task and could not have been done without the professional conference organisers. The marketing and fundraising committees, working with the management executive committee were able to produce ideas, prepare drafts and make personal contacts, but not to undertake the voluminous day-to-day tasks. Very few organisations that did not have a direct link to public health provided financial support. Few international organisations gave support. Many organisations did not respond to communications by the fundraising committee. Personal contact by a member of the fundraising committee, usually by telephone, proved to be a good way to follow up the emailed material. Looking back much of the effort produced little, but this was not predictable at the time. Marketing was, in contrast to fundraising, a relatively smooth process. There is much goodwill from organisations to promote (freely) the Congress. Also with multiple electronic media now available the work can be done quickly, reaching large numbers of people at low cost. While an international committee is customary, it is easy to see it as convened to provide (largely) moral support. Our approach was to request limited but specific help. We informed the committee that we would restrict their work to responding to three communications (on the draft scientific programme, the fundraising strategy, and the marketing strategy). This approach seemed to strike the right balance, with most members making input to these key matters, and those wishing to do so becoming more actively engaged by joining other committees. Initially, there was uncertainty about many things such as delegate numbers, costs and the total budget. Estimates had to be made as to what would be a reasonable fee and what fundraising target was feasible (£250,000). We had periods of anxiety over many issues, and much debate over the planning process. We raised a little more than £180,000, a fine performance but as it was short of target, the dual challenge was to attract more delegates and reduce the number of bursaries. The budgetary uncertainty affected the social and catering aspects of the Congress most, as here there was most room for discretionary spending.
Conclusions This article was written to give insights into the justification for the Congress coming to Scotland, the structures and processes adopted, and the experience gained, so that it might be helpful to future organisers of WCEs, or indeed any similar, large scale international conference. The organisation of a WCE is an enormous responsibility but a potentially rewarding one if it works out well i.e. the science and social programme is good, delegates come, and the budget balances while providing value for money. The key ingredients for us
were a large and willing collaboration of institutions and individuals; financial support mostly from Scotland or other UK sources; the valuable and relevant experience of the professional conference organisers; ongoing and unstinting support and advice from IEA, including a site visit to Edinburgh; and the effectiveness of the committee structure, which worked well notwithstanding its apparent complexity. Overall the 2011 WCE was a success. The scientific programme was ambitious, especially the large number of plenary lectures, but it worked as shown by the delegate feedback (see summary statistics on the Congress Website). The marketing was also successful as we exceeded our target of 1200 participants. While we did not achieve our fundraising target of £250,000, this was probably because the target was set prior to the financial crisis. We raised about 70% of the target but this took far more work and persistence than we foresaw. Funding uncertainties forced us to make difficult decisions such as restricting the number of bursaries and keeping the subsidy on the conference party to a modest £10 per head. The benefits of this WCE will be enjoyed by a worldwide community and not just delegates. In addition to the papers presented in this edition of Public Health, the plenary lectures were videoed and can be watched on the Congress website (http://www.savav.co.uk/webcasts/ieaepidemiology/index. html); and many of the PowerPoint slides are on the Supercourse Website (http://www.pitt.edu/wsuper1/globalhealth/ IEA2011.htm), the abstracts and programme were published and are available on the website of the Journal of Epidemiology and Community Health (http://jech.bmj.com/content/ 65/Suppl_1.toc). This reach, beyond the immediate participants, is unprecedented for IEA’s World Congresses. While no effectiveness or cost-effectiveness data are available, on the basis of delegate feedback and personal judgement, we judge the XIXth World Congress of Epidemiology to have given benefits fully commensurate with the costs. In the longerterm, we hope that these benefits, and our documentation of the Congress, will translate into better public health practice, better future Congresses, and improved population health.
references
1. Bhopal RS, Macfarlane GJ, Smith WC, Victora CG. World congress of epidemiology. International Journal of Epidemiology 2011;40:3e4. 2. Venkatapuram S, Marmot M. Epidemiology and social justice in light of social determinants of health research. Bioethics 2009;23:79e89. 3. Morabia Ae. A history of epidemiologic methods and concepts. Basel: Birkha¨user Verlag; 2004. 4. Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006;367:1747e57. 5. Bhopal RS, Macfarlane GJ, Cairns Smith W, Victora CG. XIXth IEA world congress of epidemiology, Edinburgh: august 7the11th 2011. Public Health 2011;125(7):482e3. 6. Bhopal R, Macfarlane GJ, Smith WC, West R. What is the future of epidemiology? Lancet 2011;378:464e5. 7. Last J. The people’s library of epidemiology. Public Health 2012;126(3):262e4.