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- A. Allen Seals, MD, FACC, Chair of ACC’s Board of Governors∗ ()
- ↵∗Address correspondence to:
Dr. A. Allen Seals, American College of Cardiology, 2400 N Street NW, Washington, DC 20037.
Although momentous progress has been made in treating cardiovascular diseases and reducing morbidity and mortality, they still remain the number 1 cause of death globally. We are living in “a new world” where global health is “central in a sustainable development paradigm,” according to Daniel José Piñeiro, MD, FACC, chair of the American College of Cardiology’s (ACC’s) Assembly of International Governors (personal communication, April 2016). He adds that as a global community, we must fight cardiovascular disease in a “smarter and more effective way.” In response to the need for more effective global action, the ACC is positioned as the professional home for cardiovascular professionals around the world—and the numbers prove that this focus is working. In the last 5 years, the ACC’s international membership has grown an average of 30% annually, and now the College proudly boasts more than 15,000 members in 137 countries around the world. Additionally, 5 years ago, the ACC had only 9 chapters outside of the United States; however, today the ACC is represented by 36 international chapters (Figure 1).
History of ACC International Efforts
The ACC’s footprint around the globe has grown a remarkable amount in the last one-half decade, but international outreach is not new to the College. In fact, in the 1960s, the College began to see an influx in international membership and global recognition, and subsequently the College’s International Circuit Courses were born. Led by Eliot Corday, MD, MACC, E. Grey Dimond, MD, MACC, C. Walton Lillehei, MD, PhD, MACC, George Burch, MD, FACC, and Simon Dack, MD, MACC, a “medical peace corps”—as College cofounder Phillip Reichert, MD, FACC, dubbed it—brought pre-eminent American cardiologists to less-developed countries throughout the world (1). The Philippines and Taiwan were the first countries to welcome ACC physicians, but over a period of 20 years, more than 70 groups of American cardiologists went to underdeveloped countries, where they gave instruction in cardiovascular diagnosis and treatment. That program has been credited with greatly improving care in these parts of the world.
Circuit courses were the ACC’s first foray into international collaboration, but they certainly were not its last, as is evidenced by the immense growth we have seen in the last few years. The ACC inaugurated a new era of international outreach in 2008 and 2009 with the formation of international chapters, the first of which was Malaysia. This move was followed by arguably 1 of the College’s most successful domestic and international collaboration experiences: the ACC’s twinning program. Led by ACC Past President John Gordon Harold, MD, MACC, the first of these programs connected the California Chapter of the ACC and the British Cardiovascular Society, facilitating the development of long-term relationships between cardiovascular professionals in the United States and the United Kingdom.
Two additional ACC chapters have developed domestic-international twinning programs: Florida with Spain, and Pennsylvania with Italy. The Florida Chapter of the ACC (FCACC) and the Sociedad Española Cardiologia program was established in 2012 with specific goals to promote joint communications in official publications; encourage joint attendance at the main annual meetings of the FCACC and the Sociedad Española Cardiologia; facilitate exchanges of Fellows in Training between teaching institutions in Florida and Spain; and most recently, to establish opportunities for FCACC members to participate in learning preceptorships in Spain. The Pennsylvania Chapter of the ACC has also established similar goals. These twinning relationships link domestic ACC chapter members with international colleagues with specific shared interests—especially in advanced diagnostic and treatment modalities available in Europe. For example, teaching institutions in Europe with active structural heart clinical programs typically use new bioprosthetic valves not yet approved in the United States.
The current chapter twinning experience has convincingly demonstrated that these international programs provide excellent opportunities for ACC members to collaborate with international colleagues on educational and training programs of mutual benefit. According to Juan Aranda, MD, FACC, Past Governor of the Florida Chapter, “these innovative international programs afford chapters—both domestic and around the globe—the ability to share experiences that lead to cross-pollination of ideas, and ultimately improve patient care in both countries” (personal communication, April 2016).
Current and Future International Collaboration
With the demonstrated value of these international partnerships, the ACC is now planning to significantly expand domestic-international collaboration. The next evolution of the international efforts from the College was formally launched this past spring at ACC.16 in Chicago, Illinois, now known as the Chapter Exchange Program. This new international initiative allows ACC chapters to further build on the twinning experience and participate in opportunities to improve heart health and cardiovascular care around the world. The Chapter Exchange Program is built on 2 collaborative requirements: 1) reciprocal participation in chapter meetings; and 2) facilitated institutional visits.
This Chapter Exchange Program is an excellent opportunity for partnership of domestic and international ACC chapters with similar interests through a structured partnership. The ACC is actively looking to add 3 new exchange relationships this year, and ACC chapters are encouraged to reach out to the College for more information on pursuing this partnership.
It is worth mentioning that in the updated ACC governance structure—which focuses on centralized authority and decentralized decision-making—the Assembly of International Governors will sit alongside the domestic Board of Governors and the Section Steering Committee in the newly formed Membership Committee. This will afford all 3 groups the ability to be more empowered to make decisions, given the ACC’s move toward a leaner leadership structure. This governance transformation will be another opportunity to bring an increased level of interaction between the domestic and international member leaders of the College, and I look forward to our expanded partnership.
Additionally, the ACC has been recognized for its partnership in helping to catalyze efforts in global health by leveraging its vast global membership to drive efforts on the ground and close the gaps in health care across populations. In particular, the College’s National Cardiovascular Data Registry registries, both inpatient and outpatient, as well as the accreditation services offered by the Society for Cardiovascular Patient Care, an institute of the College, are increasingly being used internationally to help identify gaps in care and track quality improvement effort, with more than 20 institutions from 10 countries participating to date. This number is set to increase this year as more hospitals sign on around the globe. Innovative efforts to align registry and accreditation services to improve quality of care in the China, India, the Middle East, and Brazil, among other countries, are under way. There is tremendous interest across ACC chapters in aligning data collection and creating networks for joint research and bidirectional learning to better understand both the burden of cardiovascular disease and innovative treatment strategies worldwide.
Global collaboration is vital to solve the challenge of noncommunicable diseases like cardiovascular disease. Its widespread effect makes it a prime example of a global epidemic that should not—and cannot—be tackled by an individual health care provider, hospital, health system, country, chapter, or region in isolation. At ACC.16, Immediate Past ACC President Kim Allan Williams, Sr., MD, MACC, said that “if we can work together to increase international participation in educational activities, encourage global use and exchange of data, and raise public awareness about cardiovascular disease and its risk factors, progress is well within our grasp” (Williams, K.A. ACC.16 Convocation Speech, American College of Cardiology. Chicago, IL, April 2016). If the last 5 years of collaboration and international growth are any indication of the success ahead, we are on the right path.
- American College of Cardiology Foundation
- ↵(1998) American College of Cardiology: A Visual History 1949–1999 (American College of Cardiology, Bethesda, MD), p 30.