1. Improving Nephrology around the World March 16-18, 2004 ISN COMGAN Bellagio Conference Prevention of renal diseases in the emerging world: Toward global health equity

2. Improving Nephrology around the World The Bellagio Conference would like to express gratitude for the generous contribution of The Rockefeller Foundation The International Society of Nephrology

3. The Bellagio Conference would like to express gratitude for the generous contribution of:  J&J/Ortho Biotech Europe  International Society of Nephrology  Baxter  Merck, Sharp and Dohme

4. Kidney disease and kidney failure is rising globally A Strategy for Kidney Failure 1.Rising faster in the developing countries 2.Kidney failure patients constitute a small fraction of disease but a disproportionately higher cost. 3.If prevention not started, RRT will increase

5. Improving Nephrology around the World Our Goals: to develop and implement global clinical strategies for prevention which are applicable to emerging countries The International Society of Nephrology

6. Improving Nephrology around the World To improve education of nephrologists, primary doctors and health professionals The International Society of Nephrology

7. Improving Nephrology around the World To provide training focusing on the areas of epidemiology, clinical pharmacology and clinical trials The International Society of Nephrology

8. Improving Nephrology around the World To activate specific research projects of early screening of renal disease for prevention of progression of ESRD The International Society of Nephrology

9. Improving Nephrology around the World To seek global resources to fund these goals of education and training The International Society of Nephrology

10. Improving Nephrology around the World To make results of this meeting available to other medical leaders worldwide i.e. research, the public and the media The International Society of Nephrology

11. Improving Nephrology around the World Existing Communication Strategy: 1.3,000 word article in Lancet 2.Video recording 3.Publication on the ISN website 4.Newsletter 5.Communications with national bodies The International Society of Nephrology

12. Improving Nephrology around the World It is urgent to address and reduce global incidence of chronic renal diseases especially in emerging countries The International Society of Nephrology

13. Arrigo Schieppati – “Chronic Renal diseases as a public health problem: eidemiology, social and economical implications” Meguid El-Nahas – “Risk factors of chronic renal diseases” Peter Bennett – “Global burden of diabetes: prevalence and projections” Giancarlo Viberti – “Cardiovascular risk in chronic renal diseases” Why the need to prevent chronic renal diseases? Speakers: The Bellagio Conference Day1, Session 1: Moderator: John Dirks

14. Giuseppe Remuzzi – “Prevention of progression and remission/regression strategies of chronic renal diseases: can we do better now than 5 years ago?” Dick de Zeeuw – “Early detection, prediction and potential treatments of renal and cardiovascular risk in the general population” Speakers: The Bellagio Conference Development of strategies for prevention relevant to different regions and countries Day 1, Session 2: Moderator: Robert Atkins

15. Bernardo Rodriguez Iturbe – “Prevention strategies in Latin America: from less to more developed countries” Sarala Naicker – “The need of prevention programs in Africa” Faisal Shaheen – “Prevention programs in the Middle East and Arab World” Development of strategies for prevention relevant to different regions and countries Speakers: The Bellagio Conference Day 2, Session 1: Moderators: Robert Atkins and Giuseppe Remuzzi

16. Sanjay Kumar Agarwal – “The case of prevention of chronic kidney diseases in India” Giuseppe D’Amico – “Opportunities for a Chronic Disease outreach program in China” Discussion and Round Table – “Global or local strategies for emerging countries?” Speakers: The Bellagio Conference Development of strategies for prevention relevant to different regions and countries Day 2, Session 1 (cont’d): Moderators: Robert Atkins and Giuseppe Remuzzi

17. Dan Kaseje – “Public health in emerging world” Chitr Sitthi-amorn – “Strengthening health research capacity in developing countries: a critical element for achieving health equity” Ivor Katz – “International aid and medical practice in the less-developed world: doing it right” Implementation of strategies relevant to national health care systems and specific centres in the emerging world Speakers: The Bellagio Conference Day 2, Session 3 - Moderator: Jan Weening

18. Sarala Naicker – “Africa can solve its own health problems?” Raul Herrera Valdes – “The view of Central American countries” Ricardo Corréa-Rotter – “An educational Program for Prevention of Diabetic Nephropathy for General Physicians” Speakers: How to implement strategies for national health care systems in emerging countries The Bellagio Conference Day 3, Session 3: Moderators: Jan Weening and John Dirks

19. Sanjay Kumar Agarwal – “How to approach the problem in large countries: India” Ivor Katz – “The Australian Chronic Disease Outreach Program” Peter Bennett – “The case of American Indians and Alaskan Natives” Speakers: How to implement strategies for national health care systems in emerging countries The Bellagio Conference Day 3, Session 3 (cont’d): Moderators: Jan Weening and John Dirks

20. JoAnne Epping Jordan – “Integrated approaches to prevention and control of chronic conditions” Kim Solez – “Electronic stratagies for information and research” Speakers: How to implement strategies for national health care systems in emerging countries The Bellagio Conference Day 3, Session 3 (cont’d): Moderators: Jan Weening and John Dirks

21. Prevalence of 1% (19.2 million) 1. Stage 1 5.9 M (Albuminuria alone) 2. Stage 2 5 – 13M Chronic Kidney Disease in the USA Improving Nephrology around the World

22. 1.Increase Basic Knowledge of GU Disease 2.Prevention of Chronic Kidney Disease Screening Interventional Clinical trials Increase Physician & Health Professional manpower 3.Extend and Reduce Cost of RRT 4.Establish GU Teaching and Research Centre A Global Kidney R & D Agenda

23. 1.Expand surveillance studies of GU Disease 2.Special studies in prevalence and intervention of diabetes and hypertension 3.Develop strategic policy aims in international organizations & societies and government health departments 4.Prevent acute renal failure with special attention to major diseases. A Strategy for Kidney Failure

24. 5.Increase Public Awareness for kidney Disease 6.Enhance education programs to update specialist and primary care physicians, nurses and technicians 7.Develop selected global centres of Excellence for training, clinical care and research – 10 or more in the next decade 8.Increase Funding resources A Strategy for Kidney Failure