It is with great joy, pride and pleasure that I wish the International Journal of Rheumatic Diseases a happy first birthday.
Many of you now of course know the APLAR Journal of Rheumatology is the forerunner of this journal. The APLAR Journal was delivered in June 1997 at the time of the 19th ILAR Congress of Rheumatology held in Singapore. At that time I mentioned that congresses come and go but the written word lasts forever and hoped that the new journal would continue for years to come. These words were indeed prophetic for the ILAR Congress is no more and died an ignoble death but the APLAR journal continues, albeit under a different name. For this we have to thank many people both in the Asia-Pacific region and outside for their support, hard work and contribution. The journal is particularly indebted to our incumbent Editor-in-chief Professor C. S. Lau who had the vision of bringing our journal onto the international stage and improving the quality of the scientific papers and widening its readership.
So what of the future? It continues to be challenging, especially in the next few years. The Asia-Pacific region accounts for more than 60% of the world's population or 3.6 billion people. Excluding developed countries like Japan, Australia, New Zealand and South Korea, there are probably less than 300 fully trained and accredited rheumatologists to treat this vast population. Many patients with inflammatory rheumatic diseases never even see a primary care doctor, let alone a rheumatologist. While the developed countries bask in the glory of biologic agents, many poor patients in the region are unable to get their hands on the most basic disease-modifying anti-rheumatic drugs (DMARDs) and similar drugs. Nevertheless inspite of all these drawbacks the region has advanced. Governments are more aware of the importance of musculoskeletal disorders and the public have increased expectations of the services provided to them. Because of advances in immunology and molecular biology, rheumatology has evolved from a speciality treating ill-defined, incurable diseases to one that utilizes sophisticated diagnostic tools and employs specific therapies that target chemicals and molecules. Stem cell and gene therapy are now on the horizon. With these advances come another set of problems – that of affordability. With the majority of people in the region still living on less than US$2.00 per day, how are governments going to pay for this?
However, despite this therapeutic gap, we should not lose heart. The world at the moment is going through a rough patch, but it will eventually recover. Asia will surge forward propelled by China, India, Japan, Korea and Australia in research, development and clinical science. Our journal will grow from a newborn infant to a robust teenager, and eventually to a mature, well-toned adult ready and able to take our place in the world of rheumatology. It is tough, but remember the saying: ‘When the going gets tough, the tough get going’. Within the next 20 years, Asia will experience a new renaissance and rheumatologists throughout the world, including Asia, will celebrate the Golden Age of Rheumatology.
All we need now is to remember three little words uttered by an Afro-American of black-and-white descent from middle class parents with the unlikely name of Barack Hussein Obama: ‘Yes we can’ and ‘Indeed we will’!