ISAAC, the International Study of Asthma and Allergies in Childhood, was formed in 1991 to facilitate research into asthma, allergic rhinitis and eczema by promoting a standardised methodology able to be used in diverse locations around the world.
ISAAC developed from a merging of two multinational collaborative projects each investigating variations in childhood asthma at the population level. These were an initiative from Auckland, New Zealand to conduct an international comparative study of asthma severity, and an initiative from Bochum, Germany to conduct an international study to monitor time trends and determinants of the prevalence of asthma and allergies in children.
ISAAC is a unique project investigating variations in the prevalence of these conditions at the population level and their potential causes. ISAAC, with its three phases to date, has attracted massive worldwide interest and unprecedented large-scale participation, and has become the largest worldwide collaborative research project ever undertaken in children resulting in a Guinness World Record. In its 21 years, the ISAAC programme has involved 306 centres in 105 countries with nearly 2 million children.
ISAAC has been the subject of positive editorial comment in the International Journal of Tuberculosis and Lung Disease, the leading voice of respiratory disease in developing countries, for its unique role in fostering research and critical thinking1. They state "ISAAC is a model that should be followed by all those of us who are committed to improving public health in low-income countries." ISAAC uses a simple framework which enables standard measures and comparisons across geographic, cultural and linguistic boundaries which means it can be carried out relatively inexpensively, making it particularly suitable for use in developing countries and allowing "truly global participation". This inclusive and encouraging approach has resulted in ISAAC becoming the largest study of its kind2. As stated by the Commission on Health Research for Development, '. . .for the world's most vulnerable people, the benefits of research offer a potential for change that has gone largely untapped'. Such research is essential to improve public health globally and equitably. A major barrier to achieving this is a lack of confidence of health care workers to involve themselves in research. ISAAC has addressed this obstacle and produced a body of knowledge that informs policy. The World Allergy Organization has reported that "studies such as ISAAC are a major step toward overcoming barriers to the worldwide diagnosis and treatment of asthma"3.
ISAAC has established worldwide networks with organizations concerned with health in developing countries such as The International Union against Tuberculosis and Lung Disease (IUATLD) and the World Health Organisation (WHO). ISAAC findings are cited by any organization involved in monitoring and preventing chronic respiratory diseases (CRD's) and are used to inform global health initiatives which include WHO, and its NGO the Global Alliance against Chronic Respiratory Diseases (GARD). ISAAC publications are included in the 'GARD Basket', a package of information, offered to countries by WHO to assist policy decisions relating to CRD's4. ISAAC collaborators have published more than 500 articles in over 100 journals including the Lancet, the British Medical Journal, the American Journal of Respiratory and Critical Care Medicine, Thorax and the European Respiratory Journal.
The ISAAC research programme has comprised three phases
3. Pawankar R, Baena-Cagnani CE, Bousquet J, et al. State of World Allergy Report 2008: Allergy and Chronic Respiratory Diseases. World Allergy Organisation Journal. 2008(Supplement 1):s4-s17.
4. World Health Organisation. Global Alliance against chronic respiratory diseases (GARD) basket: a package of information, surveillance tools and guidelines, to be offered as a service to countries. Geneva: World Health Organisation; 2008