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(task-force for osteoporosis. Osteoporos Int 1999;10:259-64.)Tj
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[(W)79.9 (e have been privileged to witness the globalization of)]TJ
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[(rheumatology)64.9 (. Regional congresses in Singapore 1997)]TJ
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[(\(ILAR\), Montreal, Canada 1998 \(P)91.7 (ANLAR\), Glasgow)64.8 (, UK)]TJ
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[(1999 \(EULAR\), Cape )17.7 (T)69.9 (own, South )54.8 (Africa 1999 \(AFLAR\),)]TJ
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(Beijing, China 2000 \(APLAR\), and Nice, France 2000)Tj
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(\(EULAR\) have all been attended by rheumatologists from)Tj
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(many parts of the world, and have followed the same)Tj
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(formula, covering the latest developments in basic and clin-)Tj
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(ical science.)Tj
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[(there are still major local dif)17.7 (ferences. In some countries in)]TJ
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(ties\323 pose further enormous challenges to healthcare)Tj
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(everywhere in the world. Socioeconomic factors have been)Tj
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(responsible for a radical transformation, which will be far)Tj
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(more profound and will spread more quickly than any)Tj
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[(rains in )17.7 (W)79.9 (ashington, drops fall in Paris and London.)]TJ
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[(W)79.9 (e must anticipate that medicine will evolve from a)]TJ
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[(profession into an industry)64.8 (. )17.7 (This creates a conflict between)]TJ
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(managers whose first consideration is value for money and)Tj
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(cost. Changes create challenges and opportunities for)Tj
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(deal with diseases that are often misdiagnosed, poorly under-)Tj
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(Globalization may appear to be rather a mixed blessing,)Tj
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[(a threat no less than an opportunity)64.9 (. )17.7 (Therefore \322act locally\323)]TJ
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(is an important message. Rheumatology varies in each)Tj
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[(region and there are major dif)17.7 (ferences in epidemiology of)]TJ
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(rheumatic disease. For example, acute rheumatic fever is)Tj
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(still a problem in Eastern Europe, Russia, and developing)Tj
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[(countries, while HIV)-607.3 (and tuberculosis related muscu-)]TJ
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(loskeletal problems and reactive arthritis are of major)Tj
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[(concern in )54.8 (Africa and parts of )54.8 (Asia.)]TJ
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[(The global good news is that we have ef)17.7 (fective new)]TJ
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(arthritis \(RA\), osteoporosis, and osteoarthritis \(OA\).)Tj
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[(However)39.7 (, these drugs may widen the gap between rich and)]TJ
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(and not universally available. Even in developed countries)Tj
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(strategies must be developed by rheumatologists to ensure)Tj
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(that those in greatest need or who may benefit most are)Tj
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[(selected for treatment and not only those who can af)17.7 (ford)]TJ
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(these treatments.)Tj
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