<International Circulation>: What are your impressions of this year’s WCC Meeting?
　　Dr Smith: I think it has been a landmark conference. There have been some really outstanding speakers and great attendance. I think the dialogue between the attendees and the speakers and with each other has been particularly important. What we are seeing now are increasing attendances from low and middle income countries and that they are finding that it is easier to share ideas here and that this is a forum that really relates to what is going on in their countries. At the same time， we are finding very accomplished senior faculty coming from North America and Europe who have a really strong interest in low and middle income countries. They are also finding this a very appropriate and unique forum. This will continue to develop I think. We are not about having a knock-off of AHA， ACC or ESC; I think this Congress is assuming an identity of its own which is unique and which is addressing a growing problem.
　　<International Circulation>:  This Congress is certainly different from others. There is not just a focus on new science. There is a lot of “activism” aimed at addressing certain issues and problems throughout the world. Do you have any trouble ensuring the identity doesn’t go one way or the other – that there may be too much new science and not enough problem-solving or vice versa?
　　Dr Smith: We are constantly appraising and reappraising how things go and trying new things out. For instance， at this meeting， we had the first ever focus on medical students. You couldn’t get into sessions unless you were a medical student or a speaker. It was totally awesome. Sessions were loaded with attendees and we will be doing it again. The theme of the meeting was prevention and this is something we really want youth to be involved in. Six of the speakers were Past Presidents of the American Heart Association which is really impressive.
　　<International Circulation>:  Indeed the American and European speakers that are here are the cream of the crop. Are there concerns of under- or over-representation of these speakers in terms of population? Do you think that America and Europe are not giving the WCC enough recognition?
　　Dr Smith:  I think there is increasing awareness in Europe and the United States of this meeting. I have heard that from the faculty of ACC， AHA and ESC that this is really special. They were turned on. We need to go back and look at the percentage of faculty from developing nations and analyze that. If you go to the ACC and AHA you might find people there that shrug their shoulders as they don’t know about the WHF. However， the WHF has a focus on low and middle income countries， so the people who are not in low and middle income countries are less aware of an organization whose focus is low and middle income countries.
　　<International Circulation>: The focus of your career has changed over the years. Is that a fair thing to say?
　　Dr Smith:  I would prefer to say it has expanded. I am still in the cathlabs; I still see patients and dictate my own H&Ps on them. Initially I became very interested in clinical guidelines and then from meeting people internationally as President of the AHA， became much more involved in international aspects. In trying to analyze it though， when Murray and Lopez came out with their seminal text， The Global Burden of Disease in 1996 with Harvard and WHO， that was the year after I was President of the American Heart Association， so you could almost say the timing was key and the planets were aligned. I was making international connections at a time when this whole field of cardiovascular disease was burgeoning， almost like catching a wave precisely right. All of a sudden， my career was taking me in a direction that may not have occurred if I had been president ten years earlier. I was talking last night at dinner and someone asked me how many Presidents of American Heart have been President of the World Heart Federation? The answer to that is three: Valentin Fuster， myself and Elliot Rapaport who was President back in the mid-80s. The reason I mention that is for me to say that the reason this happened is due to Murray and Lopez and so forth and that it may not have happened ten years earlier， would make Elliot Rapaport a contradiction. He was a real mensch; he was really something. Reaching the Presidency of the AHA opened my eyes to things and got me involved at a level which made me very aware.