Elections - World Federation of Hemophilia - main

WORLD FEDERATION OF HEMOPHILIA 

M EDICAL A DVISORY B OARD N EWS 

Message from the Medical Advisory Board chair 

Message from the Medical Advisory Board Chair 

Dr. Alison Street (Australia), VP Medical and the Medical Advisory Board chair 

W ith 

May 2012 – Volume 5 • No 1 

December 2010 – Volume 3 � No 2 

Dr. Alison Street (Australia), VP the Medical WFH and 2012 the World Medical Advisory Board Chair 

Congress just around the 

Wcorner, the focus of this edition of our 

newsletter 

e have 

is 

had 

the engaging 

a very productive 

Congress 

few months since the WFH 

program and other activities we have 

World Congress in Buenos Aires, 

planned for Paris in July. Participating 

and all our Medical Advisory 

at Congress is a unique opportunity to 

Board (MAB) committees have 

meet like-minded people and poten- 

continued to work hard. Congress 

material 

tial research 

is now 

collaborators, 

available on 

all 

the 

with the 

same goal in mind: Improving 

WFH website. 

treatment 

I would 

and quality 

like to 

of 

wel- 

life 

for people with inherited come bleeding all new disorders. committee It is members a meeting 

space, an educational and experience, again thank and an those inspiring, who ener- are 

continuing, getic event. This for all Congress, your support the WFH and has efforts much to on celebrate, behalf 

of including the World the Federation launch of its of 50Hemophilia (WFH). 

I would also like to take this opportunity to conpharmaceutical 

company-sponsored studies in areas of 

strategic interest to the WFH, such as inhibitor development 

and implementation of prophylaxis programs. 

With our position as a global organization that unites 

both patients and healthcare professionals, the WFH 

will foster multinational research relevant to the bleeding 

disorders community, establish strategic research 

partnerships, and ensure patient protection and ethical 

practices. 

These themes of patient and researcher collaboration 

will be expanded as part of our first Global 

Research Forum in Montreal, from March 22-23, 2011. 

This will be an interactive meeting for about 60 invited 

gratulate the medical professionals who were recog- scientific experts, agency regulators, patient leaders, 

nized at the WFH Awards Ceremony in Buenos Aires. health professionals, ethicists, researchers, and indus- 

Read more about the recipients on pages 8 and 9. try representatives. Discussions at the Forum will help 

At our recent Medical Advisory Board meeting held identify our community’s most pressing challenges 

in Montreal in November we had many opportunities and unmet research needs, and help the WFH build a 

to discuss common goals. Highlights from each com- framework for its new research initiative. 

mittee report are reflected in this newsletter. 

In closing, I would like to wish you all a very 

The roles of the newly established Research 

happy end to 2010 and a healthy and successful year 

Committee are steadily emerging, including encouragement 

of multi-centre, multidisciplinary, and non- 

ahead. 

In this issue 

Dental Report . . . . . . 2 

IHTC Report . . . . . . . . 2 

Lab Sciences 

Report . . . . . . . . . . 4 

MSK Report . . . . . . . . 4 

Nurses’ Report . . . . . 6 

Psychosocial 

Report . . . . . . . . . . 6 

Report . . . . . . . . . . 7 

Sports Camp . . . . . . . 7 

Award Winners . . . . . 8 

th anniversary celebrations, the 

40th anniversary of the IHTC Program, and the fact that this 

will be the 30th Clinical Practice, facilitated by professor Frits Rosendaal 

(ISTH); Publishing facilitated by professor Christine Lee, 

editor of Haemophilia; and Gene Transfer Technologies, 

chaired by professor David Lillicrap. 

We have invited our multinational, multidisciplinary 

experts to present their most relevant and contemporary 

data and have increased the number of free paper sessions, 

including “late-breaking” sessions, compared with previous 

congresses, to maximize participation and share our collective 

knowledge. The number and quality of the proffered 

abstracts continues to grow, reflecting the strong commitment 

of our communities to this meeting. 

It is almost time for the “Changing of the Guard” on 

many MAB committees, as chair and executive positions 

become available, and I again thank all chairs and 

WFH Congress. 

committee members for their input over the past two years. 

With that in mind, many of the lectures will touch on the Over the next couple of years, a major activity of these 

history of hemophilia and the evolution of our knowledge committees will be to engage in development and oversight 

about inherited bleeding disorders. This retrospective look at of projects in line with the WFH research strategy, a plenary 

the WFH’s history will pay tribute to its community that has topic at this year’s Congress. Please actively participate in 

endeavoured to improve treatment and care the world over. your committee’s programs at Congress to help define those 

There are many diverse topics to be covered in scien- issues of most importance for future collaborative study. 

tific sessions, including new scientific research and clinical The Congress Program Committees and MAB members 

trials profiling advances in treatment products and clinical 

care. Top specialists and researchers will provide updates 

welcome you to Paris and look forward to your feedback for 

the WFH 2014 World Congress in Melbourne, Australia. 

on HCV/HIV, models of prophylaxis, and debate the use of Finally, this is my last column for Medical Advisory 

longer-acting products versus gene therapy. These sessions Board News; as the chair of the board, and as vice-president 

will be a very contemporary look at the state of knowledge 

and practice of hemophilia and other bleeding disorders. 

In pursuit of our strategic objective to encourage and 

support data collection and clinical outcomes research, 

on the first day of Congress we have workshops in Good 

medical of the WFH, I would like to take this opportunity 

to say thank you to the bleeding disorders community, for 

your enthusiasm, determination, and perhaps most importantly, 

your friendship. Thank you for all of your support 

over the years, and enjoy the 2012 Congress experience. 

WFH Medical Advisory Board News Published by the World Federation of Hemophilia. 

Editorial Board: Paula Bolton-Maggs (U.K.); Eduardo Rey (Argentina); Assad Haffar (WFH); Keith 

Hoots (U.S.A.); Steve Kitchen (U.K.); David Lillicrap (Canada); Craig McEwen (WFH ); Elizabeth 

Myles (WFH); David Page (Canada); Elizabeth Paradis (Canada); Pier Luigi Solimeno (Italy); Alok 

In this issue 

Srivastava (India); Alison Street (Australia); Anne Duffy (Ireland). Editor: Michelle Grady (WFH) 

Message from the Medical 

Advisory VWD Board and chair RBD 

Congress workshops and 

1 

1425 René Lévesque Blvd. West, Suite 1010, Montréal, Québec H3G 1T7 Canada 

multidisciplinary sessions 2 

Tel.: +1 (514) 875-7944 Fax: +1 (514) 875-8916 E-mail: wfh@wfh.org 

Committee Membership 5 

The Medical Advisory Board News is supported by funding from Biogen Idec Hemophilia. 

Committee Committee meetings at Congress 5 

Permission to translate and/or reprint all contents of the WFH Medical Advisory Board News is granted to interested non- 

Members profit hemophilia of MAB. organizations, Back row L-R: with Nigel prior S. approval Key, MD; and appropriate Eduardo Rey, acknowledgment MD; Alison of Street, the WFH. MD; Permission Mark Skinner; does not Paula 

WFH 2012 World Congress in 

Paris, France: Calendar Sessions of 

7 

Bolton-Maggs, extend to reproduction, MD; Alok in Srivastava, whole or in part, MD; for Steve sale or Kitchen. use in conjunction Front row with L-R: commercial Elizabeth purposes. Paradis; Magdy El Ekiaby, MD; 

Anne Duffy. Not shown here: Keith Hoots, MD; David Lillicrap, MD; Johnny Mahlangu, MD; Luigi Piero Solimeno, MD. 

Members . . . . . . . 10 

Events . . . . . . . . . 11

Congress workshops and multidisciplinary sessions 

The following workshops will be offered on Sunday, July 8. The workshops are free 

for Congress delegates but space is limited so registration for the workshop of 

choice is highly recommended. Additionally, you can find some of the multidisciplinary 

sessions highlighted below. Registration is on a first come, first served basis. If you have 

already registered for Congress, email your choices to Christina Mills. For more information 

about the sessions, please contact Hélène Lussier. 

NURSES 

NURSES WORKSHOP 

Chair: Elizabeth Paradis 

Sunday, July 8, 9:15-15:00 

This professional development workshop for nurses will 

include the roll-out of a new WFH Nurses Resource Kit. 

Penny McCarthy, WFH Nursing Committee secretary, will 

present the kit and demonstrate its use. The workshop will 

also include a presentation from a French representative, 

wherein one of the national hot topics will be discussed. 

Other topics will include: Burnout and how to alleviate 

its effects on us as caregivers; hemophilia-centred nursing 

research and how to develop an abstract or poster. 

For the first time, the WFH 2012 World Congress will 

include four professional development sessions for nurses 

in the main program. These sessions have been designed for 

nurses by nurses. 

Nurses sessions 

RBD: Familiar name, rare disorder 

Monday, July 9, 16:30-18:00 

Although the names of these disorders are becoming 

more familiar, rare bleeding disorders still leave the 

hemophilia nurse with many questions. Several issues 

surrounding these unique disorders will be addressed. 

Hemophilia nursing in the surgical setting 

Tuesday, July 10, 8:45-10:00 

Hemophilia complicates all types of surgery. The hemophilia 

nurse plays a pivotal role in ensuring safe and successful 

outcomes. Hemophilia nurses will share their varied 

experiences. 

Nursing beyond the treatment centre 

Wednesday, July 11, 16:30-18:00 

This session will give insight into various nurse training 

models from around the world and how hemophilia nurses 

add value to the training outside the treatment centre. 

Inhibitors: A nurse’s challenge 

Thursday, July 12, 14:15-15:45 

Inhibitors are still considered one of the more distressing 

treatment complications of hemophilia. This session will 

address the nurse’s role in the management of inhibitors. 

MUSCULOSKELETAL 

PHYSIOTHERAPY WORKSHOP 

Chair: Angela Forsyth 

Time: Sunday, July 8, 9:30-14:00 

The Physiotherapy workshop on Sunday, July 8, will open 

with physiotherapy and rehabilitation issues. And with the 

launch of the WFH 50 th anniversary celebrations happening 

at this Congress, the workshop will also include presentations 

to highlight the past, the present, and the future of physiotherapy. 

Clinical and research topics will also be discussed. 

ORTHOPEDIC WORKSHOP 

Chair: Gianluigi Pasta 


This 90-minute session includes a presentation on sports 

and people with hemophilia, as well as a presentation on 

the preliminary data of knee registry, and eight professional 

development sessions for physiotherapists and orthopedics 

that will include both the surgical and non-surgical management 

of patients with bleeding disorders. 

MSK sessions 

Management of the elbow joint 

Thursday, July 12, 8:45-10:00 

This session will review critical aspects of the management 

of hemophilic arthropathy of the elbow and cover conservative 

management and splinting; arthroscopic synovectomy; 

fixed flexion contracture; symptomatic ulnar nerve; and the 

excision of the results of elbow arthroplasty in the hemophilia 

population, with emphasis on the indications, the possible 

technical difficulties associated with the procedure, and the 

outcomes of it. 

2 WFH Medical Advisory Board News • May 2012

Congress workshops and multidisciplinary sessions (cont’d) 

Musculoskeletal problems in persons with inhibitors: 

How do we treat? 


Treatment options can differ depending on whether 

there are bypassing agents available or not. This 

session will demonstrate the non-surgical possibilities 

in patients with inhibitors to prevent or manage an 

advanced degree of arthropathy. Pre-operative rehabilitation 

programs that postpone or prevent surgery will be 

presented as well. 

Other topics include EOS in inhibitor patients, an 

update on pre-operative and post-operative hematological 

treatment, and the cost-effectiveness and ethics of 

surgery. 

Arthropathy of the knee: When things go wrong 

Thursday, July 12, 14:15-15:45 

This session will include a discussion about the surgical and 

non-surgical treatment of stiff knee in countries where the 

availability of factor replacement differs from developed 

countries. The presentation will highlight the benefits and 

pitfalls of replacement surgery in stiff knees; post-operative 

rehabilitation in such patients; incidence of infection after 

total knee replacement in people with hemophilia; strategies 

to manage infected total knee replacements; and the rehabilitation 

program for a revised knee. 

Consequences of intra-articular bleeding in hemophilia: 

Science to clinical practice and beyond 

Monday, July 9, 8:45-10:00 

This session will discuss how basic scientific results can be 

transferred to clinical practice. Topics to be discussed include: 

Is it necessary to aspirate when it’s known that blood in the 

joint is harmful to cartilage; inflammatory cytokines are 

involved in the pathogenesis of hemophilic arthropathy, so is 

it necessary to use anti-inflammatory drugs to stop the evolution 

of arthropathy; the same is true for the synovium – is 

it possible to prevent chronic synovitis; and when should a 

synovectomy be performed? 

Pediatric Issues: Differences between developed and 

developing countries in hemophilia care 


Prophylaxis regimens differ between developed and developing 

countries, and this session will explore how and 

why that is, and the results of this difference. Surgical and 

non-surgical options between developed and developing 

countries will also be discussed. 

PSYCHOSOCIAL 

PSYCHOSOCIAL WORKSHOP 

Chair: Ruud Bos and Richa Mohan 


This full-day workshop will provide an opportunity to 

increase your knowledge and skills, exchange ideas and 

experiences, and network with psychosocial colleagues from 

around the world. Every effort has been made to ensure that 

the program is comprehensive and will focus on key topics 

in psychosocial care, psychological research, and clinical 

case presentations. There will be exciting presentations on 

the following topics: 

• Pain Management by Michelle Witkop and Angela 

Lambing 

• Risk Reduction & Harm Prevention in Sports by Dawn 

von Mayrhauser & Lauren McKernan 

• Research in Sports Assessment by Sylvia von Mackensen 

• HERO Survey Results by Frederica Cassis 

• Impact of Hemophilia on Partners/Spouses by Anne 

Duffy and Tony Roberts 

• Dealing with Sexuality and Intimacy in People with 

Hemophilia by Dr Woet Gianotten 

• Clinical Case Presentations & Discussion by Sylvia von 

Mackensen and Irene Fuchs 

Psychosocial sessions 

Adherence 

Monday, July 9, 16:30-18:00 

This session will address the subject of cultural views and 

approaches to adherence. The question, “Is patient education 

enough?” will be asked, and the session will review key 

study results. 

Ethical issues 

Tuesday, July 10, 14:15-15:45 

This session will explore the Code of Ethics and how it is 

defined in the United States, ethical issues as identified 

by psychosocial workers, the issue of disclosure, and clinical 

research trials. It will illustrate the obligations of the 

researcher and the hemophilia care team. 



Parents empowering parents: A global perspective 


Ed Kuebler and Danna Merritt will lead this session, which 

has been developed to support parents of children with 

bleeding disorders. 

Coping strategies 

Thursday, July 12, 14:15-15:45 

Life is challenging. Living with hemophilia is even more so. 

This session will cover strategies and different tools for families 

and patients to help with coping with the disease during 

the different stages in order to increase overall well-being. 

LABORATORY SCIENCES 

LABORATORY SCIENCES WORKSHOP 

Chair: Steve Kitchen 


The Laboratory Sciences professional development sessions 

will open with a pre-analytical variables and coagulometers 

evaluation workshop. Speakers will include Guiseppi Lippi, 

Pierre Toulon, Marion Echenagucia, Sukesh Nair, and Steve 

Kitchen. 

In addition to our professional development workshop, the 

Laboratory Sciences Committee will also present the following 

four 90-minute sessions during the Congress program. 

Laboratory Sciences sessions 

Difficulties and pitfalls in the laboratory diagnosis of 

bleeding disorders 

Tuesday, July 10, 16:30-18:00 

Von Willebrand disease (VWD) is the most common inherited 

bleeding disorder but variable severity and several 

classification types mean that diagnosis is often not straightforward. 

In many countries the assays are not readily 

available and/or are not standardized. The latest methods 

and the basis of VWD are discussed here, together with 

information from the International Quality Assessment 

Program (IEQAS). 

Standards and monitoring treatment 


Accuracy and reproducibility of laboratory measurements 

are important in the diagnosis and treatment of bleeding 

disorders. This article describes the process of establishment 

of international standards and some of the problems that 

have arisen in standardization of these measurements. 

Genetics of hemostasis 

Thursday, July 12, 8:45-10:00 

This session reviews the evolution of genetics over the last 

five decades as a tool for bleeding disorder investigations, 

the recent advances in molecular techniques that have 

contributed to improved genetic diagnosis of this condition, 

and the development and utility of proficiency testing 

programs and reference materials for genetic diagnosis of 

bleeding disorders. 

Global hemostasis and point of care testing 

Monday, July 9, 16:30-18:00 

Topics in this session will include thrombin generation in 

bleeding disorders: Current state of the art; whole blood 

thromboelastometry; clot waveform analysis; and diagnostic 

usefulness of adenosine triphosphate release assays 

and aggregation tests with native or platelet count adjusted 

platelet rich plasma. 

OTHER WORKSHOPS 

WOMEN AND BLEEDING DISORDERS WORKSHOP 

Chair: Dr. Rezan Kadir 


The WFH’s VWD and Rare Bleeding Disorders Committee 

has developed a three-hour presentation session for this 

year’s Congress. Dr. Rochelle Winikoff from Canada will 

explain how to establish and manage VWD and RBD, as 

well as discuss the role of the nurse coordinator in a multidisciplinary 

clinic for women with bleeding disorders. Dr. 

Ingrid Pabinger from Austria will present on the management 

of labour and delivery for all bleeding disorders and 

will cover aspects of advance planning for where to deliver, 

how to assess the need for hemostatic treatment, pain 

relief, how to manage the fetus during labour and delivery, 

and how to manage delivery of the placenta. Other speakers 

and topics will include Ann-Marie Nazzaro from the U.S.A. 

speaking on the Foundation for Women and Girls with 

Blood Disorders; Mans Edlund from Sweden will present on 

gynecological problems in women with bleeding disorders; 

Rezan Kadir from the U.K. and Flora Peyvandi from Italy 

will discuss prenatal diagnosis and antenatal complications; 

Stephan Lethagen from Sweden will present on hemostatic 

agents in pregnancy; Andra James from the U.S.A. will 



talk about post-partum hemorrhage and how to predict, 

prevent, and manage. The session will conclude with case 

studies from Debra Pollard from the U.K. 

CLINICAL RESEARCH WORKSHOP 

Chair: Frits Roosendaal 


This clinical research session will present procedures 

on initiating and conducting clinical research projects, 

involving patient populations with an associated biological 

or clinical outcome question. 

The workshop will begin with some background on 

required infrastructures and resources and then on more 

detailed accounts of the methodologies and analysis that 

may be needed in clinical research. 

Publishing workshop (Wiley-Blackwell) 

Chair: Christine Lee 


This workshop, intended for researchers and all clinicians 

who have yet to publish a paper or who have published 

Committee membership 

Elections for officer positions for 

the following multidisciplinary 

committees will be held at the WFH 

World Congress in Paris: Dental, 

Lab Sciences, Musculoskeletal, and 

Nurses. 

The Musculoskeletal, Nurses, 

and Dental Committees are also 

looking for members. Committee 

Terms of Reference state that WFH 

membership in good standing is a 

requirement for all members of the 

multidisciplinary committees. 

Visit the membership section at 

www.wfh.org to become a member, 

or for more information on your 

membership status contact fundraising 

& membership officer, 

Marlene Spencer. 

To committee members who have 

already signed up—Thank you! 

only minimally, will be presented by the three editors 

and the journal manager of Haemophilia, the official 

journal of the World Federation of Hemophilia. The workshop 

will cover all aspects of publishing, including the 

writing, submission, and review process. Specific issues 

surrounding the impact factor, plagiarism, ethics, and 

conflict of interest will be considered. The production 

process will be explained. There will also be some discussion 

about the future direction of publishing, particularly 

in the face of an increasing need for online resources. 

There will be opportunity to ask questions. 

Gene Therapy workshop 

Chair: David Lillicrap 


This 90-minute session is designed for clinicians, laboratory 

scientists, and other health professionals. It will focus 

on basic components of a gene therapy protocol, the pros 

and cons of gene delivery methods, and the organization of 

clinical trials. 

Committee meetings at Congress 

Dental Committee 


Room 243 

IEQAS Committee 

Monday, July 9, 8:15-10:15 

Room: 243 

IHTC Director’s Meeting 

Monday, July 9 12:30-14:00 

Room: 241 

Laboratory Sciences Committee 

Wednesday, July 11, 715:-8:30 

Room 241 

Medical Advisory Board 

Tuesday, July 10, 12:30-14:00 

Room 241 

MSK Committee 

1st Meeting: Wednesday, July 

11, 12:30-14:00 

Room 241 

Nurses Committee 

1st meeting: 

Tuesday, July 10, 7:15-8:30 

Room 243 

2nd meeting: 

TBD 

Psychosocial Committee 

1st meeting: 

Monday, July 9, 14:00-16:00 

Room 243 

2nd meeting: 


Room 243 



WFH 2012 World Congress in Paris, France: Sessions 

PLENARY SESSIONS 

• WFH President’s Address: Closing the Global Gap 

in Care – Past, Present, and Future Advances to 

Achieve Treatment for All – Mark Skinner, U.S.A. 

• New Approaches/Horizons to the Management of 

Hepatitis C in Hemophilia in 2012 – (TBC) 

• Implementing Musculoskeletal Outcome Assessments 

in Clinical Practice – Brian Feldman, Canada 

• Personalized Prophylaxis – Peter Collins, U.K. 

• Developing Models of Hemophilia Care – Alison 

Street, Australia 

• Prevention and Prediction of Inhibitor 

Development – Jan Astermark, Sweden 

• Gene Therapy for Severe Hemophilia B – Ted 

Tuddenham, U.K. 

• Inherited Bleeding Disease Research: Opportunities 

for the World Federation of Hemophilia– David 

Lillicrap, Canada 

MEDICAL SESSIONS 

• Treatment of Human Immunodeficiency virus and 

Hepatitis B virus Infections 

• Models of Prophylaxis Part 1 

• Trial Updates and Standardization Issues 

• Debate of Long-Acting Products Versus Gene Therapy 

• Outcome Assessment and Limitations 

• Von Willebrand Disease Biology 

• Inhibitors 

• Clinical Trial Design in Hemophilia 

• Clinical Aspects – How I Treat Inhibitors – Case 

Studies 

• Rare Bleeding Disorders 

• Inherited Platelet Disorders 

• Late-Breaking Session I 

• Late-Breaking Session II 

MULTIDISCIPLINARY SESSIONS 

• Family Issues: From Cradle to Tween 

• Family Issues: No Longer a Teenager, Not Yet an Adult 

• The Economics of Hemophilia Care 

• Outreach – von Willebrand Disease: Examples from 

Africa 

• HCV/HIV: Setbacks and Advancements 

• Practical Tips for (Re)-Discovering Movement 

• Psychosocial Models in Hemophilia: Designs 

Around the World 

• Assessing Quality of Life in Patients with Bleeding 

Disorders 

• E-Communications: Benefits and Pitfalls 

• Women’s Voices 

• Youth: Preparing Our Future 

• Patients: Members of the Care Team 

• Comprehensive Care – Case Studies 

• Developing Education Models 

• Ageing 

• Global Models of Pain Management 

• Working Together: Lessons Learnt 

• Outreach Methodology: Hemophilia 

• Questions and Answers: Sexual Health 

• Women and Bleeding Disorders 

• Debate: Seeing Both Sides 

MUSCULOSKELETAL SESSIONS 

• Management of the Elbow Joint 

• Musculoskeletal Problems in Persons with 

Inhibitors: How Do We Treat? 

• Arthropathy of the Knee: When Things Go Wrong 

• Consequences of Intra-Articular Bleeding in 

Hemophilia: Science to Clinical Practice and Beyond 

• Paediatric Issues: Differences Between Developed 

and Developing Countries in Hemophilia Care 

LABORATORY SCIENCES SESSIONS 

• Difficulties and Pitfalls in the Laboratory Diagnosis 

of Bleeding Disorders 

• Standards and Monitoring Treatment 

• Genetics of Hemostasis 

• Global Hemostasis and Point of Care Testing 

NURSES’ SESSIONS 

• RBD: Familiar Name, Rare Disorder 

• Inhibitors: A Nurse’s Challenge 

• Nursing Beyond the Treatment Centre 

• Hemophilia Nursing in the Surgical Setting 

PSYCHOSOCIAL SESSIONS 

• Adherence 

• Coping Strategies 

• Ethical Issues 

• Parents Empowering Parents: A Global Perspective 

DENTAL SESSIONS 

• MTE: Challenges of Ageing Population 

• Preventive and Therapeutic Management of Oral 

and Dental Disease 

• Surgical Management of Oral and Dental Problems 


50 

YEARS OF 

ADVANCING 

TREATMENT 

FOR ALL 

Join the World Federation 

of Hemophilia at the WFH 

2012 World Congress in 

Paris as we mark 50 years 

serving the global bleeding 

disorders community. 

Together, we will 

Close the Gap. 

CLOSE GAP 

Campaign 2012 • 2014

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