Lets think global, foster diversity and tackle inequalities in palliative care

A message from the recently elected President of the European Association for Palliative Care (EAPC), Professor Christoph Ostgathe, who is a palliative care physician and Chair of Palliative Medicine at the University of Erlangen, Germany.

Several weeks have passed since I met many of you at the tremendously successful EAPC World Congress in Berlin, Germany. With more than 3,000 participants, the 16th EAPC World Congress was the biggest EAPC event ever. It is a pleasure to see how this congress has evolved into a truly global platform for palliative care.

Prof Christoph Ostgathe who was elected President of the EAPC on 25 May 2019 at the 16th EAPC World Congress, Berlin.

At the congress, members of the EAPC elected a new Board of Directors and one of the first tasks of the board is to elect a president. I am honoured to say that they elected me as the President of the EAPC for the next four years. I am a palliative care physician and Chair of Palliative Medicine at the University of Erlangen, Germany. In accepting this new role, I realise that it is both a great honour but also a challenge and I am flattered that I have the trust of the board and our members. It was my intention to introduce myself in a blog post earlier, but a challenging issue presented itself as the first task of the new board. Recently, following a report by two US congress members, the World Health Organization (WHO) withdrew the WHO guidelines on opioid prescription and this important situation obviously required action from the EAPC Board. With our global palliative care partners, we have recently signed a statement (http://globalpalliativecare.org/who-withdrawal-of-guidance-documents/) related to this issue. In the coming days a blog post will be published here to ensure that our members are kept fully up to date.

Looking back and ahead

My experience and learning as an EAPC Board Member and Vice President over the past four years serves as a strong foundation for my role as President. I have learnt about different countries, cultures, and diverse approaches to, and resources for, palliative care in Europe and beyond. I have learnt about the global challenges of bringing palliative care into the heart of healthcare systems as part of universal health coverage and, most importantly, the impact of palliative care for patients and families. This has given me a much better understanding about the complexities and differences and what they mean for the work of a multinational association like our EAPC.

Since attending my first EAPC Congress in Palermo (2001), I have been involved in the work of the EAPC; as a congress delegate and speaker, as a scientific committee member, a task force member, and a board member. I was the Chair of the Scientific Committee for the 15th EAPC World Congress that took place in Madrid. The experience and insight gained in serving my apprenticeship means that I have a very good understanding of the working of the EAPC. And this gives me the confidence that I will be able to fulfil the role of President – enthusiastically, effectively and efficiently.

Professor Vittorio Ventafridda 1927-2008. Founding President of the EAPC from 1988 to 1995.

A tribute to our founders

In my new role, I humbly look back at all the people that have built up and developed the EAPC over the past  31 years. Many names come to mind that have made an enormous contribution to the EAPC, and thus to palliative care in general. This history is documented on our website. One name should stand here pars pro toto, Vittorio Ventafridda, the unforgotten Founding President and spiritus rector. He envisaged the role of the EAPC:

“ (a) to spread knowledge and awareness about palliative care throughout Europe; (b) to bring together already existing groups and thereby promote an exchange of experience on this matter between the most- and the least-advanced countries or regions, as the realities are very different between them; and (c) to encourage initiatives for the official recognition of palliative care”.

Thirty-one years later this vision remains unchanged.

EAPC going forward 

Even if much has been accomplished, we still have a long way to go in order to sustain the work of the EAPC and ensure that the EAPC remains a major voice globally for all palliative care professionals. Under the tenure of the last board (2015 to 2019), a major change was the move to the heart of Europe: to Brussels! In addition, the EAPC focussed on some structural changes including the new website, new working groups, the development of policies and procedures and some new ways of working within the EAPC. In an ever- changing world more challenges are ahead of us. In the coming years we plan to focus on membership and on how we can best meet the needs of our current and future individual and national association members. We also value the opportunity to foster and further develop our working relationship with our global/international hospice and palliative care partners.

EAPC Board of Directors, Berlin 2019. Left to right: Natasha Pedersen, Gert Huysmans, Josep Porta Sales, Danila Valenti, Daniela Mosoiu, Catherine Walshe, Christoph Ostgathe (President), Sébastien Moine, Sandra Martins Pereira, Sonja McIlfatrick, Karl Bitschnau, Jeroen Hasselaar and Martin Loučka.

Our common goal is to further integrate palliative care into all healthcare systems; in order to achieve this goal there is a need to provide evidence through high-quality research.

Ultimately, we have to accept that Palliative Care is not a ‘one size fits all’. A good example of this is the heterogeneous discussion last year on the proposed new definition of palliative care proposed by the International Association for Hospice & Palliative Care (IAHPC). We have to work on common goals and, at the same time, ensure that we foster diversity within the EAPC.

Diversity is a resource; but we also need to be cognisant of any inequalities that exist. We are just at the beginning of a learning curve around the issues that need to be addressed in palliative care such as gender, sexuality, age etc. The new EAPC Board will endeavour to identify, address, foster diversity and tackle inequalities over the next four years. Regarding diversity and gender balance, the board in itself is good start! Diverse, for example in regions, professions, age, competencies and balanced (six women, seven men) in gender. Let’s roll up our sleeves and get started.

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