Thriving in turbulent times: EASL reflects on 2021, looking to 2022 and beyond (2024)

Background

Though the COVID-19 pandemic continued to pose challenges throughout 2021, EASL proved to be agile, lean, and able to turn stumbling blocks into steppingstones. Our association navigated new terrain in uncertain times, with creativity and ingenuity. EASL worked continuously to refine the core offerings of education, science, and advocacy; boosted our efforts to disseminate them using digital channels; and forged a new organisational strategy for the future.

In this Editorial, the senior EASL leadership aim to give readers an overview of developments and future plans at The Home of Hepatology. This message should reach you just before the buzz of EASL’s International Liver Congress™ (ILC) 2022, our first face-to-face flagship congress in three years, in London, UK. We encourage you to read our Annual Report 2021, for more details on the names, faces, and figures that have contributed to EASL’s progress.

Thriving, not surviving, 2021 to 2022

In early 2021, the COVID-19 pandemic that had turned the world upside-down, was entering its second year. As a medical association, EASL’s board and members were directly affected by the disruption to healthcare services felt in their workplaces and among the communities they serve. Many board meetings were held online, with some board members having never met in person.

EASL’s Secretary General for that period, Prof. Philip Newsome, the Governing Board, and the EASL Office, steered EASL deftly from a pre-COVID world to one in which our association achieved exponential digital growth and provided a stream of educational content via new channels.

In June 2021, at the ILC 2021 in our hometown of Geneva, Prof. Newsome handed over the reins to us (Fig.1), incoming Secretary General, Prof. Thomas Berg, and Vice-Secretary, Prof. Aleksander Krag.

Perpetuating the soul of EASL, founding a four-year strategy

Immediately after ILC 2021, the new EASL Executive Board held a retreat, in Eberbach, Germany with the aim of establishing a four-year strategy. The setting was a monastery founded in 1120 by Bernhard von der Clairvaux (1090–1153 – Fig.2), who wrote: “The whole Soul is nothing other than Rationality, Memory and Will.”

Thus, drawing on the memory, the impressive past of our association; rationality, the science we are rooted in; and the will to advance with diligence and dedication, EASL launched a new four-year strategy to provide a longer-term vision that goes beyond the two-year term of the General Secretary. This four-year strategy will sustain and define the soul of EASL, as outlined in this Editorial.

Under this leitmotif of perpetuating the soul of EASL, merging tradition with innovation, key strategic goals include: uniting hepatology Europe-wide, launching a refreshed membership strategy, boosting inclusiveness, and streamlining working practices. EASL will focus on improving its working practices to foster transparency and cross-disciplinary interactions among its committees, with the continued support of the EASL Office. This reflection and rigour will go further.

The European Year of Youth, 2022, serves to shine a light on the importance of young people in building a better future. In line with this, EASL aims to increasingly foster excellence in the next generation of hepatologists and researchers, while also expanding its geographical reach beyond Europe. Working closely with our Young Investigators Task Force (Fig.3), EASL will both lead our community and follow the youth. Our association will draw inspiration from the youth – young hepatologists, liver nurses, and allied health professionals, via our Nurses and Allied Health Professionals Task Force – who will guide our dissemination strategies. Likewise, EASL is committed to connecting with the spirit of the next generation by developing our presence on the communication forums they use.

Since its foundation, EASL has promoted hepatology from all angles. The enthusiasm and drive for our work and activities stem from the strong will to improve the lives of patients with liver disease, to cure liver disease, or at least prevent its progression through a better understanding of disease mechanisms, and to develop individual and new therapies. However, the hepatologist as a guarantor of optimised patient care also needs the support and fellowship of professional societies.

Our association must ensure that expertise in hepatology is an integral part of everyday clinical practice, even when patients with certain complications of their liver disease are treated in sectors outside usual hepatology care, such as intensive care units, intervention units, and via tumour boards. This aspect, which has received less focus from EASL in the past, should be given more attention in the future.

EASL’s Policy and Public Health Committee and their initiatives conduct invaluable work at Europe-wide levels, positioning liver disease, and liver cancer in particular, as a high priority area for the EU Commission. These efforts will have far-reaching consequences, not only in addressing the inequitable care of patients with liver disease in Europe, but ultimately in impacting on EU funding and helping to ensure grants for researcher-initiated European study initiatives.

Membership spanning one’s life

EASL supports members from their first engagement with the association, through to their post-retirement activities. EASL has active members in their twenties, while others in their nineties are still contributing. A member can develop their career by taking advantage of fellowships and bursaries, as well as opportunities to showcase their science and develop a vibrant professional network. From summer 2022 onwards, EASL is rolling out new membership categories and benefits that will boost the value of membership and reach new members from the global hepatology community, who – to date – have not been adequately served.

Uniting hepatology for the future

By uniting hepatology, EASL strives to bring on board all our stakeholders. This includes, among others, national societies, our consortia, the EU-funded projects we support, the various categories of our members, and the projects they work in, such as European Reference Networks. The pandemic drove us to reach out to unite all these parties, to develop educational offerings, and to venture towards newly conceptualised onsite events. By reaching out to national societies in our policy and public health work, we can have a unified voice in the messages we convey.

In the interests of being recognised as the true Home of Hepatology, the reference point for all queries relating to the liver arising in Europe, EASL will be fostering and investing increasingly in thematic working groups and thinktanks.

This society-wide approach will bring on board parties engaged – whether centrally or obliquely – with current and emerging topics in hepatology, building a network of relationships and expertise to unite hepatology and drive progress in our field. Areas of interest and specialisation of overlap include obesity, diabetes, diagnostics, and imaging. In so doing, we will develop a model of how medical societies can and should work in a greater context. We welcome new, wider-reaching relationships and partnerships, building on the success of our traditional ones: with sister societies, national societies, EU-level projects, patient organisations, consortia, industry partners, and associations that convene similar associations, such as BioMed Alliance, as well as our members.

EASL’s new communication channel: EASL Studio

EASL has gained a reputation for leading in science and education. EASL Campus garnered more than 500,000 views in 2021, thereby facilitating continuous learning, and our prestigious journals, the Journal of Hepatology and JHEP Reports, and their excellent editorial teams, continue to provide avenues for scientists to showcase their work. In 2021, for example, EASL launched the first ever patient guidelines on the management of NAFLD, with input from our Educational, Ethics, and Scientific Committees. The high-quality content that EASL provides, and the learning this content fosters, are felt worldwide.

Through digital developments, EASL has succeeded in reaching an ever-broader community across the globe, but a crowning achievement for us was the launch of EASL Studio in 2021 (Fig.4), backed by a board with considerable expertise. From its first broadcast to mark Liver Cancer Awareness Month in October 2021, interest among viewers has flourished.

EASL Studio provides live weekly broadcasting, and on-demand replays, of fresh ideas and expert exchanges – entertaining, public, inclusive, and thought-provoking discussion – on topical matters relating to liver health and care. Debate goes beyond hepatology to broader factors that may affect our field. EASL Studio is rapidly becoming a platform of choice for experts in the field. Formats are being evolved to fit the content: such as classical EASL Studio sessions highlighting key topics, JHEP Live, EASL Studio onsite (e.g. at EASL’s ILC 2022), EASL Studio elsewhere, and coverage of policy- and public health-related activities.

A fresh approach to evaluating abstracts

Our flagship event, the ILC, has long drawn large numbers of excellent original contributions, for which selection processes have been stringent, and all of which are facilitated through the activities of EASL’s Scientific Committee. From early 2022 onwards, the Scientific Committee implemented a fresh strategy for reviewing abstracts. Reviewers will have a more streamlined, less ambiguous process of rating and selecting abstracts. Abstract submitters will benefit from peer review and greater transparency.

Increasing engagement in high-level advocacy events, public health, and policy

Another consideration for the future is EASL’s engagement via our Policy and Public Health Committee. Unfailing efforts have resulted in liver health being higher on the agenda at EU-level debates, voting, and when determining healthcare priorities. Our association is proud of such prestigious collaborations, including with the European Liver Patients’ Association (ELPA) and the Liver Patients International (LPI), among others, and we look forward to developing more such collaborations in the future.

Notably, in December 2021, a high-level event took place, the EASL–Lancet Liver Commission launch, together with the long-awaited report: Protecting the next generation of Europeans against liver disease complications and premature mortality.

It was a privilege to have as keynote speakers, President of the European Commission, Dr Ursula von der Leyen (Fig.5), and Editor-in-Chief of The Lancet, Dr Richard Horton. This project was conceptualised and driven by former EASL Secretary Generals, Profs Tom Hemming Karlsen and Philip Newsome. But the event was much more than a publication launch. It offers a window on the general health challenges of Europe in the 21^st century, and it is a key, evidence-based reference document that will be cited repeatedly as this topic evolves. It is the end of a publication, but the beginning of a new chapter, in which we aspire to see a paradigm shift in liver care: from treatment to prevention; from late-stage to early-stage diagnosis; and from lack of clarity among healthcare providers to clear guidance and hands-on approaches. This progress should also be supported by national and European-level initiatives.

EASL is committed to bringing about this paradigm shift in liver care, by uniting hepatology in Europe with the support of all stakeholders, especially national societies, patient organisations, other European medical partner societies, and policymakers. As a crucial first step, EASL will encourage closer attention to hepatology in primary care, to combat the stigma of liver disease and to prevent liver cancer, which is one of the most important and harmful results of all chronic liver diseases.

In February 2022, EASL held our first ever meeting devoted to viral hepatitis, Viral Hepatitis Elimination 2022, in support of the World Health Organization’s goal of elimination by 2030. Soon thereafter, EASL relaunched the Members of the European Parliament (MEPs) Friends of the Liver Group.

Conclusion: Promoting the greater good across Europe

Following two years of setbacks related to the pandemic, conflict flared up in Ukraine in February 2022. EASL promptly issued a statement condemning the invasion of Ukraine and expressing support for all those affected. During the sobering times that followed, EASL showed solidarity with the communities most affected, patients and professionals alike, and where healthcare systems became overstretched, owing to the influx of refugees and high-risk groups of people needing care. Our association shared information with liver and gastroenterology associations in neighbouring countries, sharing resources for liver patients fleeing conflict, encouraging the hosting of Ukrainian scientists across Europe, and calling for a halt to collaboration with Russian institutes.

Whether in times of peace or conflict, our mission is founded on democracy, cooperation, and sharing healthcare expertise for the greater good. With the new strategies and directions outlined in this Editorial, we remained committed to uniting hepatology: to serving our network of healthcare professionals and their patients, across Europe and beyond.

Let us draw on the words of Seneca the Younger (Roman philosopher, 4 BC – 65 AD): “Non quia difficilia sunt non audemus, sed quia non audemus difficilia sunt: It is not because things are difficult that we do not dare; It is because we do not dare that things are difficult.”

We will persevere for the greater good and look forward to delivering – in brighter times – the next Editorial, on behalf of the Governing Board and the EASL Office.