I am a respiratory physician and researcher based in Barcelona. Throughout my career, I have combined clinical practice with research, with a particular interest in understanding respiratory diseases and translating scientific advances into better outcomes for patients. This journey has reinforced my belief that progress in respiratory medicine depends on three essential elements: scientific excellence, collaboration and a strong commitment to patients. These principles have also shaped my involvement with ERS over the years.
Becoming ERS President is a great honour, but I see it above all as a responsibility. The ERS brings together a remarkable community of respiratory professionals from across Europe and beyond, united by the ambition to improve lung health. Leading such an organisation means helping this community work together, supporting the next generation of professionals and ensuring respiratory health has an even more influential voice in shaping European health policy.
Patients must be at the centre of everything we do. Physicians and researchers bring scientific knowledge and clinical experience, but patients bring a different and equally essential perspective: they know what it means to live with a disease every day.
Their involvement helps us understand which problems matter most, which outcomes make a real difference to their lives and where the healthcare system is failing. This perspective can improve research priorities, clinical study design and how services are organised. This is particularly true in policy discussions, where decisions about diagnosis, treatment and specialist services have direct consequences for patients and families. The ERS, working in partnership with the European Lung Foundation, has made important progress in developing the union between lung health professionals and patients. We need to continue developing this partnership and ensure that patients’ contributions have a tangible influence on our priorities. Ultimately, better respiratory care requires us to work with patients, not simply for them.
My interest in alpha-1 antitrypsin deficiency (AATD) stems from the fact that it is a particularly compelling example of how understanding the underlying cause of a disease can change the way we approach it.
AATD is a genetic condition that can lead to early-onset emphysema. Yet, despite available diagnostic tests, many patients remain undiagnosed or experience substantial delays in diagnosis.
As a respiratory physician, I find this particularly important because we have an opportunity to change that situation. We should not accept that a patient can have COPD for years without the possibility of an underlying genetic cause being investigated when testing suggests it might be needed .
My involvement with the European Alpha-1 Research Collaboration (EARCO) reflects my conviction that international collaboration is essential, particularly in relatively rare diseases. By bringing together researchers and clinicians from different countries, EARCO provides an opportunity to build a stronger evidence base, understand the natural history of the disease and identify ways to improve clinical practice.
Raising awareness remains a priority at several levels. Healthcare professionals need to recognise when AATD should be suspected and ensure that appropriate testing is performed. Patients and families need access to reliable information and specialist care. Policymakers and healthcare systems must also recognise the importance of timely diagnosis and equitable access to appropriate treatment.
The main message I would like patients and their families to take away is that there is a committed international community working to improve the understanding and management of AATD. At the recent ERS Alpha-1 patient webinar, researchers, healthcare professionals and patient representatives came together to discuss the latest developments in AATD research, treatment and care. The recording is now available and I encourage everyone to watch it.
We have made progress in our goals, but there are still important gaps that we need to address. The first priority is earlier and more systematic diagnosis. We need to ensure that appropriate testing is incorporated into clinical practice, that healthcare professionals are aware of the condition and that patients receive a clear explanation of what the diagnosis means for them and their families. Genetic counselling and family testing, when appropriate, are also important components of care.
The second priority is to ensure that patients receive comprehensive, evidence-based care. This includes smoking prevention and cessation, vaccination, assessment of lung function and disease progression, pulmonary rehabilitation when needed, and access to appropriate specialist advice and treatment. We must also work towards reducing unjustified differences in access to care between European countries.
The third priority is research. Because AATD is relatively rare, collaboration between centres and countries is essential. EARCO is particularly important in this respect, helping to develop the evidence needed to understand the disease in real-world settings. Data can improve our understanding of how a disease progress, find factors associated with different outcomes and help guide future research.
It is also essential that we continue listening to patients. Their questions and experiences should help guide research priorities and the development of healthcare services. The patient webinar was valuable in bringing scientific discussion closer to the people affected by the disease, and this dialogue needs to continue.
One of the most important lessons from respiratory medicine is that many of the factors determining lung health operate long before a person develops symptoms or receives a diagnosis.
This is why campaigns such as Healthy Lungs for Life are so important. They help bring lung health into public discussion and translate scientific evidence into messages that people, communities and policymakers can act upon.
We need to move beyond the perception that lung health is mainly a concern for people who already have lung disease. Lung health begins early in life and is influenced by tobacco exposure, air pollution, occupational hazards, infections and other environmental and behavioural factors. Protecting it requires action throughout the lifespan.
Awareness alone is not enough. We must combine public information with effective prevention policies. Raising awareness of air pollution, for example, must be accompanied by measures to reduce exposure. Similarly, encouraging people to seek medical advice for ongoing symptoms must go hand in hand with access to timely diagnosis and care.
This is why I value how the Healthy Lungs for Life campaign brings together healthcare professionals, researchers, patients and local communities. Improving lung health requires coordinated action across society, not just the healthcare system. Prevention is not an alternative to medical progress; it is one of its essential components.
What gives me hope is the combination of scientific progress, international collaboration and the growing recognition that lung health must become a greater public health priority, along with the growing number of patients involved in research and decision-making in healthcare.
But we must be realistic. Scientific advances do not automatically translate into better health for everyone. We still face substantial inequalities in prevention, diagnosis and access to treatment, both within and between European countries.
Lung health must become a political priority, not only a medical one. Lung diseases affect millions of Europeans and place a considerable burden on patients, families and healthcare systems. Yet they have not always received the attention or investment that this burden warrants.
To healthcare professionals, I would say that we must continue to combine scientific excellence with collaboration and a commitment to the needs of our patients. To patients and their families, I would emphasise that their experiences and voices matter and that they have an essential role in shaping the future of respiratory medicine. To policymakers, I would make a simple point: investing in lung health is an investment in healthier people, more equitable societies and more sustainable healthcare systems.
As ERS President, I want to bring these perspectives together and strengthen the role of the respiratory community in Europe. We have the scientific knowledge, the professional expertise and the capacity to make a difference. What we need now is the determination to turn these strengths into action.By the end of my presidency, I hope that lung health will have a stronger voice in European policy, advances will reach more patients and prevention will be recognised as an essential investment in the health of future generations.
About EARCO
As part of its role in coordinating patient involvement in lung health research, the European Lung Foundation (ELF) hosted an Alpha-1 Patient Webinar on 4 November 2026. Dr Marc Miravitlles joined researchers, healthcare professionals and patient representatives to discuss the latest developments in alpha‑1 research, treatment and care. The webinar also featured updates from the European Alpha-1 Research Collaboration (EARCO) and a live Q&A, giving people affected by AATD the opportunity to engage directly with experts and ask questions about the issues that matter most to them. Learn more and watch the recording
About Healthy Lungs for Life
Healthy Lungs for Life is a collaborative initiative of the European Lung Foundation (ELF) and the European Respiratory Society (ERS), supported by the Clean Air Fund. Working with patients, healthcare professionals and civil society organisations at national level, it combines scientific evidence, public engagement and advocacy to promote lung health and highlight the importance of clean air. To learn more about the Healthy Lungs for Life campaign and how to get involved, visit the Healthy Lungs for Life campaign page.
