Interview with Tobias Welte, ERS President

We asked the President of ERS, Professor Tobias Welte, about his career, his priorities and goals for his presidency.

Professor Tobias Welte is the current President of the European Respiratory Society (ERS). We asked him about his career, his priorities and goals for his presidency, and about some of the biggest challenges for lung health in the coming years and how ELF and ERS can contribute to solutions.

Could you start by giving us an overview of your background?

I am the head of the Department of Respiratory Medicine and Infectious Disease at Hannover University. I am a chest physician, but I also have a degree in infectious disease and intensive care medicine. My main interest has been clinical research in both acute and chronic lung conditions.

I got interested in respiratory medicine for a very personal reason. When I was a child, I grew up with my grandparents, who both died of lung conditions. I think this was always on my mind, and very early in my medical career I was focused on pulmonary medicine.

What is the situation for lung health like in Germany?

Lung conditions are underestimated – though I think this is true for all of Europe, and probably for most countries worldwide. If a person is short of breath, has a tight chest, has chest pain – symptoms of several lung conditions – it is thought first to be related to their heart. Respiratory medicine is not present at every university; it is not considered a main speciality in either clinical practice or education; and it is underserved in terms of funding and other sources of support.

In Germany, as in many other higher income countries, asthma, chronic obstructive pulmonary disease (COPD), lung cancer and pneumonia are the major lung conditions. However, there is also a lot of improvement in terms of diagnosis, treatment and prevention.

Germany is not a very good example when it comes to smoking cessation policy. The current smoker rate is still close to 30% and there are a lot of policy exceptions which mean that it is still possible to smoke in public places. There is also still a lot of advertising of tobacco products on billboards and in other public places.

As the economic number one in Europe, Germany also has a major problem with air pollution, which causes huge debate. However, we know that the air that we breathe in every day has a direct influence on lung health.

Why did you want to run for, and become, the President of ERS?

I have been engaged with ERS for around 25 years. I had my first term as Assembly Head at the start of the millennium, and I was first a Group Secretary in 1994. I have been part of ERS for such a long time because healthcare questions have no borders – they need global solutions. ERS represents science, education, patients and advocacy, and offers a lot of tools to improve healthcare in the long term – so it is wise to be active in this Society. There is a lot of space for communication and collaboration between individuals and also between countries, and it is a great honour to serve as President.

ERS also has a very good team of staff in Lausanne, Sheffield and Brussels – lots of very engaged people who are always a pleasure to work with.

Looking ahead, what do you hope to achieve during your presidency?

When ERS started, its main task was to bring respiratory professionals together in an annual meeting. Over time, we have expanded, improving in areas like education, where we have set up new educational tools and fellowship programmes.

We have not been as successful in other areas – for example, science. We have often provided a platform for science our members carry out, but not actually led or directly participated in the research. This has improved in recent years; for example, through the Clinical Research Collaborations, we have been coordinating registries and starting observational studies. We need to take it to the next level: organising and driving scientific programmes at the European level, and partnering with academic institutions to create research programmes that involve both researchers and patients.

ERS was set up as a European society – and Europe is still the focus of what we do. However, the membership has grown to be more global. There are also lots of lower income countries represented – from outside of, but also within, Europe – in ERS. We need to work more to understand the needs and wishes of members in these countries, which are often very different to those of higher income countries, so that we can set up education and training programmes that will work for them.

ERS has been historically very focused on its annual Congress. The Congress is still a large part of what we do, but perhaps it is time for us to broaden what we offer. We need more scientific and educational tools and conferences and to think about more innovative technology, online conferences and so on.

The European Respiratory Journal, ERS’s flagship journal, is one of the leading respiratory journals worldwide. ERS also has several other publications: the European Respiratory Review; ERJ Open Research, a free-to-access online journal; Breathe, an educational journal; and the ERS Monograph series. We have been very much focused on the ERJ over the years, and one of the major goals of the forthcoming years is to streamline and clarify the goals for the whole portfolio of journals in detail.

What are you looking forward to the most this year?

The ERS International Congress in Madrid at the end of September will be a real highlight. It is a very nice Congress centre and should be a very nice time of year in Madrid – not too hot and not too cold. It will be a meeting point for people coming from all over the world and I have great expectations.

I will also be part of lots of other events this year. I am looking forward to the ERS Lung Science Conference in Estoril, Portugal, which has more of a workshop feel and aims to really get people communicating with each other. This year, it will focus on one topic – the future of science – which I am very excited about.

Every President of ERS is also given the opportunity to organise their own Presidential Summit. Mine will take place in Hannover, my hometown, in June. The topic is ‘unmet needs in respiratory medicine’ and it will be a chance to bring together scientists, patients and funding institutions to discuss how to solve the fact that respiratory medicine is underfunded and underestimated.

What do you think are the biggest issues in healthcare right now – and what role can ERS and ELF play?

I think that chronic diseases in general – and chronic lung conditions especially – are major problems at a time in which we are seeing a challenging change in demographics. Populations are getting older and older; nobody will get older without having a chronic disease; and chronic lung conditions will be among the most common. It is about finding adequate diagnosis and precise treatments that will be affordable. ERS and ELF are playing a role by stimulating collaborations between countries and healthcare systems – enabling them to share their solutions with each other. ELF is also in a position to bring in patients and their perspectives – their voice is vital for the political and strategic planning needed to tackle this challenge.

One of the major issues for the future is preventive measures. We have been very focused on diagnostics and treatment in the past, but we need to think more about prevention – smoking cessation; fighting for clean air; vaccinations, which are effective for infectious diseases; and encouraging people to exercise.

Another thing that I think has been really neglected in the past is patient education, with regards to their conditions. At the ERS Congress last year, I saw a poster with a very disappointing statistic that 70% of patients were not using their inhalers correctly – something that really affects the course of their condition. This is another area where I think ERS and ELF can really help – through patient factsheets and public campaigns.

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