By Arun J. Sanyal, MD, AASLD President
“It was the best of times, it was the worst of times”
Charles Dickens
The first decade of this millennium has seen extraordinary advances in the understanding of human biology and the diseases that afflict mankind. These have fuelled a remarkable explosion of therapeutics for a variety of liver diseases that have brought hope and the possibility of a cure for many afflicted by these diseases. The power of genomics and high throughput technologies now bring the dream of optimizing therapies by tailoring them to the individual in to the realm of reality. However, at the same time, the medical community faces great challenges. The plight of the uninsured, the spiraling costs of medical care, the failure to diagnose chronic liver disease in its clinically silent phase when more treatment options are often available, and societal discrimination of those with liver disease are but a few such challenges. Added to this is a national shortage of adequately trained hepatologists who are capable to providing state of the art care to those with liver disease. As we close out this first decade of the current millennium, AASLD remains committed to leveraging these opportunities and facing these challenges for the eradication of liver disease and promotion of liver wellness.
Increasing Funding
AASLD has always recognized the critical role research plays in closing the gaps in human knowledge that prevent better medical care. This year marks the 60th anniversary of our society and also the 60th anniversary of the National Institutes of Diabetes, Digestive and Kidney diseases (NIDDK). While we celebrate the long and close interactions AASLD has had with NIDDK, there is no room for complacency. The increases in research funding via President Obama’s stimulus package must be sustained in order to sustain the impetus of this package on liver-related research. AASLD also recognizes the important role of the CDC in public health and the need for greater funding of liver-related research and policy making within the CDC. These form a cornerstone of the AASLD’s public policy and advocacy strategy for the coming year.
Connecting Research and Practice
The growth of therapeutics in hepatology and liver transplantation has led to the practice of clinical hepatology as a viable and growing subspecialty. AASLD will not only continue to provide a forum for the exchanges of scientific ideas and the presentation of clinical research that drives this growth but will continue to grow its involvement in practice-related issues. AASLD joined many other sister institutions to help avoid the projected Medicare reimbursement cuts that were planned for 2010. In the near future, the new budget will be sent to congress for approval. AASLD will monitor this closely and will remain vigilant to issues that impact the access to liver-related care, the ability to practice hepatology, and reimbursement-related issues that directly impact the membership. The need to react to such changes is often immediate and time sensitive. With that in mind, AASLD has invested in information technology that brings such time sensitive matters to the attention of its membership in real time and also provides an opportunity to react and make the political leadership of the country aware of the issues. We applaud those who take the time to respond to these alerts sent electronically from AASLD and encourage those who are not aware of this to be aware of it and use this to advance the science and practice of hepatology.
Chronic liver diseases are often clinically silent and are often not detected until late in the course of the disease when treatment options are more limited and the impact of the disease and treatment more severe on the patient and their family, all of which increase the direct and indirect costs of health care. The Institute of Medicine will release the report of a study on the utility of screening for viral hepatitis in the general population in the near future. Regardless of the exact findings, it is likely that this report will have a major impact on the practice of hepatology. AASLD is working closely with the CDC to eventually translate the findings of the study in to policies that will bring us one step closer to the eradication of viral hepatitis from the United States and, along with the CDC, we will plan a single topic conference focused around screening and treatment of viral hepatitis.
Our Role in Global Health Care
Another major initiative that is being undertaken by AASLD relates to the burden of liver disease both within the United States and globally. AASLD is actively partnering with sister societies from around the world as well as the WHO to better understand the global medical, social, economic, and political impact of liver disease, which will form the basis for future policy efforts to reduce this burden all over the world. It is hoped that these efforts will help alleviate the pain and suffering from liver disease for hundreds of millions of individuals who suffer from such diseases.
Training the Next Generation
These ambitious agendas require a highly knowledgeable workforce that is deeply committed to the specialty of hepatology. AASLD is fortunate to have a deeply committed group of professionals who consider hepatology to be their calling and have dedicated their life to the improvement of the liver-related health of the human race. Indeed, the greatest strength of AASLD is its membership. We anticipate the growth and continuing maturation of the special interest groups and our committees to provide the muscle that will allow the AASLD to remain the premier liver association dedicated to improvement in all aspects of the science and practice of hepatology. However, it is a matter of grave concern that the number of trainees choosing hepatology as a career remains far lower than our national needs. It is therefore critically important to focus on the recruitment and retention of a workforce of dedicated specialists who will continue to advance the science and practice of hepatology. The training and growth of hepatology manpower will and must remain a top priority of the AASLD.
2010
On a personal note, the presidency of AASLD is the greatest single honor that has been bestowed upon me and represents the pinnacle of my professional career. I embark upon this journey with a deep sense of responsibility and humility as well as excitement at the possibilities that exist. I am confident that we will continue to grow our specialty for the betterment of the human race and I look forward to working with hepatologists worldwide to advance the cause of hepatology.
This electronic newsletter is a bi-weekly publication of AASLD and replaces the former bi-monthly print newsletter and weekly e-news. Members are welcome to submit articles and may send suggestions to aharan@aasld.org.