• arthritis
• autoimmunity
• COVID-19

The last decade witnessed the ascendancy of rheumatology to become one of the most dynamic and progressive across the fields of medicine. As pandemic struck, so too our discipline emerged at the forefront of molecular medicine with the rapid uptake of immune modulatory therapeutics and depth of immune pathogenesis understanding contributing fundamentally to the COVID-19 response. EULAR, the European Alliance of Associations for Rheumatology, played a fundamental and vital role in this response in guiding rheumatic and musculoskeletal diseases (RMDs) therapeutics, vaccine use and even treatment innovations in the context of COVID-19 itself. Given this remarkable contribution, it is timely to reflect on EULAR - what is it and for what does it stand? At its core, EULAR represents people with RMDs (PARE), including their national societies, health professionals in rheumatology (HPR) and their associations and scientific societies of rheumatology across the European nations. Our mission is to reduce the burden of RMDs on individuals and society and improve the treatment and prevention of RMDs. EULAR has evolved significantly in the last 5 years, driving excellence in rheumatology education, research, promoting implementation of research advances into daily care and fighting for recognition of the needs of people with RMDs with a reimagined political advocacy programme. This progress arose substantially from our adherence to, and achievement of, the principles laid out in our current EULAR strategy set through to 2023. Accordingly, we are working now on the development of the new strategy for the period 2024–2028—in this new phase, EULAR will build on this firm foundation as we set ever more ambitious goals.

Reflection on each of these core activities is illustrative. The EULAR School of Rheumatology provides live courses and meetings, online courses and webinars, publications, bursaries, grants and certificates of the highest quality that have become a global standard. We offer resource and opportunity to various rheumatology populations including undergraduates, physicians, researchers, patients and HPR. In recent pandemic times, EULAR education rapidly pivoted to capitalise on continuous innovation and technological advances to maintain delivery of cutting-edge education, in a new online interactive structure built on the most modern educational models.

Delivery of the highest clinical standards is built not only on education but also on provision of clear frameworks for quality of care in practice. As such, EULAR treatment recommendations and taskforces addressing prevention, diagnosis, classification and treatment of RMDs have substantially contributed to the improvement in the lives of people with RMDs across Europe and beyond. Implementation science will increasingly become a core part of these efforts to ensure that the ‘theory and evidence are delivered in practice’. Crucially, these EULAR taskforces also set a research agenda. Significantly, we founded the EULAR Research Centre in 2020, with the aim of building capacity for collaborative translational, clinical and epidemiological/population research in rheumatology across Europe. The centre in turn will support and grow our core research capabilities to close key knowledge gaps highlighted in the EULAR RheumaMap, published in 2017 and updated in 2020. The RheumaMap calls to a broad audience including political classes, charitable and public funders and industry to invest substantially in rheumatology research in the next decade and highlights especially the value that will accrue in individual lives currently blighted by RMDs, healthcare economies and worldwide-related societal costs. Moreover, the EULAR research centre is designed to work in close partnership with Foundation for Research in Rheumatology, which directly funds research in Europe and in due course, we hope, will engage in the wider global space to collaborate and enable international research collaborations and interactions around the world.

Communicating cutting edge research and delivering the state of the art of knowledge to our constituencies are also achieved via the Annual European Congress of Rheumatology. This has become the primary platform for the exchange of scientific and clinical information in Europe and fosters extensive interactions among physicians, scientists, people with RMDs, HPR and representatives of the pharmaceutical industry worldwide. Since 2000, the EULAR Congress has been held in June, every year, in one of the major cities in Europe. Pandemic times required migration to the virtual world to remarkable success—more than 18000 delegates in 2020 and 17000 in 2021 attended. Over the years, the EULAR Congress has gained a reputation as the most innovative platform for the rheumatology community; in this spirit, we will now move to hybrid congress models that offer flexibility, adherence to zero-carbon ambitions and increased equity of access for delegates with flexible attendance models. Crucially, we will embrace the state of the art in the modalities of congress experience. This is timely since EULAR will shortly celebrate its 75th anniversary and the 2022 Congress will offer outstanding celebrations of the EULAR jubilee.

Despite the medical advances alluded to above, rheumatology remains too often ‘the bridesmaid’ on the political stage. A substantially revised approach to EULAR Advocacy has been transformative and now EULAR commands close attention among political authorities in the European Union and with national governments across the EULAR countries. EULAR Advocacy works to ensure that policies, regulations and legislation in Europe are focused on the burden of RMDs on individuals and society. Numerous initiatives are enacted at the European and national level with increasing impact in an iterative programme to drive ever greater visibility and action as a result.

Above all, at our heart is the ‘EULAR family’—the fantastic team of people working together across the three pillars of medical, health professional and patient societies. In prior times, EULAR may have appeared opaque reflecting its inherent complexity. A radical revision of our structures and governance rules in the last 3 years has created an inclusive organisation that truly seeks to engage with our member organisations and the wider rheumatology community—encapsulated in the launch of individual memberships imminently. Any person in the community who is willing to participate in our EULAR family can be involved in its initiatives, with individuals appointed or voted to positions of responsibility, based on their unique skills and perspectives and independent of gender, age or geographic origin. In particular, in the last 2 years, EULAR has directly faced the important concept of gender equality with work ongoing. All of the above is founded on meritocracy, an important element in any volunteer-led organisation.

Not only is our structure evolving but also our scale. In-housing many of our activities into EULAR House in Zurich will render us highly efficient in the times to come—value accrued was demonstrable during the recent pandemic. With the expansion of our admirable secretariat, EULAR is now ideally placed to rapidly adapt to life, facing new key challenge, including the unexpected post pandemic. We seek new initiatives, strategies, innovation and to work in new contexts retaining our fundamental aim of combatting the RMDs and their impact. This has never been more important than now when we transition to a new hybrid world, capitalising on virtual technology for our clinical consultations, medical communications, education and research activities—these efficiencies however must be balanced with the essential humanity that binds us together and on which we draw for inspiration and mutual support in the practice of clinical medicine and science and the lived experience of the RMDs. EULAR will embrace this new reality and prosper within it.

In closing, we would like to thank the members of the EULAR pillars who dedicate many hours of their daily work to the EULAR Family, to colleagues on the EULAR board for their continuous commitment in making EULAR successful and to the EULAR office and executive directors for their engagement and superb support. Mostly we thank the extraordinary community that is rheumatology in Europe—we wish you safe and exciting times.