<\/strong><\/span> Professor of Hepatology and Chronic Liver Failure, Roger Williams Institute of Liver Studies, King\u2019s College London; Consultant Hepatologist, Liver Unit, King\u2019s College Hospital NHS Foundation Trust, London;<\/span>\u00a0<\/span>Lead of the Liver\u2013Intestinal\u2013Microbiome\u2013Brain Interactions in Cirrhosis (<\/span>LiMBIC<\/span>) Research Group, King\u2019s College London<\/span>,\u00a0<\/span>UK<\/span>;\u00a0<\/span>Secretary General, European Association for the Study of the Liver<\/span><\/span>\u00a0<\/span><\/p>\n Citation:<\/strong><\/span> EMJ Hepatol. 2026; https:\/\/doi.org\/10.33590\/emjhepatol\/M4299163<\/a><\/p>\n I think\u00a0it\u2019s\u00a0helpful to give some historical\u00a0context\u00a0first before answering this question.\u00a0EASL\u00a0was first\u00a0established\u00a0in 1966,\u00a0and,\u00a0when it was first\u00a0established, the first meeting in Marburg,\u00a0Germany,\u00a0consisted\u00a0of 68 men and two women.\u00a0I\u2019m\u00a0unsure\u00a0if the\u00a0two women there were\u00a0hepatologists;\u00a0I think\u00a0only\u00a0one was.\u00a0For the following 58 years, that pattern\u00a0largely continued, with\u00a0White\u00a0men in their 50s typically taking on\u00a0the\u00a0Secretary General role.<\/span>\u00a0\u00a0 Now,\u00a0at EASL 2026, 52% of our registrations are women.\u00a0Women are becoming increasingly prominent in the field, and the leadership of EASL needs to reflect the people coming into the room.\u00a0For me, it has been\u00a0essential\u00a0that we achieve complete gender parity within both the leadership and the Governing Board, and we have now done that.\u00a0\u00a0<\/span><\/p>\n However, we want more\u00a0than that.\u00a0When we look now at\u00a0the\u00a0people coming\u00a0to the Congress,\u00a0we\u2019ve\u00a0got people from all over the world and\u00a0it\u2019s\u00a0wonderful. At\u00a0the last\u00a0count,\u00a08,520\u00a0delegates from\u00a0115\u00a0countries across five continents were represented at the EASL Congress, including attendees from Africa, Asia,\u00a0and Latin America. For me,\u00a0it\u2019s\u00a0just wonderful,\u00a0because hepatology\u00a0isn\u2019t\u00a0a\u00a0White European male\u00a0issue.\u00a0It\u2019s\u00a0a global problem, and,\u00a0therefore,\u00a0it\u2019s\u00a0important that our membership and our leadership represent that diversity.\u00a0<\/span>\u00a0<\/span><\/p>\n For my first meeting as Secretary General,\u00a0it\u2019s\u00a0certainly been a roller coaster, and,\u00a0at times,\u00a0quite stressful. However,\u00a0it\u2019s\u00a0also been incredibly rewarding. So many women have come up to me to thank me, and\u00a0I\u2019ve\u00a0received some amazing feedback.<\/span>\u00a0<\/span><\/p>\n I think this year\u00a0has\u00a0been the year of public health and\u00a0advocacy.\u00a0We have\u00a0absolutely amazing\u00a0science here, outstanding educational content, and the abstracts presented in General Sessions 1 and 2, as well as the late-breaking sessions,\u00a0demonstrate\u00a0just how far the field is advancing. But for me,\u00a0it\u2019s\u00a0that awareness of the growing problem of liver disease globally that has been so important.\u00a0Just in Europe, 780 people die a day from advanced liver disease, which is\u00a0about 284,000 people a year.\u00a0The cost associated with that is enormous,\u00a0and if we can even\u00a0have a slight\u00a0impact on that,\u00a0imagine how much money\u00a0we\u2019ll\u00a0save?\u00a0We\u2019ve\u00a0estimated that\u00a0we could save up to 55 billion\u00a0EUR\u00a0in Europe\u00a0just by\u00a0addressing that.\u00a0<\/span>\u00a0<\/span><\/p>\n The reason I mention this is that\u00a0two\u00a0major pieces\u00a0of work were\u00a0published shortly before the Congress began, and\u00a0we\u2019ve\u00a0been highlighting\u00a0both of them\u00a0throughout the meeting.\u00a0<\/span>\u00a0<\/span><\/p>\n One of those\u00a0big pieces\u00a0of work\u00a0was the\u00a0World Health Assembly in Geneva, the 79<\/span>th<\/sup><\/span>\u00a0World Health Assembly.\u00a0There was a resolution put forward by the WHO, nominated by Egypt,\u00a0to recognise chronic liver disease as a\u00a0non-communicable\u00a0disease\u00a0in the same way as heart disease,\u00a0cancer,\u00a0and diabetes.\u00a0The resolution was passed, marking a truly historic moment. This recognition gives us the opportunity to\u00a0leverage\u00a0its status as a\u00a0non-communicable disease\u00a0to secure the funding needed to implement meaningful policy changes. These include measures to address unhealthy diets, ultra-processed foods,\u00a0and\u00a0harmful\u00a0alcohol consumption, as well as initiatives focused on early detection, education,\u00a0and prevention.<\/span>\u00a0<\/span><\/p>\n For\u00a0me, those\u00a0things have been\u00a0really instrumental\u00a0in launching the meeting this time round, because I feel like\u00a0we\u2019ve\u00a0all got a mission now\u00a0that we need to work towards.\u00a0<\/span>\u00a0<\/span><\/p>\n One of the things that we have learned is that your gut microbiome is\u00a0really important\u00a0for\u00a0maintaining\u00a0not just\u00a0liver health,\u00a0but\u00a0also general\u00a0and brain\u00a0health, supporting\u00a0your immune system,\u00a0and so many other things.\u00a0The problem is that when you start to develop liver disease,\u00a0your gut microbiome also becomes quite unhealthy, which\u00a0then seems to perpetuate\u00a0the liver disease.\u00a0<\/span>\u00a0<\/span><\/p>\n We also know that people who drink harmful levels of alcohol, people who are overweight,\u00a0obese,\u00a0or diabetic\u00a0also have changes in their gut microbiome\u00a0that can also drive disease progression.\u00a0Therefore, the focus of my research has been\u00a0on\u00a0trying to repair the gut microbiome in a way that helps\u00a0support liver health, and potentially even reverse some of the adverse consequences of having liver disease.\u00a0Diet\u00a0is so important for\u00a0the\u00a0microbiome;\u00a0the more\u00a0fruit,\u00a0vegetables,\u00a0and fibre\u00a0we eat, the healthier\u00a0our\u00a0microbiome is, and the healthier we are, the healthier our liver is.\u00a0So\u00a0fundamentally, we can just institute dietary changes. We\u00a0don\u2019t\u00a0need to\u00a0use\u00a0cutting-edge\u00a0technologies.\u00a0However,\u00a0one of the things that\u00a0I\u2019m\u00a0also looking at in my research programme is ways to manipulate the gut microbiome\u00a0in a favourable way to improve outcomes in liver disease.\u00a0Some of the things that\u00a0I\u2019m\u00a0doing\u00a0as part of\u00a0my research programme is,\u00a0I\u2019m\u00a0running a big trial called The\u00a0PROMISE\u00a0Trial, which is looking at faecal microbiota\u00a0transplantation\u00a0(FMT). This is\u00a0taking a healthy individual and taking the bacteria from their stool,\u00a0encapsulating\u00a0that\u00a0and then giving it\u00a0to somebody with liver disease\u00a0to see if those healthy bacteria will engraft in their guts to try and improve their gut microbiome.\u00a0<\/span>\u00a0<\/span><\/p>\n At the moment,\u00a0we\u2019re\u00a0also\u00a0very interested\u00a0in\u00a0developing phage therapies.\u00a0A\u00a0phage is a virus that lives in your gut,\u00a0which helps to control populations of bacteria.\u00a0For every type of bacterium in the gut microbiome, there are also vast numbers of viruses that exist alongside them and work in conjunction with them.\u00a0<\/span>What\u00a0we\u2019re\u00a0interested in doing is using\u00a0phages\u00a0to help keep some of the less\u00a0healthy bacterial populations under control. This research is still at\u00a0a very early\u00a0stage, and what we want to work towards is putting the necessary regulatory framework in place to enable first-in-human trials.<\/span>\u00a0<\/span><\/p>\n As you can imagine, when\u00a0you\u2019re\u00a0considering the use of viruses in this context, it is essential to\u00a0proceed\u00a0very carefully.<\/span>\u00a0<\/span><\/p>\n We\u2019re\u00a0getting there, but\u00a0we\u2019ve\u00a0still got a lot of work to do.\u00a0Over\u00a0the last couple of years,\u00a0we\u2019ve\u00a0raised awareness of liver disease\u00a0as\u00a0a problem.\u00a0As I mentioned to you\u00a0earlier, having the resolution passed on the\u00a021<\/span>st<\/sup><\/span>\u00a0May\u00a0in\u00a0Geneva means that now,\u00a0MASLD\u00a0and alcohol-related liver disease, which\u00a0both\u00a0come under that umbrella of\u00a0steatotic\u00a0liver disease, are\u00a0now recognised as\u00a0non-communicable\u00a0diseases\u00a0that have\u00a0to be addressed by all of the member states, and that\u2019s so important.\u00a0However,\u00a0it\u2019s\u00a0one thing to achieve that recognition,\u00a0but\u00a0it\u2019s\u00a0another thing to\u00a0implement\u00a0the policy and the change that you need to address that. But\u00a0that\u00a0recognition is\u00a0the\u00a0first step.<\/span>\u00a0<\/span><\/p>\n Exactly.\u00a0Measures such as\u00a0minimum\u00a0unit pricing for alcohol, for example, as has been introduced in Scotland, can make a real difference. Labelling\u00a0that says\u00a0how much sugar is in\u00a0a\u00a0product\u00a0and\u00a0making people aware that ultra-processed foods are harmful to their bodies\u00a0are important.\u00a0<\/span>\u00a0<\/span><\/p>\n These are exactly the kinds of policy changes and public health initiatives that we need to push for.\u00a0<\/span>\u00a0<\/span>\u00a0<\/span><\/p>\n With the\u00a0PROMISE\u00a0trial,\u00a0we want to try to understand if repairing the gut microbiome by\u00a0putting in bacteria from a healthy individual can reverse bad outcomes\u00a0and\u00a0liver\u00a0disease. But at the same time, we still\u00a0don\u2019t\u00a0really understand why\u00a0FMT\u00a0works. We\u00a0don\u2019t\u00a0understand how those bacteria engraft in the gut and\u00a0are\u00a0not just\u00a0excreted.\u00a0And then how do they communicate with\u00a0the already\u00a0existing microbiome\u00a0in a harmonising way to\u00a0maintain\u00a0health in the gut?\u00a0So\u00a0there\u2019s\u00a0a huge piece of work ready to be done on how the microbiome,\u00a0brain,\u00a0and liver all work together\u00a0and\u00a0how doing\u00a0the\u00a0FMT\u00a0works.<\/span>\u00a0<\/span><\/p>\n There\u2019s\u00a0also another big piece of work, which is,\u00a0if FMT does work, then how do we roll that out?\u00a0Can it be a\u00a0national programme?\u00a0Would we have, for example, stool\u00a0banks, like we have blood banks?\u00a0There\u2019s\u00a0that huge piece of work\u00a0on\u00a0how\u00a0you would\u00a0orchestrate developing that as a therapy.\u00a0But\u00a0what I really like about FMT\u00a0is that\u00a0it\u2019s\u00a0recycling.\u00a0It\u2019s\u00a0kind of a\u00a0sustainable therapy, and\u00a0that\u2019s\u00a0what\u2019s\u00a0really\u00a0nice\u00a0about it.\u00a0Yes,\u00a0it\u2019s\u00a0not your\u00a0own\u00a0microbiome, but\u00a0you\u2019re\u00a0still putting something in\u00a0that\u2019s\u00a0perhaps more\u00a0harmonious with the body. So, for me,\u00a0now\u00a0we need to do lots of work\u00a0to better\u00a0understand how it works and how,\u00a0if\u00a0it\u00a0were\u00a0to be shown to be favourable,\u00a0we can\u00a0roll that out more broadly.\u00a0<\/span>\u00a0<\/span><\/p>\n I think sometimes one of the downsides of being Secretary General is that you don\u2019t always get to go to all the sessions you want to. There was the Baveno symposium. The Baveno Cooperation consortium meets every 5 years to develop concepts, definitions, and management strategies for cirrhosis and portal hypertension. They met recently in March (Baveno VIII), and the symposium really addressed some of the discussions and outcomes from that meeting, and how they might be implemented going forward into clinical practice. There were some great talks within that session. <\/span>\u00a0<\/span><\/p>\n One\u00a0particular talk\u00a0I really enjoyed was\u00a0by\u00a0Bogdan\u00a0Procopet\u00a0(Universitatea\u00a0de Medicina\u00a0si\u00a0Farmacie\u00a0\u201cIuliu Hatieganu\u201d, Cluj-Napoca, Romania)\u00a0on preventing liver decompensation, which is\u00a0quite in line with much of the work that I do. A lot of my FMT work is about preventing things\u00a0from\u00a0getting worse. So,\u00a0I very much enjoyed that session.\u00a0<\/span>\u00a0<\/span><\/p>\n What excites me is that the community is growing.\u00a0We\u2019ve\u00a0had more than 8,520\u00a0registrations at this meeting\u00a0with\u00a0600+\u00a0people online.\u00a0The liver is\u00a0being recognised as being important.\u00a0It\u2019s\u00a0no longer the little brother\u00a0that\u2019s\u00a0stuck in the corner.\u00a0The engagement, momentum, discussions,\u00a0and\u00a0enthusiasm to take things forward\u00a0are\u00a0just incredible.\u00a0There\u2019s\u00a0cutting-edge\u00a0science, for example, there was a\u00a0fantastic abstract\u00a0using RNA silencing to treat\u00a0\u03b1-1\u00a0antitrypsin\u00a0deficiencies.\u00a0That\u2019s\u00a0a very new way to potentially treat a devastating disease.\u00a0We\u2019ve\u00a0got all these\u00a0cutting-edge\u00a0therapies, but\u00a0we\u2019re\u00a0also addressing the problem\u00a0head-on\u00a0with all the policy initiatives that\u00a0I\u2019ve\u00a0already talked about.\u00a0Having a\u00a0congress full of people who are so engaged and ready to just address the\u00a0problem is\u00a0very special\u00a0to me.<\/span>\u00a0<\/span><\/p>\n I\u2019ve\u00a0tried to invite people\u00a0to the Congress\u00a0who\u00a0wouldn\u2019t\u00a0normally get the opportunity to come somewhere like this.\u00a0A\u00a0young investigator came from Ghana to talk about the problem with\u00a0alcohol-related\u00a0liver disease in their country.\u00a0We\u2019ve\u00a0had people\u00a0from Uganda to\u00a0Vietnam.\u00a0I met a group from Ukraine yesterday\u00a0who were telling me how much they were\u00a0learning here\u00a0that they can take back. Even though\u00a0they\u2019re\u00a0facing all those problems, they still have liver disease\u00a0to face\u00a0too.\u00a0It\u2019s\u00a0really warming to see that.<\/span>\u00a0<\/span><\/p>\n<\/div>\n![\"line\"](\"https:\/\/www.emg-health.com\/wp-content\/uploads\/2017\/12\/Line2-940x4.png\")
<\/p>\n<\/div>\nYou are serving as\u00a0the\u00a0European Association for the Study of the Liver\u2019s (EASL)\u00a0first female Secretary General. What does that milestone mean to you personally, and what changes would you still like to see for women entering hepatology and academic medicine?<\/h4>\n
EASL 2026 is bringing together clinicians, researchers, industry, and policymakers at a time when liver disease is rising globally. What do you think are the biggest themes or priorities healthcare professionals and scientists should pay attention to this year?<\/h4>\n
Your research has focused on the gut\u2013liver\u2013brain axis, immune dysfunction, and the role of the microbiome in chronic liver failure. How close are we to seeing microbiome-based therapies become part of routine clinical practice for patients with cirrhosis?<\/h4>\n
You\u2019vedescribed liver disease as a growing global public health challenge, particularly with the rise of\u00a0MASLD. Do you feel European governments and health systems are finally taking liver health seriously enough?<\/h4>\n
A lot of the sessions\u00a0I\u2019veattended have focused on health policy and global policy, and one theme that keeps coming up is that generating scientific evidence alone\u00a0isn\u2019t\u00a0enough. We also need effective policy change to translate that evidence into better patient outcomes. From your perspective, how does your organisation bridge the gap between scientific evidence and real-world policy impact?<\/h4>\n
You are leading major work on\u00a0FMT, including the PROMISE trial. What excites you most about the potential of\u00a0FMT, and what are the biggest unanswered questions still facing the field?<\/h4>\n
Given your own work in cirrhosis, the microbiome, and liver failure, are there any sessions at EASL 2026 that\u00a0you\u2019veparticularly enjoyed?<\/h4>\n
What excites you the most about the future of hepatology right now?<\/h4>\n
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