ESGE and Public Advocacy

Public advocacy includes a wide range of activities with the common feature of interaction of an organization with entities and individuals outside that organization. Public advocacy and lobbying are not the same. Lobbying is simply the attempt to influence decisions on behalf of a special interest group. Advocacy involves making a case and stimulating discussion based on scientific evidence and thoughtful reasoning. Scientific and evidence-based discussions are at the heart of public advocacy, while it is not a central issue in lobbying. The ESGE recognizes public advocacy as an important task and societal responsibility.

To create an infrastructure and further boost public advocacy activities, in early 2020, the ESGE promoted the ESGE Public Advocacy Working Group to the ESGE Public Advocacy Committee (PAC). The ESGE PAC is now one of seven standing committees of the Society (the others are the executive committee, and the committees for research, guidelines, education, quality improvement, and young endoscopists, respectively) [11].

The main pillars of public advocacy at ESGE include educating the public, providing information and resources to patients and caregivers, interacting with other organizations in gastrointestinal endoscopy and digestive health, and providing advice and insight to policy makers about rules, laws and regulations in collaboration with other ESGE committees / working groups and the UEG (United European Gastroenterology). The PAC is also tasked with proper implementation of ESGE guidance documents, discussing reimbursement issues in endoscopy towards authorities, and support of funding opportunities for research in endoscopy in Europe. ([Fig. 1Fig. 1])

Fig. 1 Fig. 1 ESGE Executive representatives at EU parliament.

Since its inauguration 4 years ago, the ESGE PAC has grown into a vital and strategic ESGE committee which actively engages with stakeholders and partners and promotes the importance of digestive endoscopy in Europe, advocating on behalf of patients, doctors and caregivers, and identifies areas of challenge and improvement in a wide range of areas in digestive endoscopy and digestive health in Europe.

Awareness and development

The ESGE PAC organizes and leads activities to promote the role of endoscopy in digestive cancer screening in Europe. During colorectal cancer awareness month, each year in March, the ESGE PAC provides information to caregivers, patients and policy makers about colorectal cancer, screening, and prevention. ([Fig. 2Fig. 2])

Fig. 2 Fig. 2 ESGE: 4 tips for Colorectal Cancer Awareness month.

In 2024, the ESGE highlighted new, better endoscopic treatment options for early colorectal cancer and promoted quality assurance initiatives of the ESGE to engage European endoscopists in best treatment of colorectal cancer and polyps.

The ESGE PAC is active in collaborations with partner gastroenterology organizations such as the UEG, and patient organizations such as Digestive Cancer Europe to raise awareness for the importance and opportunities for prevention, treatment, and surveillance of digestive cancers, as well as important diseases such as inflammatory bowel disease, celiac disease, pancreatic cancer and chronic pancreatitis, and biliary disease.

Endoscopic Devices

One of the main recent tasks of the ESGE PAC has been engaging in issues related to compliance, reimbursement, safety and availability of medical devices which are needed in digestive endoscopy. Without devices such as endoscopes, stents, snares and forceps, digestive endoscopy is not possible. Therefore, the availability of safe and effective endoscopy devices is of paramount interest to European endoscopists and our patients.

European Medical Device Regulation – plague or blessing

Since 2022, the ESGE PAC has identified the new European Union (EU) rules for approval of medical devices (European Medical Device Regulation, MDR) as an important area of engagement [22].

Without doubt, the new EU MDR will significantly affect European endoscopy services in the years to come. There are both threats and opportunities related to the new MDR for endoscopy patients, and the ESGE is currently actively engaging with European lawmakers, industry partners, patient organizations, and the general public to make sure that the new law is interpreted and enforced in a way which creates the most benefits and as little burden and harms as possible. Under the guidance from the PAC, the ESGE has put forward what we believe are the critical issues to be addressed:

• Better liaison of endoscopy centres with industry and regulators

• Increased need for clinical device trials at European endoscopy centres

• Higher demand for robust data of endoscopic devices after certification

• Active engagement with EU notified bodies and expert panels for device certification

The ESGE will continue to play an active role in the establishment of the new EU device system in endoscopy and supports endoscopists with relevant and updated information about the new rules and what they mean for our endoscopy services and for our patients.

The future

The ESGE through the PAC will maintain and expand its advocacy initiatives in digestive endoscopy. We will do this by providing knowledge-based background and top clinical expertise, understanding patients and their needs to achieve best possible care, and educating policy makers and the public about challenges and opportunities in European digestive endoscopy.

Conflict of Interest

The authors declare that they have no conflict of interest.

• References

• 1 Accessed January 02, 2024 at: https://www.esge.com/about-us/esge-committees
• 2 Bretthauer M, Mori Y, Zessner-Spitzenberg J. et al. Gastrointestinal endoscopy devices and the European Union Medical Device Regulation: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement. Endoscopy 2023; 55: 578-581 DOI: 10.1055/a-2052-2540. (PMID: 37080238)

Publication History

Article published online:
29 May 2024