Attending the 2025 European Association of Palliative Care (EAPC) Congress was a significant professional milestone and a meaningful personal experience. Although I have participated in many academic conferences worldwide, the EAPC remains especially significant. It is more than just a platform for presenting research ; it is a vibrant forum where the principles, objectives, and future direction of international palliative care are continually shaped.
This year, my work at EAPC concentrated on a theme that increasingly defines my professional identity: enabling palliative care upstreaming. Together with colleagues from the Asia Pacific Hospice Palliative Care Network (APHN), I delivered presentations across three connected sessions, which covered human-centred co-design, prototype development, and India’s national initiatives. These sessions offered a platform not only for sharing our work but also for collective reflection on the future of palliative care.
Session 1: Human-Centred Co-Design and the Cynthia Goh Fellowship
My initial presentation emphasised the human-centred co-design (HCD) approach and its link to the Cynthia Goh Fellowship (CGF) programme. While preparing, I revisited HCD principles: setting context, empathising, defining, ideation, and prototyping. Although these steps are common in innovation sectors, they hold particular importance in palliative care, where human suffering, dignity, and relationships are central.
I shared results from early palliative care efforts, including better symptom control, improved quality-of-life scores, enhanced caregiver well-being, and reduced costs. While these data points are compelling, they only tell part of the story. What stood out most in discussions was how colleagues connected with the ethical aspect of upstreaming: the idea that early palliative care is vital, not optional, to prevent unnecessary suffering. Presenting the alignment between CGF and HCD felt very symbolic. Cynthia Goh embodied vision, compassion, and pragmatism in developing palliative care in Asia. Placing her fellowship within a co-design framework was, in many ways, a tribute to her enduring impact. As I spoke, I sensed a shared memory in the room—a recognition that our collective efforts build on the work of pioneers.
Session 2: Developing a Prototype for Country-Specific Strategies
The second session shifted from discussing conceptual frameworks to practical testing, focusing on creating a prototype for country-specific strategies related to upstream cancer palliative care. This effort was part of a multi-national initiative involving India, China, Bhutan, Malaysia, and the Philippines.
The work followed the FRESCO process (Framework for Co-Design of Clinical Practice Tools), which involved forming advisory groups, developing prototypes, conducting usability evaluations, and refining designs based on qualitative feedback. Our aim was not to create a universal solution but to enable each country to set priorities in a way that is meaningful within their specific context.
The most memorable aspect was hearing the voices during our “think-aloud” usability evaluations. Experts openly discussed issues such as wording, cultural differences, and possible redundancy. Meanwhile, patients and caregivers highlighted what truly matters—timely communication, fair access, and stigma reduction. This valuable feedback prompted meaningful changes, transforming the prototype from a theoretical concept into a practical, real-world tool.
Session 3: Initiatives to Upstream Palliative Care in India
My final presentation focused specifically on the Indian context. India faces unique challenges—such as a high cancer burden, fragmented healthcare systems, financial toxicity, and limited access to essential medications. However, it is also a country known for innovation and resilience.
I described multiple initiatives that are shaping upstreaming in India:
- Capacity building through programmes such as CTC-PC, EQUIP, and PAICE.
- Education and training via EPEC-India, ELNEC, and multiprofessional curricula.
- Community models like the Neighbourhood Network in Palliative Care (NNPC).
- Policy interventions, such as IAPC-ISCCM-ICMR collaborations on end-of-life care.
- Technology-enabled solutions, including mobile apps and tele-triage systems.
- Financial protections, where hospices and philanthropic models reduce out-of-pocket distress.
Presenting these initiatives at a European forum was energising. Many colleagues expressed admiration for the way India has combined community mobilisation with academic rigour. For me, it was essential to demonstrate that while India still faces significant gaps, it is also contributing models that may inspire others globally.
The Conference Atmosphere: Community and Renewal
What truly made EAPC 2025 memorable was the atmosphere beyond the sessions. The venue was alive with a mix of urgency and hope. Poster halls showcased cutting-edge research, from precise symptom tracking to innovative community approaches. Plenary discussions included debates on ethics and equity.
In the corridors, I met both old friends and new collaborators. Conversations flowed naturally, covering practical topics like clinical pathways and more philosophical themes such as pain and life’s purpose. This blend of practical and existential discussions is what distinguishes EAPC from other medical conferences.
I also observed how younger professionals—nurses, social workers, early-career researchers—were assertively claiming their space. Their questions were insightful, and their posters inventive. As someone with two decades of experience in the field, I found this very reassuring: the future of palliative care is in capable hands.
Personal Reflections
As I returned from the congress, I felt a deep sense of renewal. Presenting at EAPC is always humbling—it reminds me that although our local contexts vary, our struggles and aspirations are alike. For me personally, this EAPC reminded me why I chose palliative care in the first place: to reduce unnecessary suffering, to humanise health systems, and to ensure that dignity stays central in the face of illness.
The conversations I had, the feedback I received, and the friendships I renewed—all confirmed that this is not solitary work. We are part of a movement that goes beyond geography and culture. More importantly, I took back insights and inspiration to help shape the narrative in my own country and region.
The EAPC 2025 conference was more than just an academic gathering; it was an experience of solidarity and shared purpose. Through my three presentations, I had the opportunity to tell India’s story, to experiment with co-design, and to honour the legacy of pioneers like Cynthia Goh.
As I left the congress, I remembered a phrase often repeated in palliative care circles: “We cannot change the outcome, but we can change the journey”. At EAPC 2025, I was reminded that by upstreaming palliative care, listening to patients and caregivers, and designing together rather than for them, we are indeed changing the journey—for individuals, families, and societies.
Written by Dr Naveen Salins (Cynthia Goh Palliative Care Fellow)