Personal Remarks

I was very actively involved in the business of the EFNS during the presidency of Franz Gestenbrand. Franz has always been a master at picking the right collaborators and then gives them lots of freedom to work. That is how he built up the biggest and most well equipped neurological department in Europe during less than two decades of chairmanship in Innsbruck. After a little while he showed me unlimited confidence, so I could handle a number of important matters, as discussed above, already during my time as vice-president. During that time we also gradually substituted a number of inactive members of the management committee and made plans to change the constitution to not include a first vice-president, to enable of free competition in the election of the next president. Not mentioned much above are the EFNS finances. The organization started out with a modest surplus from the Vienna congress in 1991 and an extremely efficient administrator, Uschi Tschabitscher, who worked for free in the first couple of years. However, the financial footing of the organization was terribly weak. New drugs for migraine were at that time pouring into the market, and I had excellent relations to most of the pharma companies in this field. Glaxo (now Glaxo Smith Kline) was particularly generous and provided a start-up of grant for the EFNS of 25 thousand English pounds. This money was crucial because it allowed a high level of activity in committee work until income started to flow from the annual meetings. They did not start until four years after the incorporation of the EFNS as discussed above.
After four years of hard work as a vice-president, I could take on the presidency in 1995 during the first official congress of the EFNS in Marseille. My first job was to extensively revise and improve the constitution and bylaws, because a number of problems had been encountered that slowed down the EFNS and made it less efficient. At the same time, I replaced a number of committee chairpersons who had not been active in the preceding years. Using an American style rather than a European style, I tried to institute the principle that, if persons had an office but did not do the job, then he should be replaced at the first possible opportunity. The same principle was also applied to the scientific committee as discussed above. In some cases it was actually necessary to replace chairpersons, not once, but twice or thrice before an active person was found. This pruning of the organization was perhaps the single most important activity of my whole presidency and I am proud that, when I left the presidency, the EFNS had excellent people in virtually every elected position as well as excellent employed people in the office.
Another thing that started already during my vice-presidency but continued during my presidency was a dedicated effort to improve EFNS congresses. The first congress in Marseille was planned by professor Serratrice totally according to is own scheme. Although it proved relatively successful with 1500 delegates, it was clear that EFNS needed rules about congresses. We had to do away with lengthy opening ceremonies in non-english. Even more important, we had to find ways of securing that the great majority of surplus from congresses went back into the EFNS and not to the organizing country. As president of the international headache society I had made rules for congresses requiring 2/3 of profit and 1/3 to the hosting country. For the EFNS we devised an even better system. We simply took satellite symposia out of the congress program and defined all income from satellite symposia as belonging to the EFNS. Thus, the congress account did not include income from satellite symposia. Any surplus from the meeting itself should be divided by half to the hosting country and half to the EFNS. Income from satellite symposia continues to be the dominant income the EFNS budget.
While fighting for the existence of the EFNS in fierce competition with the ENS, it was not immediately obvious how to secure high EFNS membership. Our solution was to define every neurologist in Europe who was a member of a national neurological society as a member of the EFNS. We decided to request from each national neurological society just a symbolic payment of one euro per member because we sensed a very weak support for the EFNS and (rightly to) feared that anything more would not be paid. In the beginning it was very difficult to make national societies pay even this small amount and some countries did not pay for several years. However, I decided not to exclude anybody because of lack of payment, assuming that as the EFNS gained momentum, all countries would eventually pay. This prediction proved correct and once all countries were paying members, we were able to increase the fee slightly. However, the fee from member organizations continues to be only a small fraction of EFNS income.
Serratrice had organized the first congress of the EFNS successfully, but who should do the next congresses? The prevailing view at that time was that the ENS was by far the strongest and most scientific organization and countries were not stumbling over each other in order to get the next EFNS congress. Friends came to our rescue, first and foremost Professor Cesare Fieschi from Rome. I knew him from the field of brain blood flow and metabolism. He was a highly respected leader of his department and internationally famous as a clinical scientist in the field of stroke and brain blood flow. He promised to organize the 1996 congress in Rome and did so with huge success. 2000 participants and a big surplus from satellite symposia as well as a surplus from the meeting itself. Even more important was the a very successful scientific program. Not being able to organize a full congress, we had a successful so called regional meeting in Prague in 1996. Another friend, Miguel Lainez from Valencia, together with Professor Chacon from Seville offered to host the second EFNS congress in Seville in 1997. They had the full backing of the Spanish neurological society and I knew that they would be able to stage a successful meeting. In fact what happened was that the meeting became too successful. An overwhelming four thousand two hundred participants registered and the local organizers was not at all prepared to handle such a huge volume. In addition, they had organized a huge open air welcoming event in the Piazza di Spainia. It almost never rains in Seville during autumn but on that particular day, clouds pulled up at a slow but very steady rate and rain became a very likely possibility. There were no rescue plans in case of rain such as umbrellas, tents or the like. Therefore, everything had to be evacuated and an emergency dinner was planned in the congress centre way out of town. It became 12 o’clock before that dinner was ready and only a few hundred guests took part, leaving food for another 3000 people untouched. Sponsoring companies were obviously unhappy and even if the rest of the meeting proved to be a great success with an excellent scientific and social program, the meeting left a mark on the EFNS as an organization without sufficient control of its own meetings. The number of delegates at the subsequent meetings fell to 3000 in 1999 and 2000 in year 2000. It was clear we had to control our congresses better. A tender was issued to get a core professional congress organizer who would always be with us irrespective of the site of the congress. The choice fell up on an Israeli company Kenes. This proved to be a great success and together with a number of other initiatives, it resulted in increased numbers of delegates. For the last congresses we have had more than 5000 participants.
A large number of other initiatives were taken during my presidency. They will be described elsewhere. The last two were to form the European Brain Council as reported above and to start an IT task force to develop a much better website for the EFNS. The first of these two initiatives was a big success while the second never received sufficient support from my successors. Several years later, the EFNS website is still largely as we left it in 2004.

About EFNA and EBC

The EFNS was obviously interested in promoting neurological research at the European level. Professors Amaducci, Racagani and Medlewicz and others had attempted to create a European decade of the brain similar to the decade of the brain in the United States. This led to some meetings in Brussels with the commission for research but not to much increase in brain research. Subsequently, Professor Jean-Pierre Changeux led a campaign to increase brain research in the fifth framework program of the EU and I was partly involved in this. Also this initiative had no success and I gradually realised that in order to have impact, it was necessary to have much broader support and particularly to work jointly with patient organizations. Also, it was necessary to speak a language that was understood by lay people because decision-makers usually are lay people in relations to brain research. But how could the EFNS partner with the patients? There was at that time only a few European patient associations in the neurological disciplines and no cooperation between them. In talks with Ms. Mary Baker, the idea of a federation of patient associations within neurology in Europe gradually developed. Both Mary and I tend to move from thought to action without delay. As president of EFNS I supported her activities and we appointed Evelyn Sipido as administrative support for Mary’s activities. After a couple of years of preparation, the European federation of neurological association (EFNA) was formally created during the EFNS congress in Lisbon in 1999. The EFNS now had one and only one patient organization as its partner in Europe. In the meantime I had conceived an even larger scheme. If we were to have real influence in Brussels, we had to unite all the stakeholders with an interest in brain research and brain diseases. The partner in basic science was clearly FENS, the newly formed and powerful organization of basic neuroscientists. We selected the ECNP as our partner in psychiatry and GAMIAN as the partner representing psychiatric patients. We also decided to have the pharma-industry represented because a very large proportion of brain research is conducted by companies, and because the European commission usually favours collaboration between academia and industry. The EFNS allocated one third of Evelyn Sipido’s time to do this work and this went on for several years until the EBC got its own finance. The EBC is now a well, established organization enjoying broad support from member organizations. It fights segmentation a fosters collaboration between patients and professionals, academia and industry, clinical and basic research etc. The EBC has had positive impact on both the sixth and seventh framework programme of research of the EU. Brain research has become more prominent but there is still a long way to go. The EFNS must be credited to a large extent with the creation of both EFNA and EBC. Without EFNS support, the EBC had not been formed and the collaborative spirit that these organizations are developing in Europe, would not have appeared.

  Jes Olesen, Denmark

Curriculum Vitae:

1. PERSONAL DATA AND MEDICAL CAREER Born 9.9.1941 in Hobro, Denmark. M.D. University of Copenhagen 1967. Specialist education in neurology at major teaching hospitals in Copenhagen. Clerkship at The National Hospital, Queen Square, London 1971. Resident, Department of Neurology, Cornell Medical Center, New York 1972-1973. Chief, Department of Neurology, Hillerød Hospital 1977-78. Attending neurologist Gentofte Hospital 1978-1985. Professor of Neurology, Gentofte Hospital 1985-1993. Professor and chairman, Department of Neurology, Glostrup Hospital 1993- 2000. Visiting Professor Harvard Medical School 1999. Professor, Department of Neurology, Glostrup Hospital 2001-. 2. ACADEMIC CAREER Danish thesis 1974. Lecturer in Neurology, University of Copenhagen 1975. Professor of Neurology, University of Copenhagen 1985-. Visiting Professor Harvard University 1999. 3. SCIENTIFIC JOURNALS Co-founder and Associate Editor of Cephalalgia 1980-86. Associate Editor of Pain 1986-1990. Editorial board Clinical Neuro¬logy and Neurosurgery 1978¬-1985, Functional Neurology 1985-, J. Cereb. Blood Flow Metab. 1989-1992, Acta. Neurol. Scand 1990-, Curr. Opin. Neurol. 1991-, Eur Neurol. 1992-94. Founder of Eur. J. Neurol. 1994. 4. SOCIETIES President Danish Headache Society 1980-1987 and Scandinavian Migraine Society 1983-1985. Chairman International Headache Classification Committee 1985-. President International Headache Society 1993-1995. Founding president Danish Stroke Association 1987-1992. National delegate World Federation of Neurology 1989-. Councilor International Association for the Study of Pain 1990-1996, and chairman IASP publication Committee 1990-1994. Vice president European Federation of Neurological Societies (EFNS) 1991-1995, Chairman of the Scientific Committee EFNS 1992-1995. President Year of the Brain 1997 campaign, Member European Dana Alliance for the Brain 1999. Co-founder of European Federation of Neurological Associations 2000. President European Federation of Neurological Societies (EFNS) 1995-2001. Founder and President European Brain Council (EBC) 2001- 5. HONORS Honorary member Australian Headache Society 1985 and German Headache Society 1987. Corresponding member American Neurological Association 1986 and Austrian Neurological Society 1992. Honorary member Austrian Neurological Society 1997, French Neurological Society 1999 and Association of British Neurologists 2000. Fellow of the Royal College of Physicians 1998, Doctor hon. c. University of Rome Sapienza 2001 6. RESEARCH Has published 381 papers in refereed journals and over 200 papers in books, congress proceedings etc. Has edited or written 25 books, out of which "Basic mechanisms of headache" and "The headaches” first, second and third edition are internationally acknowledged reference volumes. Has initiated and supervised 16 defended doctoral dissertations and 19 Ph.D. dissertations. The main research interest is migraine and other headaches, classification, epidemiology, genetics, human and animal studies of the mechanisms of migraine including human provocation studies, cerebral neuroimaging and animal models.