The EPUAP Open Meeting held in Tampere during September 2003 was officially opened by Kati Myllymäki. The following text reproduces her opening address to the meeting and the EPUAP would like to thank Kati and all our Finnish colleagues for their hospitality and warm welcome in Tampere.

Distinguished experts, my dear colleagues and friends, ladies and gentlemen; it is my pleasure and honour to welcome you all to Tampere and to Finland for this meeting of the European Pressure Ulcer Advisory Panel.

The topic of this conference – Pressure Ulcer Prevention and Management is of the utmost importance. This area poses many challenges when I look at it with the eyes of a general practitioner in elderly care. We are trying to alleviate suffering of our patients when we first fail in prevention and after this first failure difficulties continue if their care and treatment is not appropriate. And when these problems accumulate and when problems stretch, the waiting lists to specialized care may be unreasonably long.

With the eyes of administrator or even as a tax-payer we see that a focus upon the wrong issues – such as impaired rehabilitation, shortages of devices for the paralysed and immobile, a lack of hospice personnel and out-dated professional knowledge lead to increasing expenses, hospitalisation and great human suffering.

It is delightful to see that the European Pressure Ulcer Advisory Panel is working hard to develop deeper understanding and evidence-based knowledge of this problem, and also is striving to spread this information to all professionals working in this field.

In recent World Health Organization meetings the health ministers of the world have noted that an intersectoral approach to prevention strategies involving partnerships with communities, nongovernmental organizations, local government and private sector organizations (such as the EPUAP) is of utmost importance. In this field we do need to foster public awareness and responsible attitudes of all social and health professionals and decision-makers.

As I am working for the Finnish National Health Care Project for our Ministry of Health, I must say a few words about money – the costs of health care. Globally we see that the rapidly changing age structures of many populations will lead to changing risk profiles in the coming decades. National social and health care services are challenged by aging populations, increasing health care costs and – luckily – also by improving medical technology.

This Spring, the WHO general assembly unanimously accepted the Framework Convention on Tobacco Control and I am sure this expert audience here is very well aware of the effect of smoking on our skin’s blood circulation and the ability of our tissues to heal and recover when lacking oxygen. I wish that as health professionals you can also keep this congress smoke-free!

A diabetes epidemic is also underway. As the number of people with diabetes grows worldwide, the disease takes an ever-increasing proportion of national health care budgets. Without primary prevention, the diabetes epidemic will continue to grow. Even worse, diabetes is projected to become one of the world’s main disablers and killers within the next twenty-five years. Immediate action is needed to stem the tide of diabetes and to introduce cost-effective treatment strategies to reverse this trend. An estimated 30 million people world-wide had diabetes in 1985. The latest WHO estimate (for the number of people with diabetes, world-wide, in 2000) is 177 million. This will increase to at least 300 million by 2025 – that is only 20 years from now! And you surely know what diabetes does to vulnerability to skin problems and ulcers.

Ladies and gentlemen, we all know that prevention of a health problem is usually the cheapest option. On the other hand it is often the most difficult. From the time of Hip-pocrates to our own time and World Medical Association declarations: prevention is our ethical obligation. It is unfortunate that health care budgets or fee-for service systems seldom reward preventive work. Prevention is a major task for both health care professionals and experts in education, ordinary citizens and of course political decision-makers. To tackle the great risk factors of ageing population (osteoporosis, hip-fractures, over-weight, diabetes, smoking, strokes) we need to change our own living habits. It will be much more expensive to respond to these challenges with pharmaceuticals, surgical operations and technological device when complications already exist.

On behalf of the Ministry of Social Affairs and Health in Finland I wish you all an enjoyable stay in Tampere and a successful meeting. I am sure that all health care professionals and all our patients look forward to the information and advice you will provide for us.

And I wish that you will also have the opportunity to take care of your personal mental and physical and social well-being – prevention or health promotion – while staying in this beautiful city.