I first made a version of this slide almost 10 years ago.

What strikes me is not that the unmet needs in IBD are unchanged.

It is that the map is still recognisable ... but almost every part of it is now moving.

Awareness is rising. Treatment options are expanding. Combination strategies, microbiome therapeutics, diet, fistula therapies, strictures, passive monitoring, AI, wearables, and prevention science are all advancing.

But the gaps remain huge.

Equity is still poor. Stratification is non-existent. Holistic remission is still more slogan than service reality. And current monitoring strategies don't scale effectively.

The next decade of IBD care will not be won by another drug alone.

It will be won by connecting better therapies with better targets, better monitoring, better prediction, better patient support, and a serious attempt to prevent Crohn’s disease and ulcerative colitis before they fully declare themselves.

That is the work.