Last year I wrote an editorial for this journal in which I summarized the three primary objectives of the Pulmonary Vascular Research Institute (PVRI): to improve the care of patients all over the world who suffer from pulmonary vascular disease, to facilitate and accelerate research in the clinical and basic science of the disease, and to encourage the development of new therapies. As I approach the end of my term of office as president, it seems appropriate to consider the road traveled and the road ahead. We, the PVRI, began as a dedicated group of travelers led by Ghazwan Butrous as our inspirational managing director. Now we are a fully fledged professional organization with a permanent, stable infrastructure. We have approved and published the rules by which we govern ourselves (the "Regulations of the PVRI"), and we have an expanded worldwide membership, this superb journal led by two dedicated editors-in-chief, and an established program of annual international congresses and symposia. The congress held in Rome in January 2016 was the largest we have ever held. This coming year we are introducing a third annual conference that will be organized by, and run specifically for, the younger members of the PVRI, the Committee for Young Clinicians and Scientists. These young people are the most active members of the PVRI and are building strong links between colleagues in Europe, the Middle East, and Central Asia, which bodes well for the future of the PVRI.The PVRI has reached a crossroads. What should be our priorities, and how best should we expend our time, energy, and limited financial resources?The PVRI differs from all other organizations concerned with pulmonary hypertension in that it is global, with a mandate to help improve the care of patients all over the world. The unsung heroes and heroines of the PVRI are those working in the regional task forces. Members of the PVRI can write helpful guidelines and organize master classes and e-learning materials, as we do, but the practicalities of patient care have to be understood and learned locally. The key here is to hold national and smaller local meetings, and several regions do now hold their own annual symposia. PVRI India is about to set a wonderful example by holding a 2-day meeting next May, the first day to take place in the south of the country and the second day in the north, both meetings to be webcast to centers throughout India. It will be important for each region to establish its own pattern of annual events. Many developing countries share similar experiences, and the PVRI is ideally placed to help them support each other. There is now close collaboration between Saudi Arabia and Central Asia, but this approach should be expanded, particularly to sub-Saharan Africa. We also need to bring continents together. Next year there will be two PVRI-sponsored
