Since the inception of Essential Pain Management (EPM) and the first program in Lae, Papua New Guinea, in 2010, 19 countries have hosted EPM programs, training more than 1433 participants and 292 local instructors. Thirty-two external instructors have been trained to deliver the program and a further 32 have expressed interest. It is a good time to review where we have been, where we are now and where we are going.