Professor Downing serves on the Boards of several NGOs including the International Association of Hospice and Palliative Care, Hospice in the Weald, the African Palliative Care Association UK, the Palliative Care Association of Uganda and the Palliative Care Research Society. She is a Visiting Professor at Edge Hill University and the University of South Wales in the UK and the University of Belgrade in Serbia. She is also a Senior Honorary Research Fellow with the Cicely Saunders Institute at King’s College London, England. She was the recipient of the IJPN’s Development Award in 2006, the Robert Tiffany lectureship from the ISNCC in 2014, the Pearl Moore “Making a Difference” International Award for Contributions to Cancer Care from the Oncology Nursing Society in 2015 and was recognised as one of eight ‘Change Agents in Cancer Care’ in a publication on Women as Change Agents in Oncology in 2016.