Everton chairman Bill Kenwright has defended the way the club is run and denies suggestions health issues are affecting his ability to do the job.
A collective of Everton fan groups has called for wholesale changes at the board level, adding that Kenwright's health was "hampering his role".
Kenwright, 77, says this is not the case and has backed the other members of the Toffees board.
"Sometimes it's not easy but there are much worse off than me," he said.
In a lengthy open letter to the 'All Together Now' campaign on Everton's website, Kenwright added: "You may well know that in April 2015, I was advised I had a chronic illness that would probably be with me for the duration.
"This is, pretty inevitably, only the start of a journey where the issues usually increase. And they have. What you may also know is that most people find a spirit that will not give in and hopefully not be beaten."
The West End theatre producer and the rest of the board of directors have not attended a home game since January after what the club described as 'threatening correspondence' was received before a game against Southampton.
A group of supporters have held peaceful protest marches before every home game since, expressing their frustration at the running of the club by owner Farhad Moshiri and the board of directors, which includes Kenwright, chief executive Denise Barrett-Baxendale, chief financial officer Grant Ingles and former Toffees striker Graeme Sharp.
Kenwright, who has been Everton chairman since 2004, says their removal will not help the team's current on-field struggles, with the Toffees only out of the Premier League relegation zone on goal difference.
He also said Barrett-Baxendale is "amongst the best of the best" and found protests against Sharp and Ingles "difficult to comprehend".
"Putting your chairman on a bed sheet in a distasteful way is something that, although it hurts, I have to get used to," he said. "But… Grant and Sharpy? On banners?"
On rumors of imminent investment in the club, Kenwright said it was a "quest that we undertake relentlessly".
"Finally, there is one indisputable fact. Your board cares. It's not nice going through what we have gone through but it hasn't stopped the work rate, the desire to grow and improve and the loyalty to this club and to Evertonians."