Health

NAFLD: Sounding the alarm on a global public health challenge

March 08, 2021

Global

NAFLD: Sounding the alarm on a global public health challenge

March 08, 2021

Global
Elly Vaughan

Senior Manager, Global Health Policy and Insights at Economist Impact

Elly is Senior Manager, Global Health Policy and Insights, at Economist Impact. Alongside working on a variety of projects on non-communicable diseases, Elly has specific expertise in emergency preparedness and response, as Lead of the Global Health Security Index and having worked on a number of reviews for the European Centre for Disease Prevention and Control (ECDC) and Robert Koch Institute, including several peer-reviewed publications.

NAFLD is a silent and under-recognised global health challenge, affecting a quarter of the adult population. This report focuses on a global call to action and highlights priorities for three of the most affected regions.

Non-alcoholic fatty liver disease (NAFLD) is a little-known condition, yet a quarter of the global adult population is estimated to have it. The majority of people living with the disease exhibit no symptoms, consequently the condition often goes undiagnosed until more advanced stages, leading to worse long-term outcomes for patients and a greater burden on health systems. General awareness of the condition amongst the public and non-liver specialist healthcare providers is also low.

NAFLD shares a close relationship with type 2 diabetes, obesity and other non-communicable diseases, including cardiovascular disease. The actions required to prevent and control NAFLD overlap with the measures required for many other non-communicable diseases.

Despite the rising numbers of people affected and its substantial economic impact, NAFLD has received little attention in national and global health agendas. This programme sought to explore the opportunities and challenges for raising the profile of NAFLD within national, regional and global health policy agendas, with a specific focus on the Asia-Pacific, Latin America and Middle East regions.

A series of four workshops was held in each region, bringing together a total of 55 experts, from multiple disciplines. Global and regional calls to action were developed, based on these discussions. 

Global NAFLD call to action:

  • Awareness

    • Tailor awareness raising at a local level

    • Identify liver health champions

    • Conduct interdisciplinary, collaborative research

    • Make the investment case

  • Risk stratification

    • Articulate clear, written NAFLD care pathways

    • Define efficient and effective risk stratification approaches

    • Develop guidance for primary care management

    • Promote identification of active cases in high-risk groups

  • Integrated care

    • Integrate NAFLD into relevant clinical guidelines 

    • Prioritise patient-centred approaches to integrated care models 

    • Grow the evidence base through pilots and evaluation

    • Share lessons learned to collectively develop new models of care

  • Patient involvement

    • Form and nurture patient groups where possible

    • Engage existing diabetes and liver patient groups

    • Involve patients in service design

  • NCD integration

    • Use existing policy levers to incorporate NAFLD in to the NCD movement

    • Collaborate with existing NCD groups

    • Create an evidence base to make the investment case

    • Engage the “metabolic disease” family to create joint standards

Ultimately, this programme aimed to help fill the gap in strategic guidance around how to shape and deliver more comprehensive responses to NAFLD. Drawing extensively on the input of the expert panellists, the calls to action are the culmination of this process, which can hopefully inspire action on this pressing public health issue.

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