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The global NAFLD policy review and preparedness index : Are countries ready to address this silent public health challenge?

The global NAFLD policy review and preparedness index : Are countries ready to address this silent public health challenge?


Title: The global NAFLD policy review and preparedness index : Are countries ready to address this silent public health challenge?
Author: NAFLD policy review collaborators
Date: 2022-04
Language: English
Scope: 10
Department: Office of Division of Clinical Services I
Faculty of Medicine
Series: Journal of Hepatology; 76(4)
ISSN: 0168-8278
DOI: https://doi.org/10.1016/j.jhep.2021.10.025
Subject: Adult; Global Health; Humans; Non-alcoholic Fatty Liver Disease/complications; Obesity/complications; Policy; Public Health
URI: https://hdl.handle.net/20.500.11815/3336

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Citation:

NAFLD policy review collaborators 2022 , ' The global NAFLD policy review and preparedness index : Are countries ready to address this silent public health challenge? ' , Journal of Hepatology , vol. 76 , no. 4 , pp. 771-780 . https://doi.org/10.1016/j.jhep.2021.10.025

Abstract:

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas. METHODS: We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied. RESULTS: The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were categorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and <2% of the different strategies for related conditions included any mention of NAFLD. National NAFLD clinical guidelines were present in only 32 countries. CONCLUSIONS: Although NAFLD is a pressing public health problem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at national and global levels. LAY SUMMARY: Around a third of the countries scored a zero on the NAFLD policy preparedness index, with no country scoring over 50/100. Although NAFLD is a pressing public health problem, a comprehensive public health response is lacking in all 102 countries. Policies and strategies to address NAFLD at the national and global levels are urgently needed.

Description:

The data collection and analysis were funded by the EASL International Liver Foundation with support from, Intercept, Bristol-Myers-Squibb Company, Genfit, and MSD. Data collection for the original European data was funded by the EASL International Liver Foundation supported by Gilead Sciences Europe Ltd., Allergan Pharmaceutical International Ltd., Bristol-Myers-Squibb Company, Pfizer Inc., and Resoundant Inc. Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

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