Scientists Call for Urgent Measures to Combat the Silent Surge of Liver Diseases

In a groundbreaking convergence of global health experts, the unveiling of the first meeting of the Global Think-tank on Steatotic Liver Disease has cast a critical spotlight on a silently escalating public health crisis. Convened within the historic Palau Macaya in Barcelona and supported by the Barcelona Institute for Global Health (ISGlobal), the assembly drew more than 100 international specialists who collectively issued an urgent alert: the vast majority of individuals affected by metabolic dysfunction-associated liver diseases remain undetected within current healthcare frameworks. This invisibility poses a profound risk, with many cases progressing to severe liver complications before diagnosis is achieved.

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a pervasive yet covert threat, currently afflicting approximately one-third of adults worldwide. This prevalence underscores the necessity for heightened awareness and early detection strategies. Within this spectrum lies metabolic dysfunction-associated steatohepatitis (MASH), a more aggressive variant that affects approximately 5% of the general population but often evades clinical identification until irreversible liver damage, such as cirrhosis or hepatocellular carcinoma, has ensued. The silent progression of MASH, particularly among individuals displaying risk factors such as type 2 diabetes and obesity, challenges existing paradigms of liver disease management and necessitates a shift towards preemptive medical intervention.

Compelling scientific discourse emerged alongside the simultaneous publication in The Lancet Regional Health – Europe, where eminent hepatology and metabolic researchers advocated for a transformative objective: to double the diagnosis rate of MASH by the year 2027. This ambitious target recognizes the gap between disease burden and clinical recognition, illuminating the pressing need for innovative diagnostic approaches. Early identification holds the promise of intercepting disease progression, enabling timely therapeutic intervention that could substantially reduce morbidity, mortality, and the overarching healthcare costs attributed to advanced liver pathology.

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Central to this diagnostic revolution is the integration of non-invasive modalities and artificial intelligence (AI)-driven technologies. Techniques such as transient elastography, controlled attenuation parameter (CAP) imaging, and serum biomarker panels are emerging as frontline tools capable of stratifying risk with minimal patient burden. Coupled with AI algorithms trained on vast clinical datasets, these methods enhance predictive accuracy, optimize resource allocation, and facilitate their deployment within primary care settings where early interaction with at-risk populations frequently occurs. This synergy between technology and clinical practice heralds a new era of accessibility and efficiency in liver disease diagnostics.

Furthermore, the therapeutic landscape for MASLD and MASH is rapidly evolving, marked by the recent approval of a novel pharmacological agent demonstrating efficacy in halting or reversing inflammatory and fibrotic processes within the liver. This advancement amplifies the imperative for timely diagnosis, as access to effective treatment is now a tangible reality rather than a distant goal. Medical leaders emphasize that treatment innovations, however promising, must be paired with comprehensive screening and diagnostic frameworks to maximize patient outcomes and alleviate the burgeoning public health burden.

Achieving a paradigm shift by 2030 demands a cohesive and multifaceted strategy. Experts propose embedding routine liver disease screening protocols within existing health check-up regimens, particularly targeting individuals with established metabolic risk factors. Such integration warrants recalibration of healthcare policies, including reimbursement mechanisms that incentivize primary care practitioners to adopt liver testing algorithms proactively. Multidisciplinary collaboration transcending hepatology to include endocrinology, cardiology, and patient advocacy groups is pivotal to crafting resilient care pathways tailored to diverse patient populations.

Authors and leaders, including Dr. Jeffrey Lazarus of ISGlobal’s Public Health Liver Group, emphasize the critical transition from reactive to preventive hepatology. The future of liver disease management hinges on anticipation—not merely addressing patients with advanced fibrosis but systematically identifying and managing those at an earlier, asymptomatic stage. This preventive approach could profoundly impact global metabolic health, reducing progression rates and ultimately mitigating the associated societal and economic tolls.

Concurrently, the Global Think-tank has spotlighted the imperative to reformulate the discourse surrounding liver disease through the People-First Liver Charter, recently published in Nature Medicine. This groundbreaking initiative challenges stigmatizing terminology and advocates for language that foregrounds the individual rather than clinical labels. The charter’s person-centred care framework is designed to foster dignity, respect, and equity within healthcare interactions, recognizing that stigma and discrimination frequently delay diagnosis and treatment, thereby exacerbating disease outcomes. Endorsed by more than 70 organizations worldwide, this movement seeks to recalibrate societal and clinical perceptions, fostering more compassionate, inclusive health environments.

The evolving epidemiology of liver disease in Spain exemplifies the broader global trends. Data reveal a concerning escalation; in 2021, the Spanish population living with MASLD numbered approximately eight million, with projections indicating a surge to 12.7 million individuals—over a quarter of the nation’s population—by 2030. MASH cases are expected to climb from 1.8 million in 2016 to 2.7 million by the end of the decade. Correspondingly, mortality attributable to MASH is forecasted to double, reaching nearly 7,600 deaths annually, with healthcare expenditures exceeding $3.5 billion by 2040, more than doubling current costs. This data compels urgent policy reforms and systemic responses.

Spain’s response, as urged by Dr. Lazarus, involves the development of a comprehensive national strategy under the stewardship of the Ministry of Health, collaborating closely with autonomous regional authorities. Key components include the establishment of a MASLD registry, integration of MASLD metrics into core health indicators, augmented training programs for healthcare workers, implementation of automated diagnostic tools in primary care, and bolstering community-based support services. Such an approach would position Spain as a potential leader in addressing this escalating challenge, providing a model for other nations grappling with similar epidemics.

Despite its enormous prevalence—estimated to affect over 1.5 billion people globally—chronic liver disease has largely been marginalized within the broader umbrella of non-communicable diseases (NCDs). This oversight represents a critical gap in both global health policy and clinical practice. With the United Nations High-Level Meeting on NCDs scheduled for September 2025, the experts convened in Barcelona have called emphatically for this historical neglect to be rectified. Integrating chronic liver diseases into global health agendas and national NCD frameworks is essential for securing resources, guiding policy, and galvanizing coordinated international efforts.

The intersection of emerging technology, novel therapeutics, comprehensive policy, and stigma reduction forms a multifaceted battlefront against MASLD and MASH. This urgent campaign demands not only medical innovation but also systemic commitment to transforming care delivery landscapes. Only through early diagnosis, inclusive language, targeted public health strategies, and interdisciplinary collaboration can this silent epidemic be unveiled, addressed, and ultimately curtailed.

As the global community stands at this critical juncture, the imperative is clear: embrace a proactive, anticipatory, and person-centred approach to metabolic liver diseases. Doing so promises a future where millions are spared the devastating consequences of advanced liver pathology, healthcare systems mitigate unsustainable burdens, and affected individuals reclaim dignity and quality of life. The window for transformative action is now, and the stakes could not be higher.

Subject of Research: People

Article Title: A call for doubling the diagnostic rate of at-risk metabolic dysfunction-associated steatohepatitis

News Publication Date: June 5, 2025

Web References:

Global Think-tank on Steatotic Liver Disease: https://sldthinktank.com/
The Lancet Regional Health Europe article: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(25)00112-7/fulltext
People-First Liver Charter: https://www.nature.com/articles/s41591-025-03759-8
MASLD/MASH in Spain Policy Brief: https://sldthinktank.com/policy_and_insights/masld-mash-in-spain-a-liver-health-policy-brief/

References:

Lazarus, Jeffrey V. et al. “A call for doubling the diagnostic rate of at-risk metabolic dysfunction-associated steatohepatitis.” The Lancet Regional Health – Europe, 2025.
Lazarus, J.V., Ivancovsky Wajcman, D., Pannain, S., et al. “The People-First Liver Charter.” Nature Medicine, 2025.

Keywords: Liver damage, Steatohepatitis, Artificial intelligence, Medical diagnosis

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