Hon’ble Shri Ashwini Kumar Chaubey ji, Minister of State for Health and Family Welfare; Dr Vandana Gurnani, Additional Secretary, Health; Dr Sunil Kumar, Director General Health Services; Dr SK Sarin, Director, ILBS; distinguished experts and policy makers from the Centre and the States,
It is my pleasure to join you today to celebrate World Liver Day.
I am delighted to note that India is the first country in the world to include non-alcoholic fatty liver disease (NAFLD) in its national programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke. Congratulations, Hon’ble Minister, Dr Harsh Vardhan, for taking this lead.
The global prevalence of NAFLD is estimated to be about 24%, and is an increasingly important cause of cirrhosis, liver cancer and end-stage liver disease.
A systematic review published in the Lancet in 2019 showed that the overall prevalence of NAFLD in adults in Asia varies from 15% to 40%.
In India, the community prevalence of NAFLD varies from 5% to 32%, depending on age, gender, area of residence and socioeconomic status.
It is estimated that between 1990 and 2017 there has been a 100% increase in the incidence of new liver cancer cases, two-thirds of which are attributable to viral hepatitis, and 16% due to unknown causes, including NAFLD.
NAFLD is the third most common cause of cancer-related deaths worldwide, and its growing burden may increase the incidence of hepato-cellular carcinoma and mortality.
It is imperative that all countries in the Region develop and implement national action plans to prevent and control liver diseases, including NAFLD, for which a range of evidence-based policies can be applied.
We have heard that many patients with NAFLD have a high risk of liver-related morbidity and mortality along with metabolic comorbidities, and that this may place a growing strain on health care systems.
For countries to meet this challenge, and develop context-specific preventive and therapeutic interventions, they must understand the NAFLD burden, for which high-quality data are needed.
We are all aware that metabolic syndromes such as obesity, diabetes and high cholesterol are strong risk factors for NAFLD. Hence, it is crucial that policy makers and health care providers promote health-positive behaviours such as physical activity and healthy eating that help prevent NAFLD.
The WHO package of essential noncommunicable disease (NCD) interventions must continue to be rolled out across the Region to enhance early diagnosis and management of chronic liver diseases, including NAFLD, and it is heartening that all Member States have now adopted this innovative tool.
I encourage all countries to include interventions to address NAFLD in their multisectoral NCD action plan, and to also integrate these interventions with the Regional Strategy and Action Plan on Hepatitis.
Together, we must continue to advance liver health in a coordinated and strategic manner, at every step of the policy, planning, implementation, monitoring and evaluation continuum.
Distinguished participants,
WHO is committed to supporting all countries in the Region to prevent and control NCDs and achieve universal health coverage (UHC) – two of the Region’s eight Flagship Priorities.
The strategic vision of the primary health care movement, which was launched at Alma Ata in 1978, and renewed with the Almaty Declaration of 2018, is essential to our onward progress towards UHC, which will in turn help prevent and control NAFLD.
However, we face a range of challenges, the most pressing of which is the ongoing COVID-19 pandemic.
The Region is right now experiencing a dramatic upsurge in cases, and it is vital that countries continue to strengthen public health measures that stop infections and save lives, such as adequate surveillance, testing and contact tracing, and supportive quarantine and compassionate care.
Consistent use of masks, hand hygiene, ventilation and social distancing continues to be our best guards even today, and should be strictly followed, even by people who have already been vaccinated.
Crucially, countries must continue to maintain essential health services, which has been a key point of focus throughout the response.
We must advance the Region’s Declaration on the Collective Response to COVID-19, and continue to promote increased financial allocations towards health, with the aim of strengthening health system resilience in all countries of the Region.
On World Liver Day, I leave you with four messages to advance liver health and promote a healthier and more sustainable future for all.
First, choose a healthy and balanced diet that is primarily plant-based and rich in fruits, vegetables, whole grains and healthy fats.
Second, maintain a healthy weight by consuming a healthy diet combined with regular exercise.
Third, say no to alcohol, smoking and drugs.
And fourth, be sure to get vaccinated against hepatitis B, so that together we may end its unnecessary burden.
I wish this conclave all success and take this opportunity to thank the Hon’ble Minister for his leadership, the team of technical experts – led by Dr Sunil Kumar and Dr SK Sarin – and the WHO collaborating centre for hepatitis, for their untiring efforts to advance liver health and end major NCDs.
Thank you.