Scientific Community Urges Greater Action Against the Silent Rise of Liver Diseases

During the first meeting of the Global Think-tank on Steatotic Liver Disease, supported by the Barcelona Institute for Global Health (ISGlobal) and held in the Palau Macaya of Barcelona on 5–6 June, more than 100 international experts issued a stark warning: millions of people will continue to go unseen by healthcare systems unless early detection and person-centred care for liver disease are prioritised without delay.

A common but invisible disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects around 33% of adults globally. Its more aggressive form, metabolic dysfunction-associated steatohepatitis (MASH), is estimated to affect 5% of the general population. People with type 2 diabetes, obesity or other cardiometabolic risk factors are at significantly higher risk. However, despite its severity, MASH often shows no symptoms until it reaches an advanced stage -when it can progress to cirrhosis or liver cancer.

On 5 June 2025, The Lancet Regional Health Europe published an article in which leading hepatology and metabolic health experts call on health systems to double the MASH diagnosis rate by 2027. This advanced disease affects millions silently and is rarely detected early, representing missed opportunities for timely intervention that could improve outcomes and reduce healthcare burdens.

The paper highlights non-invasive tools and AI-based technologies that can help identify at-risk patients in primary care, as well as the recent approval of a new treatment, which makes the need for improved diagnostic access all the more pressing. Effective treatments must go hand in hand with better diagnosis, the authors argue.

To deliver a paradigm shift in the response to MASH and eliminate this growing public health threat by 2030, the authors propose concrete actions such as routine screening for at-risk groups, integrating liver testing into regular health check-ups, updating reimbursement policies, and fostering collaboration across primary care, endocrinology, cardiology, and patient organisations.

“The future of the fight against MASH lies in anticipation: not only treating advanced patients but also identifying those without fibrosis early on. This shift towards preventive hepatology is key to improving the metabolic health of millions around the world,” says  Jeffrey Lazarus, Head of the Public Health Liver Group at ISGlobal, a centre supported by the ”la Caixa” Foundation, and lead author of the study.

Changing the language and care around liver disease

In parallel, over 40 experts have published the People-First Liver Charter in Nature Medicine, a roadmap to end the stigma surrounding liver diseases, which often delays timely diagnosis and treatment. The authors call for a shift towards person-centred language and care models that prioritise the individual over the diagnostic label. This approach aims to promote respect, empathy and reduce health inequities, in line with recent global efforts to rename liver diseases with more inclusive terms, thereby enhancing dignity and empowerment for patients. It has been endorsed by 70+ organisations. 

Chronic liver disease in Spain

A policy brief focusing on Spain was also presented during the Global Think-tank, analysing the current situation and offering concrete recommendations to advance the national health system’s response to MASLD/MASH. Spain is facing a significant rise in liver disease cases, with a growing impact on mortality and healthcare costs.

In 2021, approximately eight million people in Spain were living with MASLD. This figure is expected to rise to 12.7 million (27.6% of the population) by 2030. In 2016, there were an estimated 1.8 million cases of MASH, a number projected to increase to 2.7 million by 2030. As a result, MASH-related mortality is expected to double, reaching around 7,590 deaths in that year. Furthermore, direct healthcare costs associated with the disease could more than double, from $1.48 billion in 2021 to $3.5 billion in 2040.

Faced with this scenario, Lazarus warns: “We recommend a national strategy led by the Ministry of Health and in close collaboration with all autonomous communities that includes a MASLD registry, its inclusion in key health indicators, enhanced training for healthcare professionals, automated diagnosis in primary care, and strengthened community-based services.”

Although it affects more than 1.5 billion people, chronic liver disease remains largely excluded from global strategies to address non-communicable diseases (NCDs). With less than four months until the United Nations High-Level Meeting on NCDs, set to take place in September 2025, experts gathered in Barcelona called for this historical gap to be closed and for the accelerated integration of chronic liver diseases into global health policies and clinical practice.

"Health promotion is key to both preventing steatotic liver disease onset and slowing its progression. Hence, we need public health policies aimed to rising awareness, promoting healthy behaviors, implementing evidenced-based community interventions, promoting early detection, and reducing health inequalities" stated Esteve Fernández Muñoz, Secretary for Public Health of the Government of Catalonia, Spain, during the meeting.

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. https://doi.org/10.1016/j.lanepe.2025.101320 

Lazarus, J.V., Ivancovsky Wajcman, D., Pannain, S. et al. The People-First Liver Charter. Nat Med (2025). https://doi.org/10.1038/s41591-025-03759-8