Barcelona, Spain – A global think-tank of over 100 international experts convened in Barcelona, issuing a critical call to action: millions are at risk of remaining undiagnosed and untreated for steatotic liver disease unless healthcare systems prioritize early detection and person-centered care. Teh meeting, supported by the Barcelona Institute for Global Health (ISGlobal), highlighted the urgent need for a paradigm shift in addressing this growing public health threat.

The Invisible Threat: MASLD and MASH

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects approximately 33% of adults worldwide.its more aggressive form, metabolic dysfunction-associated steatohepatitis (MASH), impacts an estimated 5% of the global population. Individuals with type 2 diabetes, obesity, or other cardiometabolic risk factors face a substantially elevated risk. The insidious nature of MASH lies in its frequently enough symptom-free progression until advanced stages, where it can lead to cirrhosis or liver cancer.

A recent article in The Lancet Regional Health europe features leading hepatology and metabolic health experts urging health systems to double the MASH diagnosis rate by 2027. The paper emphasizes that this advanced disease silently affects millions, with missed opportunities for timely intervention that could improve outcomes and reduce healthcare burdens.

the experts highlight the potential of non-invasive tools and AI-based technologies to identify at-risk patients in primary care. The recent approval of a new treatment further underscores the urgency for improved diagnostic access.The authors argue that effective treatments must be coupled with better diagnosis.

Jeffrey Lazarus, Head of the Public Health Liver Group at ISGlobal, emphasized the importance of preventive measures.

To combat MASH and eliminate this growing public health threat by 2030, the authors propose concrete actions:

• Routine screening for at-risk groups.
• Integrating liver testing into regular health check-ups.
• Updating reimbursement policies.
• Fostering collaboration across primary care, endocrinology, cardiology, and patient organizations.

Reimagining Liver Disease: Language and Care

In a parallel effort, over 40 experts published the Peopel-First Liver Charter in Nature medicine, advocating for an end to the stigma surrounding liver diseases. This stigma frequently enough delays timely diagnosis and treatment. The authors call for a shift towards person-centered language and care models that prioritize the individual over the diagnostic label. This approach aims to promote respect, empathy, and reduce health inequities, aligning with recent global efforts to rename liver diseases with more inclusive terms, thereby enhancing dignity and empowerment for patients. The charter has garnered endorsement from over 70 organizations.

Chronic Liver Disease in Spain: A Case Study

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

Key statistics for Spain:

• 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, projected to increase to 2.7 million by 2030.
• MASH-related mortality is expected to double, reaching around 7,590 deaths in 2030.
• Direct healthcare costs associated with the disease could more than double, from $1.48 billion in 2021 to $3.5 billion in 2040.

Lazarus recommends a thorough national strategy:

We recommend a national strategy lead 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.
Jeffrey Lazarus, Head of the Public Health Liver group at ISGlobal

Despite affecting more than 1.5 billion people, chronic liver disease remains largely excluded from global strategies to address non-communicable diseases (NCDs). With the United Nations high-Level Meeting on NCDs approaching in September 2025, experts in Barcelona called for the accelerated integration of chronic liver diseases into global health policies and clinical practice.