Health ministry integrating non-alcoholic fatty liver disease in national programme

Union Health Minister Harsh Vardhan launched the operational guidelines for integration of non-alcoholic fatty liver disease (NAFLD) into the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS), on Monday.

Vardhan noted that India is the first country in the world to identify the need for action on NAFLD. “The government of India has realised that the existing non-communicable diseases (NCD) programme’s strategies can now be aligned to achieve the objectives to prevent and control NAFLD,” he said.

The minister also said that the menace of NAFLD can be tackled with three steps which include behaviour and lifestyle changes, early diagnosis and management of the disease, building of capacity at various levels of health care for prevention, diagnosis and treatment of NAFLD.

“Once the disease develops, there is no specific cure available, and health promotion and prevention aspects targeting weight reduction, healthy lifestyle, and control of aforementioned risk factors are the mainstays to disease progression and prevent the mortality and morbidity due to NAFLD,” he specified.

Vardhan said that the government is of the view that existing NPCDCS programme strategies can easily be aligned to prevent NAFLD through lifestyle changes, early diagnosis, and management of associated non-communicable diseases as well as NAFLD. “Accordingly, doable actions have been identified with main focus on health promotion and prevention of common NCDs which would also specifically cater to the identified needs of NAFLD,” he stated.

Vardhan said that NAFLD, the abnormal accumulation of fat in the liver, is a serious health concern as it encompasses a spectrum of liver abnormalities, from a simple non-alcoholic fatty liver (NAFL, simple fatty liver disease) to more advanced ones like non-alcoholic steatohepatitis (NASH), cirrhosis and even liver cancer.

“Over the last two decades the global burden of NASH has more than doubled. Globally, NASH caused 40 lakh prevalent cases of compensated cirrhosis in 1990, which increased to 94 lakh cases in 2017. NAFLD is emerging as an important cause of liver disease in India,” he estimated.

Underscoring the importance of tackling NAFLD as a step to manage the country’s burden of non-communicable diseases, Vardhan noted, “Epidemiological studies suggest the prevalence of NAFLD is around 9 to 32 per cent of the general population in India with a higher prevalence in those overweight or with obesity and those with diabetes or pre-diabetes”.

“Researchers have found NAFLD in 40 to 80 per cent of people who have type-2 Diabetes and in 30 to 90 per cent of people who are obese. Studies also suggest that people with NAFLD have a greater chance of developing cardiovascular disease. Cardiovascular disease is the most common cause of death in NAFLD,” he added.

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