The Ministry of Health & Family Welfare recently made headlines with their new operational guidelines for integrating Non-Alcoholic Fatty Liver Disease (NAFLD) with the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS). Launched in 2010 under the National Health Mission (NHM), the NPCDCS aims to prevent and control Non-Communicable Diseases (NCDs).
Understanding NAFLD
NAFLD refers to the unusual build-up of fat in the liver, excluding secondary factors such as excessive alcohol use or viral hepatitis. Essentially, fatty liver disease occurs when excess fat accumulates in liver cells. This condition is a pressing health concern, as it includes a range of liver abnormalities.
These range from a straightforward non-alcoholic fatty liver (NAFL, simple fatty liver disease) to more severe conditions such as non-alcoholic steatohepatitis (NASH), cirrhosis, and even liver cancer. Steatohepatitis implies inflammation of the liver along with concurrent fat accumulation, while mere fat deposition is called steatosis. Cirrhosis, on the other hand, is a severe complication involving loss of liver cells and irreversible scarring of the liver.
Moreover, NAFLD poses an independent predictor of future risk for cardiovascular diseases, type 2 diabetes, and other metabolic syndromes like hypertension, abdominal obesity, dyslipidaemia, and glucose intolerance.
Risks Associated with NAFLD
Over the last two decades, the global burden of NASH has seen a significant increase, with more than a twofold rise. Notably, NASH caused 40 lakh prevalent cases of compensated cirrhosis in 1990, which rose dramatically to 94 lakh cases in 2017.
Epidemiological research highlights that NAFLD affects approximately 9% to 32% of the general Indian population, with a higher incidence in overweight or obese individuals and those with diabetes or prediabetes. Once this disease develops, no specific cure exists. The only viable solution is health promotion and prevention methods targeting weight reduction, healthy lifestyles, which could prevent NAFLD-related mortality and morbidity.
Government Measures for NAFLD Control
The government has taken significant steps to control NAFLD, including aligning NPCDCS programme strategies. This aims to prevent and manage NAFLD by promoting behavior changes, encouraging early diagnosis, and building capacity at various healthcare levels.
As part of the Ayushman Bharat scheme, the government is pushing for enhanced screening of cancer, diabetes, and hypertension. Alongside the ‘Eat Right India’ and ‘Fit India Movement’, the government’s overall vision is to shift focus from Diagnostic Cure to Preventive Health.
