The EU's Health Crusade: Battling Non-Communicable Diseases, but is it Enough?
The EU's ambitious Healthier Together initiative is at a crossroads. As it enters its final phase, experts are sounding the alarm about a critical oversight: the program's potential failure to address liver health and obesity, two interconnected issues at the heart of Europe's metabolic crisis.
But here's where it gets controversial: Despite the initiative's focus on non-communicable diseases (NCDs), liver disease, a key player in metabolic health, is conspicuously absent. This omission, according to Cyrielle Caussy, a professor at Lyon 1 University, means ignoring a central organ driving Europe's NCD epidemic. The liver's role in glucose and lipid metabolism, as well as its direct link to various NCDs, is undeniable.
Steatotic liver disease (SLD), a condition affecting four in ten adults globally, remains largely unnoticed in EU strategies, including Healthier Together. This oversight is partly due to the persistent misunderstanding of obesity, which is not merely about weight, but about adipose tissue dysfunction, as explained by Dra Andreea Ciudin Mihai from the Universitat Autònoma de Barcelona.
A glimmer of hope emerges with new GLP-1 medicines, hailed as game-changers for diabetes, fatty liver, and cardiovascular disease. However, access is limited due to lack of reimbursement, highlighting a stark inequality. Prof Caussy emphasizes that those who need these drugs the most often cannot afford them.
And this is the part most people miss: Early detection of advanced liver disease is both feasible and cost-effective, yet it is not widely implemented. A simple FIB-4 score, a free test, can indicate risk, and more accurate methods like trans-elastography are available for follow-up. Prof Dr Gamal Shiha from the European Liver Patients' Association underlines the importance of patient education and selection for specialist care.
The prevention gap is a growing concern. Dr Kremlin Wickramasinghe from the WHO Regional Office for Europe points out that 80% of deaths are caused by risk factors that are rarely discussed with patients. He advocates for a health system that addresses these factors and reduces stigma. Before investing in expensive screening machines, he suggests integrating primary healthcare and reducing the burden.
The EU's policy shortcomings are also in the spotlight. MEP Tomislav Sokol criticizes the slow progress on front-of-pack nutrition labelling, warning that prevention may fall through the cracks in the next financial framework. He argues that the EU's powers on labelling, marketing, and prevention are underutilized, and that political courage is needed to prioritize long-term health solutions.
As Healthier Together nears its conclusion, the question remains: Can the EU truly turn the tide on NCDs without addressing liver health and obesity? The evidence and solutions are at hand, but will they be acted upon? The future of Europe's health hangs in the balance, and the decisions made now will shape the well-being of its citizens for years to come.
