Liver disease takes many forms. Types range from alcoholic liver disease to cirrhosis to fatty liver disease, among many others. In India, many are at risk. As reported by Health Issues India in 2017, liver disease – then identified by the World Health Organization (WHO) as the tenth most common cause of death in India – was set to affect one in five Indians.
The importance of the liver cannot be understated. “The liver…is responsible for performing crucial functions related to immunity, digestion, metabolism, storage of absorbed nutrients, and excretion. Keeping your liver in good shape is the key to preventing liver diseases,” explains Dr Amit Jain, MS MCh (GI Surgery) FMAS FALS FIAGES. Liver health can be maintained by a range of lifestyle factors, including maintaining a balanced diet and a healthy weight; vigilance against hepatitis; and responsible consumption of alcohol.
Yet India faces a number of issues. Its obesity burden has steadily risen in recent years. Alcohol consumption, similarly, has increased. And the country shoulders a substantial burden of hepatitis, with viral hepatitis affecting almost sixty million Indians and killing 1.5 lakh people in the country annually.
The Union Ministry of Health and Family Welfare, on World Liver Day (observed today with the theme of ‘Keep your liver healthy and disease-free’), tweeted “this World Liver Day, let’s pledge to take care of our liver and also spread awareness about causes of liver disease and tips for prevention.” Awareness, indeed, is key. Only by promoting the benefits of a healthy liver and the means by which to lower one’s chance of developing liver disease can the scourge of liver disease be mitigated.
One particularly important point is the need to increase availability of liver transplants for those affected by liver disease. As we noted in 2017, “once a patient has severe cirrhosis the life expectancy is around two to three years without a liver transplant. The situation regarding liver transplants mirrors that…of the kidney transplant market. For kidneys there is a mass shortage of transplants being performed, with most sourced from living people, rather than cadavers. This has led to a thriving black market.
“Liver transplants also follow this trend, with 97 percent of transplants sourced from living people. This is despite the simpler and more effective transplant methods of sourcing from cadavers. The number of operations occurring, much the same as with kidneys, is far fewer than is needed.”
Fundamentally, reforms ought to be made. Increased availability of treatment, awareness of preventative measures, and – if needed – a system to ensure transplants can be accessed by those who need them will be needed if India is to course-correct when it comes to liver disease.