The global Fatty Liver Disease-Sustainable Development Goal country score for 195 countries and territories

Background & Aims
Fatty liver disease is highly prevalent, resulting in overarching wellbeing and economic costs. Addressing it requires comprehensive and coordinated multisectoral action. We developed a fatty liver disease-Sustainable Development Goal (SDG) country score to provide insights into country-level preparedness to address fatty liver disease through a whole-of-society lens.

Approach & Results
We developed two fatty liver disease-SDG score sets. The first included six indicators (child wasting, child overweight, non-communicable disease [NCD] mortality, universal health coverage service coverage index, health worker density, and education attainment), covering 195 countries between 1990-2017. The second included the aforementioned indicators plus an urban green space (UGS) indicator, covering 60 countries for which 2017 data were available. To develop the fatty liver disease-SDG score, indicators were categorised as “positive” or “negative” and scaled from 0–100. Higher scores indicate better preparedness levels. Fatty liver disease-SDG scores varied between countries (n = 195), from 14.6 (95% UI 8.9–19.4) in Niger to 93.5 (91.6–95.3) in Japan; 18 countries scored > 85. Regionally, the high-income super-region had the highest score at 88.8 (87.3–90.1) in 2017, while south Asia had the lowest score at 44.1 (42.4–45.8). Between 1990-2017, the fatty liver disease-SDG score increased in all super-regions, with the greatest increase in south Asia, but decreased in eight countries.

Conclusions
The fatty liver disease-SDG score provides a strategic advocacy tool at the national and global levels for the liver health field and NCD advocates, highlighting the multi-sectoral collaborations needed to address fatty liver disease, and NCDs overall.

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