1st EUROPEAN NASH-NAFLD POLICY SUMMIT REPORT , 31st May 2017

The first European Policy Summit on non-alcoholic fatty liver disease was organised by the European Liver Patients’ Association (ELPA) in partnership with the European Association for the Study of the Liver (EASL) and took place in the European Parliament the 31 of May 2017 hosted by Alojz Peterle, Member of the European Parliament (MEP). The event was moderated by ELPA Vice President Marko Korenjak and EASL EU Counsellor Prof Helena Cortez-Pinto.

The Summit was divided into four parts: a session setting out the challenges and giving a medical overview, followed by three different sessions aimed at identifying the economic burden of the disease, defining the role of the EU and what concretely it can do to fight this disease and presenting the patient perspective. The Summit gathered together European and national policy makers, leading clinicians, experts and patient advocacy groups active in liver diseases to call for a concrete action across Europe in the face of the next major public health challenge to be faced in Europe. As Alojz Peterle stated: “as Members of the European Parliament we were elected to represent the voice of the European citizens. When it comes to health issues we must therefore speak in one voice with our patients and do everything in our power and position to put NAFLD-NASH challenge in the centre of our policy efforts”.

EVENT OBJECTIVES
The Summit had the following main objectives:
– Make policy-makers, decision-makers and general public understand what NAFLD-NASH are
and their socio-economic impact on our society.
– Identify how policy can help put in place an effective strategy to face this new public health threat.
– Identify concrete next steps that would help in tackling this new challenge.
– Start engaging key stakeholders to find effective policy answers.
– Establish ELPA – EASL leadership in non-alcoholic fatty liver disease policy arena.

MAIN OUTCOMES
Prof. Vlad Ratziu introduced the clinical aspects of NAFLD and NASH highlighting how statistics for nonalcoholic fatty liver disease are alarming: at global level its prevalence is 25% and it affects all strata of the population. He called for interventions that will also have an impact on other non-commutable diseases including cardiovascular diseases and diabetes. Dr. Homie Razavi anticipated the results of its study on disease burden of non-alcoholic fatty liver disease showing that in absence of interventions liver diseases associated with NAFLD will more than double over the next 15 years. He suggested that the EU should promote awareness of NAFLD and strategies to reduce the disease burden (including weight loss and diet) and called for better reporting systems to track NAFLD related disease burden to measure progress. Participants explored potential measures to reduce the burden of the disease and to mitigate the impact that non-alcoholic fatty liver diseases will have on the sustainability of European healthcare systems as ELPA President, Tatjana Reic, pointed out: “the seriousness of NAFLD and the potential impact it will have on healthcare systems needs to be recognised and addressed before we encounter an epidemic across Europe. The community needs to take action to establish effective policies for early detection and effective therapies, and put more effort into prevention policies across the European Union.” ELPA Vice President, Marko Korenjak, asked for “a strong role of patient organizations and of European policy-makers in facing this new public health challenge to ensure that this topic is high on the political agenda in order to find adequate solutions to avoid that action will be taken too late when this epidemic will have badly hitten Europe and its member healthcare systems”. For, European Parliament is the voice of the citizens therefore one of the voices of patients in Europe together with patient organizations. At present, these diseases are not a priority in the EU. Although EU member states are guardian of the exclusive competence on health, the European institutions could act vigorously inducing member countries to take action on this new public health challenge. The hepatitis C example was mentioned as a pathway
to be followed: the EU is supporting member states in fighting this disease through concrete actions to keep the topic high in the political agenda not only at EU level but at national level. As a result, countries are not only committing to eliminate the disease but implementing concrete actions to achieve this objective. As explained by Mrs Ingrid Keller (DG Health and Food Safety): “the EU has at its disposal some policy tools to shape the environment: funding programmes such as Horizon 2020 and the EU Health Programme”. If the first one is focused on research and innovation, the second one aims at promoting health, protecting citizens from serious cross-border health threats, providing support to build sustainable health systems and facilitating access to better and safer healthcare. Moreover, the European strategies, including for example 2007 Strategy on Nutrition, Overweight, and Obesity-related Health Issues or the Council Conclusions on Nutrition and Physical Activity adopted in June 2014. ELPA was honoured by EU Commissioner for Research and Innovation, Carlos Moedas’ video where he pointed out being a patient himself and stressed the “need to scale up efforts in research and innovation to develop simple, cost-effective and non-invasive tests” that will allow to “improve guidance to member states on primary care and better management”.

In the closing remarks, prof Helena Cortez-Pinto, the EU Counsellor at EASL, reminded that MEPs missed a rare prevention opportunity to restrict the marketing of junk food to minors when debating the Audio Visual Media Services Directive: “childhood obesity is the plague of the 21st century and MEPs could have tightened restrictions on marketing to minors”. The Summit ended giving the floor to two NAFLD patients (introduced by Prof. Sven Francque) who shared their stories and pointed out how their biggest challenge is to understand this disease, how to treat it, how to change lifestyle and diet.

NEXT STEPS
– The Steering Committee will meet in Autumn to start planning next year edition.
– By the end of 2017 the programme and the content will be presented to Commissioner Moedas.
– In the beginning of 2018 the Steering Committee will gather again to define the agenda and
prepare key recommendations (to be announced during the Summit).
– The new agenda will be sent out within March 2018.
– All participants, from policy makers to world leading physicians, were very satisfied by the Summit
and expressed their interest in participating in the next year edition, always in May.
News about the Summit were published, among others, on: Global Liver Institute (July Health Policy Update), Aboutpharma Italy, Diabete Com, IstoIndex Singapore (Nash Highlights), Inovasi, World News, SlovenjaHep, Pressportal Switzerland and Germany, Kompetenz Germany, Firmen DB, Freedom Germany, Nachrichten Actuell Austria, Austria Shafaqna, UCC Irland, Irish Tech News. Disclosure: the 1st EU Nash-Nafld Policy Summit received unrestricted grants from: BMS, Genfit, Intercept.