“The liver is a window to the 21st century health of the European population.”

Triggered by the rising burden of liver disease in Europe occurring on a changing landscape of aetiologies, The Lancet and the European Association for the Study of the Liver (EASL) commissioned a multidisciplinary effort to delineate the current burden of liver disease throughout Europe. Our priority was to identify barriers to the improvement of liver health and identify the necessary solutions.

Liver disease is now a leading cause of years of working life lost in Europe, second only to ischaemic heart disease. In the past a fundamental problem has been the focus on end-stage liver disease and its complications; cirrhosis and cancer – it is critical now that we move our target upstream to prevent the development of advanced liver disease by embracing simple methods for early identification of progressive liver fibrosis coupled with strategies for disease prevention and application of several innovative and efficient therapies that became available in recent years. Underserved and marginalised communities, including children, require particular attention, and the significant stigma associated with liver disease needs tackling including the removal of stigma-associated terms in medical nomenclature. Policy actions for marketing, pricing and taxation of alcohol and unhealthy foods are of paramount importance with an ability to reduce premature morbidity and save the lives of almost 300,000 people per year across Europe.