Jeffrey V. Lazarus, Trenton M. White, Leire Agirre-Garrido, Kushala Abeysekera, Paul N. Brennan, Radan Brůha, Stefan Buttigieg, Patrizia Carrieri, Helena Cortez‐Pinto, Robert Flisiak, Sven M.A. Francque, Gema Frühbeck, Liliana Simona Gheorghe, Hannes Hagström, Adriaan G. Holleboom, Krasen Ivanov, Mojca Jensterle, Peter Jepsen, Juozas Kupčinskas, Henry E. Mark, Didac Mauricio, Saba Mohamed Bibi, Christophe Moreno, Anna Mrzljak, Eleni Papanicolaou, Maria Papp, Georgios Papatheodoridis, Markus Peck-Radosavljevic, Nicola Pugliese, John D. Ryan, Rogério T. Ribeiro, Riina Salupere, Lubomir Skladany, Ieva Tolmane, Hannele Yki-Järvinen, Jörn M. Schattenberg, Juan M. Pericàs, Mattias Mandorfer, Tomislav Bulum, Sanja Musić Milanović, Vibor Šeša, Azina Chara, Malekou Elsa, Georgios A. Pouros, Pari Georgia, Constantinou Nikoletta, Christodoulou Maria, Picolos Michalis, Avraam Thalia, Christodoulides Theodoros, Karel Dvořák, Achim Kautz, Carolin V. Schneider, Johannes Wiegand, Cristina Bianco, Stefano Ciardullo, Loreta A. Kondili, Cristina Panico, Serena Pelusi, Gianluca Perseghin, Salvatore Petta, Maria Giovanna Quaranta, Federico Ravaioli, Luca Valenti, Roberto Vettor, Ainis Dzalbs, Anda Kivite-Urtane, Laila Meija, Ivars Tolmanis, Indre Ceponiene, Jonas Ceponis, Indrė Gustaitytė, Povilas Šabanas, Willem Pieter Brouwer, Manuel Castro Cabezas, Joost Drenth, Laurens A. van Kleef, Fabrice MAC. Martens, Jean WM. Muris, R Bart Takkenberg, Maarten E. Tushuizen, Yasaman Vali, Jerzy Jaroszewicz, Dorota Zarębska-Michaluk, Guilherme Duarte, Maria Paula Macedo, Gonçalo Pinto Mendes, Sara Policarpo, Florentina Furtunescu, Corina Silvia Pop, Marek Rac, Borut Jug, Katja Novak, Danica Rotar Pavlič, Rocío Aller, Núria Alonso, Antonio J. Amor, Javier Ampuero, Maria T. Arias-Loste, Jesus M. Banales
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a public health threat in Europe. With an estimated 30.4% prevalence among the adult population in the European Union and United Kingdom, it is the most common chronic liver disease and is closely linked to obesity and type 2 diabetes, which can be considered as indicator conditions. Despite the scale of the burden, the spectrum of MASLD, including its advanced form, metabolic dysfunction-associated steatohepatitis (MASH), is weakly represented-or even absent-from health policy and development agendas. Further, the extent to which regional and national clinical practice guidelines (CPGs) on other liver diseases and related fields incorporate information on MASLD/MASH prevention or management is unclear. In this Series paper, we reviewed policy attention to MASLD/MASH across the European Union and the United Kingdom. We report low policy readiness across European countries to address MASLD/MASH. Only two (7.1%), Romania and Sweden, had a subnational strategy, while 13 (46.4%) referenced MASLD/MASH in other national or subnational action plans, predominantly those for liver disease and obesity. No country included MASLD/MASH in its priority non-communicable disease list. Additionally, 15 (53.6%) countries had national MASLD/MASH CPGs, while 25 (89.3%) mentioned MASLD/MASH in other national CPGs, most often those for obesity, diabetes, cirrhosis, liver transplantation, and primary care, respectively. We conclude that MASLD/MASH remains insufficiently addressed from a policy perspective, which contributes to low readiness to address this public health threat.