Untreated Hepatitis, Other Conditions Can Lead to Cirrhosis and Death – Contagion Live

Report on Liver Disease as a Barrier to Sustainable Development

This report analyzes the public health challenges associated with liver disease, particularly cirrhosis, through the lens of the United Nations Sustainable Development Goals (SDGs). It highlights how untreated hepatitis, societal stigma, and gaps in healthcare education impede progress towards global health, equality, and education targets.

SDG 3: Good Health and Well-being – The Core Challenge

Chronic liver disease represents a significant obstacle to achieving SDG 3, which aims to ensure healthy lives and promote well-being for all at all ages. The progression of untreated chronic hepatitis B, C, and D to cirrhosis directly undermines this goal.

• Target 3.3: End Epidemics of Communicable Diseases: Viral hepatitis is a primary cause of cirrhosis. Failure to prevent, diagnose, and treat these viruses contributes to a persistent public health crisis, directly conflicting with the goal of ending such epidemics.
• Target 3.4: Reduce Premature Mortality from Non-Communicable Diseases: Cirrhosis, the replacement of liver tissue with scar tissue, is a life-threatening non-communicable condition. With mortality rates recorded at 15.6 deaths per 100,000 population in 2020, it is a major contributor to premature death.

Systemic Barriers to Liver Health: A Case Study Analysis

A case study involving a newborn diagnosed with a congenital liver condition highlights several systemic failures that obstruct progress on multiple SDGs. The infant, Dean, was born with non-functional bile ducts, leading to fatal liver failure.

SDG 5 & SDG 10: Gender Equality and Reduced Inequalities

The experience of the infant’s mother reveals deep-seated inequalities and gender bias within the healthcare system.

1. Stigma and Misinformation: A persistent, outdated stigma linking cirrhosis exclusively to alcohol misuse leads to misjudgment and delays in care. This directly impacts SDG 10 (Reduced Inequalities) by creating barriers for patients with non-alcohol-related liver disease.
2. Gender Bias in Healthcare: The mother was repeatedly questioned about alcohol consumption during pregnancy, an incorrect and biased assumption. This points to a failure in achieving SDG 5 (Gender Equality) by subjecting women to accusatory and inequitable healthcare experiences.
3. Inequalities in Access to Information: Critical information regarding the infant’s encephalopathy was withheld from his parent, and access to expert second opinions required extraordinary personal effort, highlighting significant inequalities in patient access to comprehensive care and knowledge.

Consequences of Systemic Failures

The infant’s condition led to severe, multi-systemic health consequences that underscore the liver’s critical role and the devastating impact of its failure:

• Brittle bones and multiple fractures due to poor vitamin absorption.
• Uncontrolled bleeding from an inability to produce clotting factors.
• Nutrient loss, weakened immunity, and hormonal imbalances.

The infant passed away at a young age, a preventable tragedy rooted in a lack of specialized knowledge and effective communication within the medical system at the time.

Strategic Response: Aligning with SDG 4 and SDG 17

In response to this personal loss and the recognition of a broader public health failure, the Dean Thiel Foundation was established. This initiative, along with the subsequent Liver Health Initiative, directly supports the achievement of key SDGs through targeted action.

SDG 4: Quality Education

A primary mission is to address the widespread lack of knowledge about liver health among both the public and medical communities. This aligns with SDG 4 by promoting lifelong health literacy.

• Developing and disseminating clear, accessible educational materials on the liver’s functions.
• Raising public awareness about preventable causes of liver disease, including viral hepatitis.

SDG 17: Partnerships for the Goals

The initiative exemplifies SDG 17 by fostering collaboration to achieve its objectives.

• Advancing liver research to find treatments and cures.
• Collaborating with other organizations to influence health policy.
• Working to ensure that no other individuals suffer due to a lack of information or understanding of liver health.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The primary Sustainable Development Goal (SDG) addressed in the article is:

• SDG 3: Good Health and Well-being. The entire article focuses on health issues, specifically liver diseases like hepatitis and cirrhosis. It discusses disease causes, the consequences of untreated conditions (cirrhosis, death), mortality rates, the importance of medical research, and the need for public health education and awareness to prevent disease and improve patient outcomes.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the article’s discussion of liver disease, mortality, and healthcare, the following specific targets under SDG 3 can be identified:

1. Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
   • Explanation: The article explicitly mentions that “chronic hepatitis B, C, and D can lead to cirrhosis” and also refers to “hepatitis E.” The author’s mission is to protect people from “attack by viruses like viral hepatitis,” directly aligning with the goal of combating this specific communicable disease.
2. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Explanation: Cirrhosis is a non-communicable disease that the article states can “often lead to death.” The text provides a specific mortality statistic for the condition and the author’s entire story is a call to action for prevention and better understanding to reduce deaths from liver disease.
3. Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
   • Explanation: The personal story of the author’s son, Dean, highlights significant gaps in quality healthcare. This includes misjudgment from physicians due to stigma (“repeatedly questioned whether I had consumed alcohol”), a lack of full disclosure of symptoms (“encephalopathy, had not been disclosed to me”), and the recommendation of a “risky invasive procedure” and an “unapproved medication.” The author’s search for “expert guidance” underscores the need for access to quality and reliable healthcare services.
4. Target 3.b: Support the research and development of vaccines and medicines for the communicable and non-communicable diseases…
   • Explanation: A core part of the author’s response to her son’s death was to address the “lack of research and understanding.” She explicitly states that she “founded the Dean Thiel Foundation to advance liver research,” which is a direct action in support of this target.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article mentions one explicit indicator and implies others that are relevant for measuring progress:

1. Mortality rate from chronic liver disease and cirrhosis (Explicit):
   • Explanation: The article provides a direct statistic: “15.6 deaths per 100,000 population in 2020.” This figure serves as a direct indicator for measuring progress on Target 3.4 (reducing premature mortality from non-communicable diseases).
2. Incidence of hepatitis (Implied):
   • Explanation: By identifying viral hepatitis as a primary cause of cirrhosis, the article implies that the incidence rate of hepatitis B, C, D, and E is a critical indicator. Reducing the number of new infections is essential to achieving Target 3.3 (combating hepatitis).
3. Level of public awareness and education on liver health (Implied):
   • Explanation: The author states that “knowledge about the liver…remains absent from national health education efforts” and her foundation works to create “educational materials.” This implies that progress can be measured by tracking the level of public understanding of liver health, which is a key component of prevention efforts related to Targets 3.3 and 3.4.

4. Table of SDGs, Targets, and Indicators

Source: contagionlive.com