Document Type



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.


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.

Digital Object Identifier (DOI)


© 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

APA Citation

Lazarus, J. V., Han, H., Mark, H. E., Alqahtani, S. A., Schattenberg, J. M., Soriano, J. B., White, T. M., Zelber-Sagi, S., Aali, A., Abbasi-Kangevari, M., Abu-Gharbieh, E., Abu-Shawer, O., Aggarwal, M., Ahinkorah, B. O., Ahmad, A., Ahmadi, A., Alahdab, F., Alkhayyat, M., Almustanyir, S., … Dirac, M. A. (2023). The global fatty liver disease-sustainable development goal country score for 195 countries and Territories. Hepatology, Publish Ahead of Print.