Liver health equity requires investment in research to address the burden

06 November 2022

2 minute read

Source/Disclosures

Disclosures:
Cryer does not report any relevant financial information.

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WASHINGTON — Funding liver disease research and reducing inequities in liver care requires an investment commensurate with its prevalence and burden on the health care system, a guest speaker at The Liver Meeting said.

“When I think about diversity, equity and inclusion, I think my life is a testament and a testament to when all is well,” Donna R. Cryer, JD, founder and CEO of the Global Liver Institute, and a 28-year liver transplant survivor, told attendees. “[I am testimony to] when we invite people who may look different, speak differently, who may embody leadership in a different form than we are used to, and make sure they have everything they need to succeed. My goal is to ensure that each patient has the best chance of achieving the same result.

Donna Cryer

“Equity is not a one-size-fits-all solution,” Donna R. Cryer, JD, told The Liver Meeting.
Source: Helio

She noted, however, that there remain critical disparities between research funding and the burden of liver disease compared to other conditions and disparities between liver disease – particularly among racial and ethnic groups. with liver disease.

“When we think about types of inequalities, an example can be found simply by looking at estimated NIH funding for 2022: $3 billion for HIV versus $644 million for all forms of hepatitis, although the rates prevalence of hepatitis are much higher,” Cryer said.

Similarly, she noted that the budgets of liver disease advocacy groups “are a fraction” of those of patient advocacy organizations like the American Heart Association and the American Cancer Society.

“If you could pull together all the patient advocacy organizations in the liver space, I don’t think we’d be equal to the salary of the CEO of the American Heart Association,” Cryer said.

Funding for disease advocacy and research is critical to addressing widespread disparities in liver care, but cirrhosis and chronic liver disease remain some of the least funded diseases relative to the health care burden we face today. ‘they represent ; this is likely due to the lingering stigma that these diseases are associated with alcoholism, drug addiction, and morbid obesity.

“We have to do better,” Cryer said. “If we want to have advocacy, then we have to invest in advocacy. If we want to do research on liver disease, so that we can solve these problems and find cures for the hundreds of liver diseases that lack treatments or cures, then we have to invest in it — we have to invest in it at the level of prevalence and impact on the health care system.

Cryer noted that inequities also exist in liver disease – “equity is not one size fits all” – with diseases having differences in genomics, differences in environment, differences in how diseases are triggered and progress.

“In pediatric liver disease, for example, most people don’t realize that 50 percent of all admissions associated with pediatric liver disease occur in black children,” she said. “Similarly, we can look at NALFD and NASH and see the particular disparities and propensities within our Hispanic and Latino populations.”

Similarly, although hepatitis B is well known to disproportionately affect Asian Americans, there have been notable barriers to recognizing these risks in the United States, particularly with regard to testing. of hepatitis B before the induction of chemotherapy.

“We should think about how we involve the community in training the field, in training clinical research, in the questions that are asked, in raising community awareness, as well as the type of information that is fed back to the community so they can be full participants with an understanding of how their community is uniquely affected so they can help save themselves.

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