Liver Cirrhosis: it is time to act! Moldova case

Abstract

Liver Cirrhosis is known as a disease causing irreversible scarring of the liver, however treatment of the underlying liver disease and determination of its possible causes can slow or stop the progression of cirrhosis. The number of patients with chronic liver diseases, such as viral hepatitis and cirrhosis has increased over time all over the world. Liver cirrhosis is a major clinical problem worldwide and is associated with high morbidity and mortality, and often affects persons during the most productive years of life. According to WHO and available statistical data there is a disastrous situation with respect to liver cirrhosis in the Republic of Moldova. For the majority of the main causes of death in the Republic of Moldova, mortality due to diseases of the digestive system, with a leading role being played by chronic liver diseases and cirrhosis has been one of the highest in the WHO European Region as a whole. Although chronic liver diseases and cirrhosis are the main cause of death in the Republic of Moldova, and have a significant impact on quality of life of these patients, there has been relative paucity of data with respect to the real situation, and as a result no strategic plan and actions for diseases prevention. The goal of this thesis is to elaborate strong strategies for public health policy-makers in order to make possible to prevent chronic liver diseases, especially liver cirrhosis in the Republic of Moldova, and to decrease the impact of liver cirrhosis on the society. In order to reduce the public health impact of cirrhosis in the Republic of Moldova, primary prevention programs that focus on encouraging alcohol abstinence, reducing high-risk behaviors for hepatitis virus infection and vaccinating for Hepatitis B, and enforcing the law with respect to pesticide use are urgently needed. Action plan should include four main strategies: 1.National Alcohol Harm Reduction Strategy; 2. Promoting vaccination (HBV) program; 3. Reducing high-risk behaviors for VH; 4. Law enforcement with respect to pesticides use. Implementation of this action plan should be in close collaboration with the Government of the Republic of Moldova, Ministry of Health and Social Protection, Ministry of Ecology and Environment Protection, non-governmental organizations, social programs, and International representatives working in this field. This plan is a long-term one. In conclusion, it is very important to implement the action plan on a national level and governmental support is of considerable importance. The challenges are significant and so are the efforts and resources required to meet them for the best outcome.