The People-First Liver Charter

Nature Medicine

Reducing the stigma and discrimination that people living with liver conditions experience requires rethinking how diagnoses, diseases, etiologies and circumstances are perceived — a shift that begins with the language used to name and describe them.

Illustration: Sergio Dosal

The People-First Liver Charter, led by the Global Think-Tank on Steatotic Liver Disease, calls for a universal approach that places people living with liver conditions at the centre of care, policy, and research.

This means recognising individuals as experts in their own lived experiences and as essential partners in managing their health. It requires steady improvements in how we speak, think, and act—challenging long-held biases that have too often defined liver health by conditions instead of people.

By focusing on the whole person, not just their diagnosis, we can foster dignity, equity, and stronger, more sustainable responses that improve health and well-being.

Illustration: Sergio Dosal

  • Put people first, not their condition
  • Avoid labelling or defining people by their condition
  • Use neutral language
  • Avoid overstating the severity of a condition
  • Highlight abilities over limitations
  • Emphasise people’s capacity to manage their health and right to support
  • Recognize people as contributors to society, not burdens
  • Use comprehensible, consistent and precise language

  • Reduction of stigma and discrimination
  • Avertion of blame and fear
  • Empowerment of people
  • Fostering of a supportive environment
  • Increments in health service utilisation
  • Enhancements in the quality of care
  • Improvements in the care experience
  • Boosts in treatment uptake and ongoing engagement
  • Improvements in health outcomes

  • Delivering proof of impact
  • Assessing people’s language needs and preferences across age and socioeconomic strata, genders, ethnicities and geographies
  • Collaborating across health fields to promote consistent use of people-first language

What role will you play in putting people first?

What role will you play in putting people first?

Organisations and journals that endorse
the People-First Liver Charter

Patient & Advocacy Organisations

  • Fatty Liver Alliance
  • Global Liver Institute
  • Liver Patients International
  • World Hepatitis Alliance

Networks/Movements

  • International Liver Cancer Movement
  • International Network on Health and Hepatitis in Substance Users

Patient & Advocacy Organisations

  • Fatty Liver Foundation – USA
  • MASH Cities – USA

Professional Societies

  • American Association of Clinical Endocrinology – USA
  • Canadian Association for the Study of the Liver – Canada
  • Canadian Association of Hepatology Nurses – Canada
  • Obesity Medicine Association – USA
  • Tri-state Obesity Society – USA

Research & Academic Institutes

  • City University of New York Graduate School of Public Health and Health Policy – USA
  • Harvard Medical School Program in Global Primary Healthcare – USA

Patient & Advocacy Organisations & Professional Societies

  • Egyptian Foundation for Integrated Medicine in HepatoGastroenterology and Pulmonology – Egypt
  • National Liver Institute – Egypt
  • Steatotic Liver Disease Study Foundation in Middle East and North Africa – MENA

Patient & Advocacy Organisations

  • Society on Liver Disease in Africa

Networks

  • Africa Advocacy Foundation (Europe-based, Africa-focused)

Patient & Advocacy Organisations

  • Brazilian Nursing Association Minas Gerais Section – Brazil
  • Chilean Association of Hepatology – Chile
  • Colombian Association of Hepatology – Colombia
  • Intersectoral Forum for Non-communicable Diseases in Brazil – Brazil
  • Observatory of Chronic Conditions and Food – Brazil
  • Sweet Life Association – Brazil

Research & Academic Institutes

  • School of Nursing of the Federal University of Minas Gerais – Brazil
  • Specialised Rehabilitation Center III, City Hall of Volta Redonda – Brazil

Patient & Advocacy Organisations & Professional Societies

  • LiverWELL – Australia
  • New Zealand Society of Gastroenterology – New Zealand

Patient & Advocacy Organisations

  • British Liver Trust – UK
  • European Liver Patients’ Association – Europe
  • Irish Liver Foundation – Ireland
  • Italian Liver Foundation – Italy
  • Macedonian Society for Gastroenterohepatology – Republic of North Macedonia
  • Nobody Left Outside – Belgium
  • Platform for International Cooperation on Undocumented Migrants – Belgium
  • Rare Liver Diseases Alliance of Moldova – Republic of Moldova

Professional Societies

  • European Society of Paediatric Gastroenterology, Hepatology and Nutrition – Europe
  • Slovak Society of General Practice – Slovakia
  • Swedish Society of Gastroenterology – Sweden

Research & Academic Institutes

  • Barcelona Institute for Global Health (ISGlobal) – Spain
  • Biomedical Research Networking Center in Diabetes and Associated Metabolic Diseases – Spain
  • The Global Think-tank on Steatotic Liver Disease – Spain
  • Working Group for Innovation in Healthcare – Poland

Networks

  • Correlation-European Harm Reduction Network – Europe
  • European AIDS Treatment Group – Europe
  • Portuguese Association for the Protection of Diabetics – Portugal
  • UNITE Parliamentarians Network for Global Health – Portugal

Patient & Advocacy Organisations & Professional Societies

  • Forum for the Study of the Liver – Bangladesh
  • Kalinga Gastroenterology Foundation – South Asia (India)
  • Nepalese Association for the Studies of the Liver – Nepal
  • Qazaq Association for the Study of the Liver – Kazakhstan
  • South Asian Association for Study of the Liver – South Asia
  • South East Asia Regional Alliance – Nepal
  • Yellow Warriors Society Philippines – Philippines

Research & Academic Institutes

  • Shanghai Xinhua Hospital – China

  • Annals of Hepatology – Mexico
  • BMC Biology – UK
  • BMC Global and Public Health – UK
  • BMC Medicine – UK
  • Communications Medicine – UK
  • Genome Biology – UK
  • Genome Medicine – UK
  • Nature – UK
  • Nature Cancer – USA
  • Nature Communications – UK
  • Nature Health – USA
  • Nature Medicine – USA
  • Nature Mental Health – USA
  • Nature Metabolism – USA
  • Nature Reviews Endocrinology – UK
  • Nature Reviews Gastroenterology & Hepatology – UK
  • npj Gut & Liver – UK

Endorse the Charter

By endorsing the People-First Liver Charter, your organisation affirms its commitment to dignity, equity, and care shaped around people, not conditions. Together, these commitments move us closer to a future where everyone has the chance to live in better health, with no one left behind.

Add your organisation’s voice by completing the form below.

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