How early detection of disease can advance equitable liver health across APAC

In the fight against liver disease, one factor determines everything else: timing. Yet for millions across Asia-Pacific (APAC), time is stolen by silence. Unlike many conditions, liver diseases, including hepatitis B and C, fibrosis and liver cancer often progress without symptoms. By the time they’re detected, damage is advanced and options are limited. That makes early detection essential. Whether it’s diagnosing hepatitis before it leads to cirrhosis or catching hepatocellular carcinoma (HCC) while it’s still treatable, the window to act is narrow and too often missed.

This matters profoundly in APAC, where the burden is vast and under-acknowledged. The region accounts for nearly 63% of global liver disease deaths and three-quarters of liver cancer mortality worldwide. Chronic hepatitis B causes the majority of liver-related deaths in APAC, with the region home to 59% of global HBV cases. At the same time, non-viral drivers, like Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD),linked to obesity, diabetes and sedentary lifestyles, are rapidly accelerating liver damage in younger and more diverse populations.

Despite progress in curative therapies and diagnostic innovation, most liver diseases in the region are still detected too late. More than 80% of liver cancer cases are diagnosed at an advanced stage and up to 87% of hepatitis B and up to 80% of hepatitis C infections remain undiagnosed. These gaps are not due to a lack of medical solutions; they reflect the complex challenge of delivering early detection across diverse health systems.

Factors such as limited access to screening, evolving risk profiles, low public awareness and variable integration of diagnostics into frontline care all contribute to missed opportunities for early intervention. In many countries, diagnostics are still not consistently prioritized within national health strategies.

If timing is critical in liver care, then diagnostics must be where care begins. Investing in earlier, easier and more equitable detection is a clinical imperative and a health system opportunity. When people can be tested before symptoms appear, they can access treatment earlier, live longer and avoid more costly interventions down the line.

This is not a technological problem, it’s a systems gap we have the tools to close.

Diagnostics are where liver care begins; yet they’re still treated as optional extras in many national health strategies. Less than 1% of global health funding is allocated to diagnostics, despite the fact that over 70% of clinical decisions depend on them. The result is what the World Health Organization calls a ‘diagnostics gap’ and nowhere is it more visible than in liver health.

But this gap is not inevitable, it reflects choices we can change. Across APAC, there are emerging models showing how diagnostics can drive more equitable care when integrated thoughtfully into national health systems.

In China, risk-prediction using Roche’s proprietary algorithm, such as the GAAD score, is now part of national HCC surveillance guidelines, allowing clinicians to stratify patients and prioritize early monitoring. These kinds of tools, especially when paired with digital workflow platforms and community-based lab infrastructure, make it possible to shift liver disease detection upstream, before symptoms appear.

Examples like China show the potential to evolve liver health systems through better diagnostic design. Moving from pilot to policy and toward longer-term, system-wide solutions requires intentional investment and integration.

Governments across APAC must act now to close the diagnostic equity gap and to align national efforts with the APAC Liver Disease Alliance’s roadmap for hepatitis and liver cancer control.

That means:

These aren’t just technical adjustments. They’re policy choices that determine who gets care and when. And, they reflect a broader truth: no matter how advanced our tools become, access begins with design.

While policymakers across Asia-Pacific play a vital role in advancing liver health equity, industry stakeholders also have a responsibility. Roche is committed to supporting progress through regionally validated diagnostics, public-private partnerships and solutions that bring testing closer to communities. Together, we have an opportunity to strengthen liver health systems ahead of the 2030 hepatitis elimination targets. By embedding liver diagnostics into national insurance schemes and integrating early detection into existing care pathways, we can ensure that prevention begins where it matters most.

Liver health doesn’t start at the hospital. It starts with access to a test. With the right policies, we can make early detection the norm, not the exception.