FDI calls for measurable action on oral health at 144th WHO Executive Board
The World Health Organization Executive Board (WHO EB) held its 144th session in Geneva, Switzerland, from 24 January–1 February to review reports and resolutions ahead of the World Health Assembly in May. As a non-state actor in official relations with WHO, FDI delivered statements, some of which were joint with the International Association for Dental Research (IADR) that highlighted gaps and pushed for oral health integration across the agenda items detailed below.
The World Health Professions Alliance, of which FDI is a member, also made three statements on universal health coverage (UHC), human resources for health, and water, sanitation and hygiene services.
WHO prioritizes oral health indicators
WHO’s proposed programme budget for the next two years, which underpins its five-year strategic plan, the 13th General Programme of Work (13GPW), faced intense debate during the EB. During the budget discussion, countries also considered the WHO Impact Framework, which sets out 42 targets and indicators, including two oral health indicators, that will measure the 13GPW “three triple billion” targets (1 billion more people benefitting from UHC; 1 billion more people better protected from health emergencies; and 1 billion more people enjoying better health and well-being). Since many countries questioned WHO’s plans to measure the WHO Impact Framework and feasibility of data collection for the indicators, the EB decided that a consultation with Member States on the framework should take place before the upcoming 72nd World Health Assembly (WHA72) in May.
FDI commended WHO for including two oral health indicators as part of the UHC billion target that focus on monitoring the prevalence of dental caries among 5 to 19-year-olds and edentulism among 65+ year-olds within the WHO Impact Framework. Unfortunately, there is no budget allocated to monitor the two oral health indicators, which FDI urged WHO to rectify.
The United States and Italy oppose taxation on sugar-sweetened beverages
The EB reviewed the WHO report and workplan to support Member States in fulfilling their commitments made at the 2018 High-level Meeting on the prevention and control of noncommunicable diseases (NCDs). The report contained an update from WHO on the latest scientific knowledge concerning the effectiveness of taxation on sugar-sweetened beverages (SSB) to reduce sugar consumption, which cited nine peer-reviewed studies in Chile, Mexico and the United States. The studies consistently found that the purchase, sale and consumption of taxed SSB decreased and the purchase, sale and consumption of untaxed beverages, especially bottled water, increased. Based on this body of evidence, WHO recommended Member States to implement SSB taxation. The United States and Italy were the only two countries who refuted WHO’s evidence and recommendation; they requested WHO to remove SSB taxation from the report.
FDI and IADR applauded WHO for recommending SSB taxation in its report, which was excluded in the 2018 Political Declaration on NCDs. Sugar is the primary factor for the development of dental caries (tooth decay) – the most prevalent NCD – globally. According to the 2015 WHO Fiscal policies for Diet and Prevention of NCDs, taxing sugary drinks can lower consumption and reduce obesity, type 2 diabetes and tooth decay.
No UHC without primary healthcare
2019 is a pivotal year for UHC: Member States will meet in New York this September for a high-level meeting to step up commitments and action on UHC. Speaking to the EB, FDI and IADR highlighted that UHC cannot be achieved unless primary healthcare integrates oral health; they urged Member States to uphold their new global commitments in the Astana Declaration to strengthen primary healthcare and UHC. FDI and IADR also requested that the outcome document for the High-level Meeting on UHC acknowledge oral health as a key component of primary care and UHC.
Calls for accelerated action on Sustainable Development Goal 3 – the health goal
Although countries reported taking targeted action on NCDs to realize Sustainable Development Goal (SDG) 3, action on oral health is lagging, as there are no oral health specific SDG targets. FDI and IADR encouraged Member States to adopt a Common Risk Factor Approach when developing and implementing SDG 3 strategies to reduce the NCD burden. WHO’s report to the EB revealed that at least half of the world’s population do not have full coverage of essential health services. FDI and IADR called for Member States to include basic oral healthcare as part of UHC to improve health outcomes and reduce inequalities in access to care. WHO is also coordinating the Global Action Plan for healthy lives and well-being for all to accelerate progress towards achieving the SDGs. The plan will be open for consultation this year and released at the High-level Meeting on UHC this September. FDI and IADR pledged to participate in the consultation to ensure that oral health is not left behind.
Progress in global antimicrobial resistance efforts but gaps remain
Antimicrobial resistance (AMR) was high on the agenda with many countries struggling to establish multisectoral AMR working groups to develop their national action plans. FDI and IADR advised countries to involve dentists when developing their plans and called for Member States to develop guidelines and prescribing policies on antibiotic use for dentists. Dentists prescribe up to 10% of all antibiotics used worldwide so they are key players in the fight against AMR.
Health of migrants and refugees
Countries discussed priorities for the draft Global Action Plan 2019–2023 on the health of refugees and migrants. FDI stressed that the draft Action Plan must integrate essential oral healthcare within the plan’s meaning of “essential healthcare service packages” and monitor the oral health status of refugees and migrants. FDI also recommended that countries implement at a minimum WHO’s Basic Package of Oral Care, which includes access to emergency care and pain relief, affordable fluoride toothpaste and tooth decay management.
What happens now?
The 144th WHO EB, composed of 34 individuals who are technically qualified in the field of health and designated by each Member State, approved the agenda for WHA72, which will take place from 20–28 May in Geneva, Switzerland. FDI will attend and continue to push for oral health to be integrated within the global health and development agenda, so that governments understand that you can’t be healthy without good oral health.