UN Political Declaration on NCDs lacks bold action and explicit commitments

FDI Statement of Concern

FDI World Dental Federation (FDI) is deeply disappointed with the flawed Political Declaration adopted today (27 September 2018) by the United Nations Assembly at the High-level Meeting on Noncommunicable Diseases (UN HLM on NCDs).

Poor oral health is a silent epidemic affecting billions of people across the globe. More than half of the world’s population (3.5 billion) suffer from untreated oral diseases,1 which can result in pain, infection, tooth loss and loss of productivity. Oral diseases, such as tooth decay (dental caries), gum disease and oral cancer, are the most common and preventable NCDs afflicting humankind.2 Yet the Political Declaration has missed the critical opportunity to take targeted action on oral health. Oral diseases pose significant health care challenges to governments and no country can end its NCD epidemic unless it effectively addresses oral health.

FDI is extremely concerned that the Political Declaration only mentions the main four NCDs (cardiovascular diseases, cancer, chronic respiratory diseases and diabetes) and fails to acknowledge other NCDs including oral diseases, which were recognized in the 2011 UN Political Declaration and addressed in the 2018 Report of the World Health Organization (WHO) High-level Commission on NCDs.

Among the many weaknesses in the Declaration, the document lacks any meaningful financing and investment commitments for NCDs. Without targeted investment in widespread preventative interventions the burden of oral diseases will continue to accelerate unabated. The indirect costs due to oral diseases worldwide amounts to a staggering figure of more than US $140 billion yearly.1 Every country will yield significant economic and social benefits from investing in oral disease and NCD prevention and control. The document also fails to include sufficient accountability mechanisms to measure time-bound commitments and sets the next UN HLM on NCDs in seven years’ time in 2025 to review progress.

The Declaration also excludes the WHO Best Buys and several other WHO recommended interventions related to sugar, tobacco and alcohol taxation. Taxation on sugar sweetened-beverages, in particular, is a proven mechanism for reducing sugar consumption (especially among low-income households) and can contribute to reducing the NCD burden. The 2015 WHO Fiscal Policies for Diet and Prevention of NCDs even proposes sugar taxation as one of the main fiscal policy interventions for NCD prevention. It is widely acknowledged that oral diseases and other NCDs share modifiable risk factors including an unhealthy diet – particularly one high in sugar and as such can benefit from an integrated response.

While the Declaration does not go far enough to address the NCD epidemic that the world faces today, FDI welcomes some positive elements in the document. The Declaration emphasizes the need for increased political leadership from Heads of State and Government, scale-up of implementing commitments made in the 2011 and 2014 HLMs and the Sustainable Development Agenda, and engagement of civil society and people living with NCDs in the NCD response. It also recognizes that social, economic and environmental determinants affect risk factors for NCDs.

Untreated oral diseases have increased by 40% since 19901 and will continue to rise unless countries take urgent action. Oral health can no longer afford to be overlooked and left behind by countries in the development and implementation of national plans and strategies. Oral health is one of the main pillars of overall health and given the shared risk factors with other NCDs should be integrated into policies addressing them.3

FDI stands ready to assist Member States with going beyond commitments made in the Declaration and pledges to work with its National Dental Associations to uphold countries’ commitments and hold them accountable for their inaction. The time to act on oral health is now.

References

  1. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Lancet 2017 390(10100):1211-59.
  2. FDI World Dental Federation. The Challenge of Oral Disease - A call for global action. 2nd ed. Geneva: FDI World Dental Federation, 2015. Available from: https://www.fdiworlddental.org/resources/oral-health-atlas/oral-health-atlas-2015. Accessed 25 September 2018.
  3. Sheiham A, Williams DM, Weyant RJ, et al. Billions with oral disease: a global health crisis – a call to action. J Am Dent Assoc 2016 146(12):861-4.

Share it