The World Health Organization held its first global meeting on oral health on 26 to 29 November 2024. The three and a half day meeting was held in Bangkok and hosted by the Government of Thailand. The meeting was key in preparing for the 4th UN High-Level Meeting on NCDs (non-communicable diseases) to be held in 2025. The aims of the meeting were: to strengthen the capacity of ministries of health to fulfill the commitments they made in the World Heath Assembly’s 2021 resolution on oral health (WHA74.5); and accelerate implementation of the Global Oral Health Action Plan 2023-2030 as part of broader NCD and UHC (universal health care) agendas. The 89-page document ‘Global strategy and action plan on oral health 2023-2030′ had been published earlier in 2024. The meeting first allowed discussion on this document and urged member states to take the many action points forward and, second, to agree the ‘Bangkok declaration’ which would inform preparations for the 4th UN high-level meeting on NCDs so as to ensure better recognition and integration of oral diseases in the future global NCD agenda.
Nigel Borrow, Lorna Macpherson and Andrew Rugg-Gunn, representing The Borrow Foundation in Thailand.
All 194 member states were invited to send up to two delegates each: 110 intended to be there but, because of travel difficulties, 98 member states were present in person, which was considered a very good response; this included the chief dental officer where there was one. A grant to WHO by The Borrow Foundation allowed the 45 countries classed as ‘least developed’ to attend at no cost and 36 countries took up this offer and were present in person. Unfortunately, chief dental officers from none of the UK countries were able to attend.
The meeting was opened by Dr Tedros A. Ghebreyesus, WHO Director General, and closed by Assistant Director General Dr Jérôme Salomon. Attending was Dr Guy Fones, Director Non-Communicable Diseases (NCDs) WHO to which oral health belongs, and Dr Benoit Varenne, Dental Officer WHO. Interpretation in all six official UN languages was provided; a few presentations were in French but most of the dialogue was in English.
The meeting considered the six strategic objectives given in the WHO document – two per day over the first three days. These were:
-
Oral health governance – for example, ensuring that oral health is represented within the national governmental health agency in member states
-
Oral health promotion and oral disease prevention
-
Health workforce
-
Oral health care – ensuring universal health care for oral health
-
Oral health information systems
-
Oral health research agendas.
Case studies from across the world illustrated success in these areas, and panel discussions highlighted opportunities and threats. During each afternoon, countries were divided into the six WHO Regions to discuss issues raised in the morning. Between 5 and 6 pm on each of the three days, delegates had a choice between six side events, such as sugar control, school oral health programmes, oral cancer, Noma, and digital oral health to name just five of the 18 topics. Oral disease is included within NCD and many of these non-communicable diseases sharing risk factors, with oral disease the most common. Lessons learnt from the meeting were presented on the last morning which was classed as a high-level session, being addressed by several ministers of health and WHO regional directors. A Global Coalition on Oral Health was formed to assist member states to take their oral health strategies forward, consisting of Member States, ‘non-state actors’ such as IADR, FDI, UN agencies, and charities such as The Borrow Foundation. The Bangkok Declaration was adopted and can be viewed via the WHO website – this will go forward to the UN meeting on NCDs mentioned above.
The UK was well represented by academics who were invited by WHO to speak on specific topics. Principal amongst these was Richard Watt, director of WHO Collaborating Centre at UCL, who spoke on leveraging upstream interventions, and sugar control. With regard to the latter, it should be noted that over 100 countries, including the UK, have introduced tax on high-sugar foods, most commonly on SSB (sugar-sweetened beverages).
Many good examples of oral health promotion and disease prevention were presented, some of the best from the host country, Thailand, which has a Ministry (and Minister) of Public Health, a healthy schools programme which includes daily toothbrushing for all children and, to ensure universal health coverage, ‘30 Baht treatment anywhere’ entitling all ages to dental care for less than £1 The importance of WHO in improving oral health worldwide should not be underestimated. This was illustrated by Fiji’s experience where, as a sugar-producing country, the sugar industry managed to have ‘sugar’ classed as an ‘essential food’. The 2015 WHO report on sugar and health changed that completely so that now Fiji has sugar-reducing programmes and sugar is no longer an essential food.
For those who attended, the meeting was deemed a great success. The organisation was outstanding. Recognition of the medical, social and economic importance of oral diseases globally, regionally and nationally is vital to provide funding to take the well-described oral health strategies forward – there is no health without oral health. These strategies must by integrated within NCD upstream, mid-stream and downstream strategies – for example, fiscal control of sugar-marketing, healthy school programmes, infant feeding advice. New workforce models should be explored, allowing integration and diversification, if the goal of universal health coverage (UHC) is to be achieved for oral health. Targets are set for 2030: much work in the next six years.
link