NCD strategy must address oral diseases

"The quest for prevention and control of NCDs would not be complete without addressing oral diseases," FDI told the WHO Executive Board, meeting in Geneva from 16 to 20 January 2012.

In an intervention on 19 January, FDI called upon WHO to take four specific actions regarding oral health and NCDs: first, to ensure that oral diseases are incorporated into NCD programmes and included in national health planning, and second, to include oral diseases at the same level as the four main NCDs in the Global NCD Monitoring framework, its indicators and targets.

FDI's third recommended action is to add a target related to reducing days at school or work missed due to oral diseases, which would also address wider determinants of health and general development. Finally, it called upon WHO to develop and agree a set of optional and more comprehensive oral health targets and indicators for which global oral health community can make precise proposals.

FDI strategy

FDI's intervention at WHO follows its successful bid along with the sustained efforts of a number of other governmental and non-governmental stakeholders, to have oral diseases specifically referred to in the Political Declaration on the Prevention and Control of NCDs agreed at the United Nations Summit in September 2011.

The Declaration's Article 19 now recognizes that "renal, oral and eye diseases pose a major health burden for many countries and that these diseases share common risk factors and can benefit from common responses to non-communicable diseases".

Monitoring

Since that time, FDI has intensified its contacts with WHO and attended key events such as the World Conference on Social Determinants of Health held in Rio de Janeiro from 19 to 21 October.

Further, FDI attended an informal dialogue with NGOs last December as part of the preparatory process for the January consultation. There, FDI emphasised the need for oral health indicators, with the need to identify targets for children (see page 3).

Later, on 21 December 2011, Dr da Silva and Executive Director Dr Jean-Luc Eiselé, met with to key WHO executives to discuss the sustainability of the WHO oral health programme in the light of a 20% cutback in WHO, which, Dr da Silva conceded might indeed have an impact on the oral health budget. He emphasized, nonetheless, that "It's up to FDI, not WHO, to develop and formulate the oral health message! It's FDI's role to influence the WHO's agenda on the topics that we feel are crucial."

Its presence and statement at the January WHO Executive Board very much reflects FDI's intention of doing so.

Post-UN Summit

In its resolution (Resolution EB130.R7) issued following the Executive Board Meeting, WHO urged Members States to implement the UN Political Declaration and draw upon the policies, strategies, programmes and interventions, and tools recommended by WHO.

Further, WHO urged members States to strengthen their commitment to implementing noncommunicable disease programmes and participate fully in the WHO-led process of developing a comprehensive global monitoring framework, including a set of indicators.

Key requests

The resolution, co-sponsored by Australia, Barbados, Canada, Costa Rica, Kenya, Norway, Russia, Switzerland and the US, was intended to ensure WHO has a clear timeline for the actions required of it by the Political Declaration.
 

Its calls for action include a request to WHO Director-General Dr Margaret Chan to submit a substantive progress report on the development of a framework, includinga set of indicators and targets, to the sixty-fifthWorld Health Assembly in May 2012) and complete the work on the global monitoring framework, including a set of targets and indicators, based on a Member State consultation held before the end of 2012.

Timeline

The current Global Action Plan on NCDs expires next year. The nextwill run from 2013 to 2020 and it is imperative for WHO to have a draft ready for consideration by the WHO Executive Board at its January 2013 meeting.

More on FDI, NCDs and Oral Health

NCDs: WHO's post-UN-Summit activity

FDI, a "highly respected partner of WHO"

FDI at key world health event

FDI: federating to achieve goals

FDI omnipresent during 2-day UN Summit

Oral diseases are obstacles to development, says UNDP

FDI + NDAs = success at UN Summit

FDI produces Media Kit for World Oral Health Day 2011

Live.Learn.Laugh: update

2011 was a very successful year for the FDI World Dental Federation's partnership with Unilever Oral Care, known as Live.Learn.Laugh. Over the course of the year, 27 National Dental Associations from around the world worked with their Unilever Oral Care partners to set up oral health improvement projects that aim to measurably improve oral health through encouraging twice daily brushing with a fluoride toothpaste.

These projects, now up and running, are making a real difference to oral health around the world.

Workshops

The progress of partnership was assisted by a global workshop, held in May last year, which helped partnership teams plan and launch their projects. A similar workshop is scheduled for February in Turkey, to give project leaders from participating National Dental Associations the opportunity to discuss practical aspects of the project implementation and management, with a special focus on project evaluation.

This evaluation aspect will be particularly important given partnership teams will be approaching key milestones over the course of 2012 and want to produce interim results.

FDI World Dental Federation is proud of the partnership's achievements and looks forward seeing the results of another successful year, working in partnership to measurably improving the oral health on a global scale.

Oral health and NCDs: FDI to produce Advocacy Guide

FDI is in the process of preparing an Advocacy Guide on oral health and noncommunicable diseases for its member national dental associations. It will include a themed analysis of the Political Declaration resulting from the United Nations Summit on NCDs, held in New York last September.

UN Declarations are statements of intent, adopted and agreed by UN Member States. It is very much up to interested parties to follow up and ensure that, within the context of any Declaration, the UN and its agencies carry out tasks assigned to them and that national governments are accountable for the undertakings they have made.

FDI, by virtue of its presence in Geneva, is well placed to maintain contacts with the UN and other international agencies such as WHO and thereby ensure international follow-up.

National follow-up

However, it is only FDI NDAs that are in a position to follow up the commitments that their respective governments have signed on to. The FDI Advocacy Guide is designed to supply them with the explanations and information they need to raise the subject of oral health and NCDs with their ministers of health/chief dental officers.

It provides suggestions on how the Declaration might be used to motivate and support national governments tasked with implementing its commitments.

The NCD Advocacy Guide is set to be launched during the Chicago Dental Society 147th Midwinter Meeting (23–25 February 2012).

NCDs: WHO’s post-UN-Summit activity

On 9-10 January 2012, WHO convened an Informal Consultation with Member States and other Agencies of the United Nations. The subject under discussion was a comprehensive global monitoring framework and voluntary global targets for the prevention and control of NCDs.

This is the second response of WHO to monitoring and evaluation tasks set down in the Political Declaration of the High-level Meeting of the UN General Assembly on the Prevention and Control of Noncommunicable diseases. These tasks include developing a comprehensive global monitoring framework, including a set of indicators, and preparing recommendations for a set of voluntary global targets.

Informal dialogue
With this in mind, WHO held an informal dialogue with NGOs last December as part of the preparatory process for the January consultation. It also issued a WHO discussion paper. FDI attended the meeting and emphasised the need for oral health indicators, with the need to identify targets for children (see page 3).

Currently, FDI is supporting an initiative to host a side-meeting during the WHO Executive Board meeting (16-21 Jan) on the proposals for monitoring, targets and options for partnerships.

Note that WHO has also posted a record of the meeting of UN agencies on 8 December to agree follow-up to NCD Summit.

FDI will keep readers fully informed of the evolving consultation process within WHO as information becomes available.
 

FDI, a “highly respected partner of WHO”

"We are a highly respected partner of WHO!"

This was the conclusion of FDI President Orlando Monteiro da Silva, interviewed 21 December after a high-level meeting at WHO Headquarters in Geneva.

Meeting participants included, from FDI, Dr da Silva and Executive Director Dr Jean-Luc Eiselé, and, from WHO, Dr Ala Alwan, MD, Assistant Director-General for Noncommunicable Diseases and Mental Health and Dr Poul–Erik Petersen, who leads the Global Oral Health Programme within the context of Chronic Disease and Health Promotion.

"This was the first time I had contact with Poul-Erik Petersen and Dr Alwan on noncommunicable diseases and, to speak frankly, my impression is that FDI has much more strength, reputation and consideration than I thought," stressed Dr da Silva, adding that, as a recognised expert in oral health "I think [FDI] can very well have a certain level of influence on the WHO agenda … our voice is very much heard."

Concern over shrinking budgets

The meeting took place at the specific written request from FDI to discuss the sustainability of the WHO oral health programme in the light of a 20% cutback in WHO funding due to the current economic and financial crisis.

In making the request, Drs da Silva and Eiselé highlighted FDI's long tradition of collaboration with WHO Oral Health Programme, an essential link, they said, "in fulfilling our mission of improving oral health care worldwide".

In separate letters, they urged WHO Director General Dr Margaret Chan as well as Dr Alwan and his colleagues "to recognize that there is need, in particular for developing countries, to keep this oral health unit at WHO Headquarters and this position within WHO core activities.

Four issues

In their letters, Drs da Silva and Eiselé cited four major issues in support of their view: first, oral health's excellent integration into the WHO strategy on NCD prevention and second, the need for a central coordinating office to support the commitment to member countries to the recent World Health Assembly Resolution on Action Plan for Oral Health.

Third, they cited the ongoing UNEP negotiations on mercury, which require the voice of health professionals and patients that can only be provided by WHO, and fourth, the fact that strong support of an Oral Health Office within WHO Headquarters is essential for FDI global activities.

Words of caution

In the wake of the 21 December meeting, the FDI President had some words of caution: the 20% cuts might indeed have an impact on the oral health budget. He called for a joint effort among all FDI stakeholders to ensure the impact would be minimal, but noted difficulty of getting the ‘oral health' message across to politicians.

"We have to make oral health more visible, more trendy, more fashionable. Shouldn't we be more active in that role? It's up to FDI, not WHO, to develop and formulate the oral health message! It's FDI's role to influence the WHO's agenda on the topics that we feel are crucial."

The oral health agenda

For Dr da Silva, the best way to avoid going backwards 30 or 40 years in terms of oral health promotion is to look forwards and prepare a possible joint FDI/WHO oral health roadmap for the coming years.

FDI's member national dental associations have a crucial role to play. "The context is not an easy one … governments all over the world are having great difficulty in allocating financial resources.

"NDAs should remain vigilant: they have to make sure that oral health stays on the national agenda," concluded Dr Monteiro da Silva.