UN Side Event Hosted by NYU and The Lancet Calls for Oral Health to Be Integrated into Universal Health Coverage

UN Side Event Hosted by NYU and The Lancet

11/01/2019

Incorporating oral health care into universal health coverage (UHC) and examining the influence of the sugar industry on oral health worldwide were central topics of discussion at the September 22 United Nations (UN) side event on oral health, jointly organized by the NYU College of Dentistry's World Health Organization (WHO) Collaborating Center and The Lancet.

The event preceded the UN General Assembly's first High-Level Meeting on Universal Health Coverage on September 23, and followed The Lancet's publication of a series on oral health earlier this summer. It was cosponsored by the governments of Egypt, Japan, and Thailand, as well as the World Economic Forum, with support from the Henry Schein Cares Foundation.

"Oral health is largely ignored in conversations about global health and UHC, but The Lancet's Series on Oral Health and our recent event have been critical in creating visibility and urgency for oral health," said Richard Niederman, chair of the Department of Epidemiology & Health Promotion at the NYU College of Dentistry and director of the WHO Collaborating Center for Quality-improvement, Evidence-based Dentistry. "As my colleague Habib Benzian said at the event, ‘The voice of The Lancet carries weight,’ and this helps us to mobilize change across sectors and around the world to implement policies and practices that can improve oral health."

In July, The Lancet—one of the world's leading medical journals—published its first-ever Series on Oral Health with a collection of papers describing why oral health has been neglected and advocating for urgent reform and public health action. Speaking at the September 22 event, Jocalyn Clark, executive editor of The Lancet, described the medical community's conflicting reactions to the series, both questioning why a medical journal was taking on oral health and wondering why there are not more medical journals covering oral health due to its public health relevance and impact.

Dr. Clark, who commissioned and edited The Lancet Series on Oral Health, introduced five of the series' coauthors, who spoke at the event about their research and contributions to the series.

Dr. Robert Weyant of the University of Pittsburgh School of Dental Medicine discussed the global burden of oral diseases, which are among the most prevalent diseases around the world. He noted that oral diseases are “socially patterned,” with the heaviest burden of disease falling on the most vulnerable members of society.

Dr. Cristin Kearns of the University of California, San Francisco, highlighted the importance of common risk factors related to a number of non-communicable diseases, and sugar intake in particular. She discussed the influence of the sugar industry on science and policy processes, calling for reforms and strong conflict of interest policies to shield public health and dental research from harmful industry interference.

Speaking about the challenges, limitations, and opportunities for health system responses in oral health, Dr. Paul Allison of McGill University said, "We need to think about how to bring oral health care back into overall health care in terms of education and health systems." He also stated that dental health care systems are falsely incentivizing a disease-centered approach rather than prevention.

Dr. Stefan Lisl of Radboud University in the Netherlands discussed the economic impact of oral diseases, noting that dental diseases are the third most expensive to treat after diabetes and cardiovascular disease.

Finally, Dr. Habib Benzian of NYU's Colleges of Dentistry and Global Public Health, shared five key policy recommendations of the series to improve global oral health:

  1. Better data for decision-making
  2. Stronger policies to address determinants of oral disease and noncommunicable diseases—for example, taxing unhealthy products
  3. Tackling inequalities through inclusive universal access to essential oral health care for all
  4. A modernized workforce, including trained mid-level providers who are part of a larger team with dentists, and a focus on prevention
  5. Global advocacy to raise the profile and priority of oral health with decision-makers

"Universal health coverage provides a window of opportunity for the oral health community and can give us new momentum," said Dr. Benzian, who also serves as the associate director of global health and policy for NYU Dentistry's WHO Collaborating Center. "No one organization or sector can enact these recommendations alone, underscoring the need for collaboration and the important roles that governments, the private sector, academia, and others can play. Change happens incrementally, but together we have to start somewhere."

Representatives of the governments of Japan and Thailand discussed their countries' approaches to advancing access to oral health care as part of universal health coverage, and the World Economic Forum's representative highlighted the crucial importance of public-private partnerships and multi-sectoral cooperation to achieve UHC.

The event concluded with two panels comprising speakers representing different sectors and key oral health stakeholders, including academia, corporate, research, professional, and civil society organizations. The panelists discussed opportunities and challenges for partnerships and multi-sectoral collaboration in oral health, including the important role of corporations in the context of advancing UHC and access to essential oral health care. Experts on the final panel focused on commercial influences on public health and offered cautionary tales of how the sugar industry has interfered with policies and public health, similar to tactics from the tobacco industry, along with recommendations for preventing such interference.

In his recorded closing-remarks, The Lancet's Editor-in-Chief, Dr. Richard Horton, emphasized that the neglect of oral health is a collective failure of the entire global health community. He pledged the journal’s full support to fight for better recognition and priority for global oral health.