Oral diseases and NCDs in the Western Pacific Region need to be prioritised

Peng et al. (2024) expertly outline the significant burden of non-communicable diseases (NCDs) in the Western Pacific Region (WPR).1Peng W. Zhang L. Wen F. et al.Trends and disparities in non-communicable diseases in the Western Pacific region.Lancet Reg Health West Pac. 2023; 43100938https://doi.org/10.1016/j.lanwpc.2023.100938Summary Full Text Full Text PDF Scopus (1) Google Scholar However, oral diseases as a key group of NCDs are absent from the review. The WPR faces unprecedented oral health challenges with 800 million people suffering from diseases such as caries, severe periodontal disease, oral cancer, and edentulism, as highlighted in last year's regional summary of the WHO Global Oral Health Status Report.2World Health Organization (WHO)Global oral health Status Report - towards universal health coverage for oral health 2030. Regional summary of the western Pacific region. WHO, Geneva2023https://www.who.int/publications/i/item/9789240070868Google Scholar Like for all NCDs, the burden of oral diseases is especially high for Pacific Island countries, including some of the highest rates of oral cancer globally. The region's governments show mixed responses towards these challenges. Some WPR high-income countries are providing comprehensive oral healthcare across the life-course, such as Japan by including its super-ageing populations,3Aida J. Fukai K. Watt R.G. Global neglect of dental coverage in Universal Health Coverage systems and Japan's broad coverage.Int Dent J. 2021; 71: 454-457Crossref PubMed Scopus (24) Google Scholar or Australia and New Zealand by expanding the oral health workforce to enhance access for children and vulnerable groups.4Mathu-Muju K.R. Friedman J.W. Nash D. Oral health care for children in countries using dental therapists in public, school-based programs, contrasted with that of the United States, using dentists in a private practice model.Am J Public Health. 2013; 103: e7-e13Crossref PubMed Scopus (0) Google Scholar At the same time, most Pacific Island countries struggle to provide even essential services, with limited or no access for rural, remote, or socioeconomically disadvantaged communities. Over half of the region's countries spend less than $10 USD per person annually on oral health.2World Health Organization (WHO)Global oral health Status Report - towards universal health coverage for oral health 2030. Regional summary of the western Pacific region. WHO, Geneva2023https://www.who.int/publications/i/item/9789240070868Google Scholar The stark underfunding of public oral healthcare is a major barrier to universal health coverage (UHC) for oral health through inadequate healthcare infrastructure, low workforce numbers, lack of essential supplies, and low-quality services. The recent WHO Global Oral Health Action Plan (2023–2030) provides crucial guidance and leadership,5World Health Organization (WHO)Draft global oral health action plan (2023-2030).https://www.who.int/publications/m/item/draft-global-oral-health-action-plan-(2023-2030)Google Scholar especially since more than half of the region's countries have no oral health policy, and more than a quarter have no dedicated oral health staff at the Ministry of Health to support planning, service delivery, monitoring, and evaluation. In response to the region's oral health needs, a coalition of heads of oral health services established the Oral Health Pacific Islands Alliance (OPIA).6Tatui L. McCool J. Nosa V. Rethinking and establishing a dental collaboration in the Pacific region.Pac Health Dialog. 2018; 21: 108-110Crossref Google Scholar Their Suva Declaration provides a strategic framework to guide and support the political and health system prioritization of oral diseases in all WPR countries.7Oral Health Pacific Islands Alliance (OPIA)Suva Declaration on improving oral health in the Pacific islands region.2023https://www.fnu.ac.fj/wp-content/uploads/2023/08/Suva-Declaration-2023.pdfGoogle Scholar The initiative aims to facilitate future strategies, health policies, service improvements, and research that can transform national oral disease responses and contribute to the broader goals of UHC. We encourage WHO WPRO, as well as all WPRO member states to accelerate integration of oral diseases into the regional NCD and UHC agendas, guided by the technical consensus of the Suva Declaration. Progress in advancing knowledge, capacities and supporting policies for oral health at government and community levels across the region is crucial for achieving health equity in the region. All authors conceptualized the manuscript, HB developed the first draft; all authors critically revised and approved the final manuscript. LM, SP, LT and KT are founding members of the Oral Health Pacific Islands Alliance (OPIA) and members of the OPIA executive committee. SP is married to the WHO WPRO director. LM and HB are members of the Lancet Commission on Oral Health; HB is Co-Director of the New York University WHO Collaborating Centre for Quality Improvement and Evidence-based Dentistry and policy advisor for OPIA. No funding has been received for drafting this correspondence. Trends and disparities in non-communicable diseases in the Western Pacific regionThe WHO Western Pacific region bears disproportionate deaths from non-communicable diseases (NCDs), with increased overall NCD proportional mortality over the past two decades. The disease burden of mental health increased, resulting from rapid ageing, enhanced stress, and the COVID-19 pandemic, but it was largely neglected. The highly diverse cultures, religions, political systems, socioeconomic contexts, lifestyles, and environmental factors probably have led to massive disparities across countries in NCD mortality, risk factors, and NCD management. Full-Text PDF Open Access

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