Oral health at the heart of the fight against NCDs in the ...ghf2016.g2hp.net/files/2016/12/PS2_2_Varenne.pdf · Oral health at the heart of the fight against NCDs in the African

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Oral health at the heart of the fight against NCDs in the African Region

WHO’s Strategic Orientations

Dr Benoit VarenneRegional Adviser, Oral Health Noncommunicable Diseases ClusterWHO Regional Office for Africa

PS2-2 : Prevention and control of noncommunicable diseases: new challenges and priorities for oral health

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1. Policy Context

2. Burden & Impact

3. WHO Strategic Orientations

4. Key policy documents & tools

5. Concluding Remarks

Presentation outline

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1. Policy Context

2. Burden & Impact


4. Key Policy Documents and Tools



Major Major Milestones: 2011 Year of NCDsMilestones: 2011 Year of NCDsWHO African Region Ministerial Consultation on

the preparation for the Moscow Ministerial Consultation and the High Level Summit on

Noncommunicable Diseases

Brazzaville, 4‐6 April 2011

United Nations high‐level meeting onNoncommunicable Disease prevention and control.

Political declaration on the Prevention and Control of Noncommunicable Diseases adopted

New York, September 2011

First Global Ministerial Conference on Healthy Lifestyles and Noncommunicable Disease Control

Moscow, April 2011

UN Political Declaration on NCDsUN Political Declaration on NCDs(New York, 19‐20 September 2011)

....Article 1919. Recognize that renal, oral and eyediseases pose a major health burden formany countries and that these diseasesshare common risk factors and canbenefit from common responses to non‐communicable diseases;

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2011Political

Declaration

2011Political

Declaration

2014Outcome Document

2014Outcome Document

2011BrazzavilleDeclaration

2011BrazzavilleDeclaration

2015SDGs

2015SDGs

2015AAAA

2015AAAA

20183rd HLM20183rd HLM

Historic crossroads: Getting to 2018Historic crossroads: Getting to 2018

2018

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1. Political (Policy) Context

2. Burden & Impact


4. Key policy documents and tools



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Oral Health is Oral Health is a state of being free a state of being free from chronic mouth and facial pain, from chronic mouth and facial pain, oral and throat cancer, oral sores, oral and throat cancer, oral sores, birth defects such as cleft lip and birth defects such as cleft lip and palate, periodontal (gum) disease, palate, periodontal (gum) disease, tooth decay and tooth loss, and tooth decay and tooth loss, and other diseases and disorders that other diseases and disorders that affect the oral affect the oral cavity.cavity.

Oral Health is more than healthy teeth!Oral Health is more than healthy teeth!

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Oral diseases are among the most common NCDs and may affect people throughout their lifetime, causing pain, disfigurement and even death

Dental caries is the most prevalent chronic disease worldwide (60‐90% of school children)

From 1990 to 2010 the regional average increase in DALYs from burden of dental caries was between 42% and 78%*

Burden for periodontal disease increased between 68% and 75%, while the global average increase was 57%

Globally, about 30% of people aged 65–74 have no natural teeth

Burden & Impact of oral diseases (1)Burden & Impact of oral diseases (1)

• Petersen PE et al, The global burden of oral diseases and risks to oral health, Bulletin of the World Health Organization,83(9): 661–669, 2005.• MarcenesW, Kassebaum NJ, Bernabe E, Flaxman A, NaghaviM, Lopez A, Murray CJ. Global Burden of Oral Conditions in 1990‐2010: A Systematic Analysis. J

Dent Res. 2013;92(7):592‐597

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Prevalence of oral cancer is high among men and is increasing mainly in eastern and southern Africa. 8‐9thmost common cancer

Oral manifestations of HIV infection are common with 40‐50% of infected and up to 84% of patients with AIDS showing oral lesions

Noma is a oro‐facial gangrene affecting children below of 6 years‐old. Estimates range from 30,000 to 140,000 new cases of noma per annum, and 70% to 90% of children affected die without having received any care

Oral diseases can have a profoundly negative impact on quality of life. They restrict activities causing millions of school and work hours to be lost each year

Burden & Impact of oral diseases (2)Burden & Impact of oral diseases (2)

• http://globocan.iarc.fr/Pages/fact_sheets_population.aspx. The WHO’s International Agency for Research on Cancer• Awirea IF, Chaprnand GN. 2012. Oral manifestations of HIV/AIDS in sub‐Saharan Africa: a systematic review. J Med Applied Biosci. 4:87 ‐ 102.

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Median oral healthcare coverage Median oral healthcare coverage in adults 18+ years with expressed in adults 18+ years with expressed needneed

0102030405060708090

Low income Lower middle income

Upper middle income

High income

• HosseinpoorAR, Itani L, Petersen PE. Socio‐economic Inequality in Oral Healthcare Coverage: Results from the World Health Survey. J Dent Res. 2010.

Due to unequal distribution of oral health professionals and lack of appropriate facilities, 90% of oral diseases remain untreated

Coverage for oral health care of adults with expressed need ranges from 21% to 64% in the Region

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RRelationship elationship between oral diseases between oral diseases & other & other NCDs NCDs goes beyond common risk goes beyond common risk factorsfactors

Diabetes mellitus is linked with the development and progression of periodontitis

Causal link between high sugar consumption, and diabetes, obesity and dental caries

Oral Diseases are linked to HIV, Low Birth Weight, Cardiovascular Disease, and Diabetes

Smoking and tobacco use and harmful use of alcohol are key risk factors for development of HPV‐negative oro‐pharyngeal cancers

Oral diseases are increasing due to a growing consumption of sugars and inadequate exposure to fluorides. Their treatment places considerable economic burden on communities and individuals.

• Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015.• HashibeM, Sturgis EM. Epidemiology of oral‐cavity and oropharyngeal carcinomas: controlling a tobacco epidemic while a human papillomavirus epidemic emerges. Otolaryngol Clin

North Am. 2013; 46:507‐520.• Lempert SM, Froberg K, Christensen LB, KristensenPL, HeitmannBL. Association between body mass index and caries among children and adolescents. Community Dent Oral Epidemiol.

2013 doi: 10.1111/cdoe.12055. Rodriguez T, Altieri A, Chatenoud L, Rodriguez, T et al. "Risk factors for oral and pharyngeal cancer in young adults". Oral Oncol. 2004, 40 (2): 207–213)

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2. Burden & Impact





WHO strategic orientationsWHO strategic orientations

Build multisectoral actions beyond the

health sector

Advocate for strong & sustained political

leadership

Make diseases prevention and ORH promotion

work by addressing common risk

factors

Ensure universal

coverage to primary oral health care

Reinforce comprehensive surveillance systems for

NCDs and their risk factors

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44 55

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2. Burden & Impact





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Regional Oral Health Regional Oral Health Strategy 2016Strategy 2016‐‐2025 2025

The Strategy is the first ever oral health policy document aligned and interlinked with the global NCD agenda

It focusses on 4 objectives and aims to achieve 5 oral health targets

Oral health professionals improve oral health by contributing to the fight against NCDs

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Objective 1: Strengthening national advocacy, leadership, multisectoral action and partnerships for integrated prevention and control of oral diseases

Objective 2: Reducing common risk factors of oral diseases and NCDs, promoting oral and general health and ensuring regular and general use of appropriate fluorides

Objective 3: Strengthening health system capacity for integrated prevention and control of oral diseases

Objective 4: Improving integrated surveillance of oral diseases, monitoring and evaluation of programmes and research

Regional Oral Health Strategy 2016Regional Oral Health Strategy 2016‐‐20252025

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Official release, 4th May 2016, Niger

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Other existing tools & experiencesOther existing tools & experiences

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2. Burden & Impact





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Concluding Remarks Concluding Remarks

1. The global momentum on NCDs provides a unique opportunity for countries to prioritize oral health so as to directly contribute to the reduction of NCDs

2. Using the solid NCDs policy foundations and the regional consensus on oral health about priority actions based on effective population‐wide prevention interventions & and comprehensive patient‐centred care strategies

3. Under the leadership of countries sustainable mechanisms should be created for coordination of technical and financial partners and make optimal use of the opportunities created by all the stakeholders.

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Thank [email protected]

….now let's talk about real life experiences from the field!