Public Health Professionals’ Education and Training (PET) Policy: Ensuring a Trained Public Health Workforce

Globally, public health training primarily occurs through Master of Public Health (MPH) programs, although undergraduate and doctoral programs also exist. Although difficult to measure, globally public health teaching programs appear to be increasing in number. Accreditation of public health programs, however, remains inconsistent.

There are several locally developed public health competency sets, designed to guide the content of public health education programs and practice guidelines. A recent analysis has demonstrated that these competency sets align with the content and meaning of the Global Charter, with some including additional competencies driven by local (but globally relevant) need (including human rights, cultural responsiveness, and systems thinking) (Coombe et al, 2020). It is also worth noting that efforts are underway to include competencies related to climate change and holistic approaches, such as One Health (for example, WHO ASPHER, 2021).

Developing such competencies, as well as tackling hyper-specialized, fragmented, and “silo” learning models to influence complex webs of policy and governance, can be achieved through building interprofessionalism and interdisciplinarity.

Global Emergencies and the Demand for Public Health Workforce Training

In 2019–21, the world experienced massive transcontinental bushfires in both North and South America, the Arctic, and Australia; at least 20 major floods and cyclones, including Cyclone Amphan in Asia; severe droughts affected all continents (more than 10% of North America); earthquakes and landslides; volcanic eruptions; and infectious diseases, including the SARS CoV-2 pandemic. All these emergencies mobilized public health responses, highlighting the need for public health leaders and professionals to be involved at every level of emergency management and recovery planning and execution.

In the short or long term, the consequences of public health emergencies result in populations that are, in some ways, restricted or displaced, with associated threats to wellbeing, including the security of shelter, food and water provision, health care, income, gender equality, and education. Many aspects of universal progress towards the Sustainable Development Goals are disrupted when such emergencies arise. For example, analyses point to a regression in women’s progress as a result of epidemics (Power 2020, Özkazanç-Pan 2020).

During environmental and health emergencies, public health competence, including familiarity with its key principles, is essential to the management and subsequent recovery of people, their environments, and coexisting plants and animals. Most of these events have resulted in the mobilization of public health responses.

In addition, there is now evidence that public health graduate employers are seeking specific competencies in climate change and global warming, including climate change justice, climate mitigation, GIS mapping, and climate modelling (Krasna et al., 2020).

The Critical Role of Trained Public Health Departments

It is therefore critical that public health efforts are included in the mitigation and recovery plans developed for real-world use, but this is not possible if trained public health professionals do not staff public health departments, and if public health professionals are not part of routine governance and government processes. Results of the recent PHWINS survey in the USA showed that only 14% of public health staff had public health qualifications (Sellers et al, 2019). We note that in Australia, very few advertised public health jobs require public health qualifications (Watts et al, 2019).

In addition, public health graduates are employed in many sectors, not necessarily in the broad field of public health and health care or the government sector. There is a need to assess the labour market demand and develop public health job taxonomies which will clearly define governmental jobs and job profiles to enhance hiring of public health graduates (Krasna H et al, 2021), bearing in mind that the supply of graduates may outstrip current employment demand (Watts et al, 2021).

Challenges in Maintaining Public Health Programs

Public health is both reactive and proactive. However, public health initiatives can cause public health programs to become victims of their own success, because when public health initiatives work, the obvious and immediate need for them dissipates. Examples of successful programs include routine contact tracing in non-pandemic times, clean air and water initiatives, and accident-reduction programmes. Often, these initiatives are handed over to specialized departments, for example, women’s health and cancer screening programs.

Maintaining resources for routine public health program maintenance can be difficult when resources are limited and public interest and political imperatives wane. When interventions work well to prevent disease, it can seem as if nothing has happened, making the importance of sustained public health provision invisible to the general public.

Public health initiatives are also multifaceted; they often begin with straightforward epidemiology, but successful controls also draw on social epidemiology, health promotion, policy, cultural responsiveness, Indigenous knowledges, systems thinking, advocacy, and capacity building. The WFPHA Global Charter can be applied to any public health problem and used to identify gaps and shortfalls in short- and long-term responses.

Arguably, management of the ongoing SARS-CoV-2 pandemic has been hampered in many places by inappropriate, fragmented, partial, and incomplete application of public health initiatives.

Example of an Outbreak Response Lacking Public Health Coordination: Housing Tower Lockdowns in Melbourne

During the COVID pandemic, on the afternoon of July 4th in Melbourne, and early in Melbourne’s “second wave,” with no warning, a group of nine public housing tower blocks housing around 3,000 people were completely locked down. The towers had been identified as central to the transmission of SARS-CoV-2 and also connected to other transmission sites. This was the first time emergency powers in relation to the pandemic had been enacted in Victoria.

Residents were immediately confined to their homes, not allowed to leave even for necessities such as medicines and infant formula. Following testing, although rules were relaxed somewhat in eight blocks, residents of one tower remained confined for two weeks. The tower blocks house a multicultural group of residents, many of whom arrived as asylum seekers and refugees, for whom English is not a first language, and for whom having members of the security services patrolling their homes, with whom they were not able to effectively communicate, was frightening.

The decision to lock down the towers was made by the Victorian Government, which, although acting on broad public health advice, was made at speed and without apparent consultation with public health staff. Whilst the appropriate health officer signed the orders, it was with insufficient time to discuss the implications of this action.

An ombudsman investigation into the way this was conducted showed that whilst the need to lockdown might have been necessary, the way it was carried out, without due consideration of the impact on residents, breached their human rights.

Despite Australia’s SARS-CoV-2 response being an example of a reasonably well-controlled outbreak response, it has nevertheless encountered challenges with far-reaching implications when public health-trained staff were not involved in incident management. This example shows that, even in a country with a trained core public health workforce, poor communication between departments when public health responses are not implemented and coordinated by public health professionals can have far-reaching implications.

Importance of Public Health Workforce Training Across All Units

Public health is a discrete part of health service provision, with its own specialist training. Some critical aspects of public health have developed as sub-specialities (for example, epidemiology and biostatistics, vaccination and immunization, and health promotion) in the same way that other health specialities have. However, the successful implementation of public health programs requires an understanding of all aspects of public health.

It has been noted that public health units in various countries are led by people with little or no public health training, a factor that has been considered by public health organizations in the past, including the WHO and the WFPHA (Sadana 2007, WHO 2006). As there is a potential oversupply of public health graduates, public health units need to prioritize employing public health-educated graduates to prevent them from being lost to other employers and missing meaningful change-agent opportunities (Watts et al., 2021; Krasna et al., 2021).

We propose that the importance and visibility of public health can be improved if appropriately trained people are included in all plans, directly or indirectly, that involve the health of whole populations.

We note that not all public health education programs are based on public health competencies and are not all accredited courses, potentially leading to inconsistencies in course content and delivery (Watts et al., 2021). We therefore also propose that public health education draws on practical experiences from service provision, where possible through teaching staff having government public health service provision, including through joint appointments, and that all public health teaching programmes should be based on a locally appropriate set of competencies, and that public health courses should be accredited. This will provide graduates with a set of knowledge and skills on which employers can rely.

Recommendations

• The WFPHA endorses the need for all jurisdictions working with populations affected by emergencies to employ staff who have been appropriately trained in public health.

• That WFPHA endorses the inclusion of staff trained in public health (both during the development of public health plans and programmes designed to manage responses to public health emergencies, and during regular activities), whether the need arises from environmental or pathogenic causes.

Actions Sought

• The WFPHA petitions its members, including their managers, to demonstrate the importance of undertaking training in accordance with a set of public health competencies that align with the WFPHA Global Charter.

• The WFPHA petitions its members to ensure that those teaching in core areas of public health are appropriately trained in the discipline of public health, in accordance with a set of public health competencies that align with the WFPHA Global Charter.

• The WFPHA, through the PET working group, identifies and distinguishes between foundational and specialized competencies for the purpose of accrediting varying programme levels (undergraduate, postgraduate, and doctoral levels), similar to the CEPH mechanism in the USA, to both harmonize public health training globally and distinguish between public health training and the more hyper-specialized and fragmented learning models.

• The WFPHA develops a mechanism to endorse public health competency sets for accreditation of public health education and training programs.

• That WFPHA lobbies the WHO to recommend that appropriately qualified people staff public health departments and teaching programs.

References

Coombe L, Severinsen C, Robinson P. Practical competencies for public health education: a global analysis. International Journal of Public Health. 2020, 65: 1159–1167.

Krasna H, Czabanowska K, Jiang S, et al. The Future of Careers at the Intersection of Climate Change and Public Health: What Can Job Postings and an Employer Survey Tell Us?. Int J Environ Res Public Health. 2020;17(4):1310. Published 2020 Feb 18. doi:10.3390/ijerph17041310

Krasna H, Czabanowska K, Beck A, Cushman LF, Leider JP. Labour market competition for public health graduates in the United States: A comparison of workforce taxonomies with job postings before and during the COVID-19 pandemic. Int J Health Plann Mgmt. 2021;1–17. https://doi.org/10.1002/hpm.3128KRASNA ET AL.-17.

Lomazzi M. A Global Charter for the Public’s Health—the public health system: role, functions, competencies and education requirements. European Journal of Public Health, 2016:26:2: 210–212. doi.org/10.1093/eurpub/ckw011

Özkazanç-Pan B, Pullen A. Gendered labour and work, even in pandemic times. Gend Work Organ. 2020 Sep; 27(5): 675–676. doi: 10.1111/gwao.12516

Power K. The COVID-19 pandemic has increased the care burden of women and families. 2020. Sustainability: Science, Practice and Policy, 16:1:67-73.doi.org/10.1080/15487733.2020.1776561

Sadana R, Mushtaque A, Chowdhury R, Petrakova A. Strengthening public health education and training to improve global health. Bull World Health Organ. 2007 Mar; 85(3): 163.doi: 10.2471/BLT.06.039321.

Sellers K, Leider J, Gould E, Castrucci B, Beck A, Bogaert K, Coronado F, Shah G, Yeager V, Beitsch L, and Erwin P. The State of the US Governmental Public Health Workforce, 2014–2017. American Journal of Public Health 2019,109: 674-680.

United Nations. United Nations Sustainable Development Goals. Developed for release in 2015. Cited 12/02/2020 

WFPHA. The Global Charter for the Public’s Health. World Federation of Public Health Associations, 2020. Cited 05/01/2021.

Watts RD, Bowles DC, Fisher C, Li W. Public health job advertisements in Australia and New Zealand: a changing landscape. Australian and New Zealand Journal of Public Health: 2019, 43(6):522-428.

Watts RD, Bowles DC, Fisher C, Li W. The growth of Australian public health graduates and courses, 2001-2018: implications for education and employment opportunities. Australian and New Zealand Journal of Public Health. Early View, First published: 22 February 2021.

WHO. World Health Report 2006: Working Together for Health. Geneva: World Health Organization; 2006. (Cited 26/02/2021)

WHO. WHO-ASPHER Competency Framework for the Public Health Workforce in the European Region. 2020. WHO Regional Office, Copenhagen, Denmark. (Cited 20/03/2021 at https://www.euro.who.int/__data/assets/pdf_file/0003/444576/WHO-ASPHER-Public-
Health-Workforce-Europe-eng.pdf.)

WHO. Essential public health functions, health systems and health security: developing conceptual clarity and a WHO roadmap for action. Geneva: World Health Organization; 2018. Licence: CC BY-NC-SA 3.0 IGO. (Cited 05/01/2021 at https://apps.who.int/iris/bitstream/handle/10665/272597/9789241514088-eng.pdf?sequence=1&isAllowed=y.)

The Value-Based Vaccination Approach: Strengthening Sustainable Healthcare Systems

Healthcare systems worldwide are under pressure to optimize resources while still delivering high-quality, patient-centred care. Achieving long-term sustainability requires a shift toward frameworks that support financial efficiency and improved health outcomes. Value-based vaccination, a core application of value-based healthcare, provides a comprehensive framework for evaluating the broader impact of vaccines across personal, societal, allocative, and technical dimensions.

First introduced in 2010, value-based healthcare initially centered on efficiency and on health gains relative to resources invested.

Today, the concept is broader and built on four interconnected pillars essential for solidarity-based healthcare systems:

• Personal value: Ensuring vaccination aligns with individual goals and patient needs.

• Societal value: The contribution of vaccination to community wellbeing, social participation, and collective protection.

• Allocative value: Equitable distribution of vaccination resources across populations.

• Technical value: The efficiency and effectiveness of vaccination strategies.

When applied to vaccination, these four pillars highlight benefits that go far beyond disease prevention. Vaccination generates productivity gains, reduces care needs, offers community protection (including herd immunity), and strengthens social cohesion. These broad benefits contribute directly to the Sustainable Development Goals by fostering healthier, more economically stable societies.

Increased investment in vaccination programs, coupled with greater recognition of the full value of vaccines, will save lives, reduce long-term costs, and improve health outcomes across the life course. Vaccination should therefore be viewed not only as disease prevention, but as a high-value public health investment.

This report synthesizes evidence on the personal, societal, allocative, and technical pillars of value-based vaccination. It provides recommendations for advancing meaningful policy actions that reflect the full value of vaccines.

Issue

Healthcare systems must optimize resources while maintaining patient-centered care. Sustainability efforts must evaluate financial realities and quality improvements. Value-based vaccination supports this balance by ensuring decisions reflect outcomes that matter to individuals, communities, and health systems as a whole.

Approach

A systematic review of English-language literature published between December 24, 2010, and May 27, 2020, was conducted across three central scientific archives. Studies were included if they addressed the value of vaccination against vaccine-preventable diseases and were conducted in advanced economies, as defined by the International Monetary Fund.

A detailed analysis was conducted of studies in which value was a key focus. A steering committee of international vaccination experts contributed additional insights and helped develop recommendations.

Results

The review identified 107 studies, with the following trends:

• 72.9% were primary research studies.

• Approximately half directly addressed the value.

• 83.3% evaluated only one value pillar.

• Two-thirds focused on technical value.

• Only 11.1% addressed allocative value, and 16.7% addressed societal value.

Key findings include:

• Technical value is typically evaluated through cost analyses (cost-effectiveness, cost-utility, cost-benefit, cost-of-illness, and budget impact). Still, these traditional economic models often fail to capture the broader societal benefits of vaccination.

• Personal value is most often assessed through attitudes, preferences, and perceptions—essential factors for improving vaccine uptake.

• Societal value encompasses indirect protection (herd immunity), reduced antimicrobial resistance, social responsibility, cohesion, and overall population well-being, all of which require further evidence.

• Allocative value is often limited to affordability but should also encompass equity, accessibility, and appropriate resource allocation.

Recommendations

The steering committee and evidence synthesis generated the following recommendations to support value-based decision-making for vaccines.

Decision-Making Process

• Develop capacity-building initiatives for researchers and policymakers to strengthen the integration of value-based vaccination in decision-making.

• Embed all four pillars of value into national, regional, and supranational vaccine policy frameworks.

• Improve governance by increasing collaboration between authorities, health professionals, scientists, citizens, and industry.

• Promote shared decision-making across all stakeholders involved in vaccination programmes.

Research

• Build consensus on the dimensions of the four value pillars as they apply specifically to vaccination.

• Identify barriers to assessing the full value of vaccines.

• Expand and translate research on the broad societal impact of vaccination.

• Strengthen evidence generation to support evidence-based vaccine policy and post-implementation evaluation.

• Develop tools and models that enable HTA and related frameworks to more accurately assess the full value of vaccination.

• Foster innovative public–private partnerships that support sustainable vaccine development.

Public Engagement

• Identify key levers that can increase public understanding of the full value of vaccination.

• Improve vaccination literacy among healthcare professionals and the general population.

• Develop and test strategies that actively engage communities in vaccination efforts.

Moving Forward to Strengthen Value-Based Vaccination

Integrating the full spectrum of value (personal, societal, allocative, and technical) is essential for strengthening sustainable healthcare systems and unlocking the broad benefits of vaccination. By enhancing evidence generation, improving decision-making frameworks, and elevating public engagement, value-based vaccination can support healthier, more resilient societies for generations to come.

Advancing COVID-19 Vaccine Equity Through Global Collaboration and Public Health Leadership

Around the world, governments and health systems continue to grapple with the far-reaching consequences of COVID-19. The virus does not respect borders; instead, it has exacerbated long-standing inequities rooted in social, economic, and political disparities. These inequities shape who gets sick, who gets care, and who gains access to life-saving tools such as vaccines.

Immunization remains one of the most effective public health measures, second only to clean water. Each year, vaccines prevent an estimated 2.5 million deaths and significantly reduce disease-related treatment costs. The COVID-19 crisis has underscored a critical lesson: the global balance must shift from treating disease to preventing it. Lifelong immunization is essential not only for individual health but also for sustainable health systems and community resilience.

Despite significant scientific progress and rapid vaccine development, access remains profoundly unequal. The World Federation of Public Health Associations (WFPHA) and its Global Immunization Taskforce are increasingly concerned that COVID-19 vaccine distribution may not be implemented equitably, placing vulnerable populations in low-income settings at greatest risk.

Why COVID-19 Vaccine Equity Matters Now More Than Ever

Prevention and Sustainability

Immunization saves lives, improves quality of life, and strengthens the foundation of sustainable healthcare systems. It also contributes to social and economic development, ensuring that communities can thrive long after a crisis ends.

However, disruptions to routine immunization programs during the pandemic have put 80 million children under one year old at risk of preventable diseases. As COVID-19 vaccinations rolled out globally, demand quickly outpaced supply, creating conditions in which wealthier nations could secure and pay for limited vaccine doses at the expense of communities most in need.

Lessons from Past Immunization Efforts

History shows that even when safe and effective vaccines exist, vulnerable groups in low-income regions may not gain access for years (or ever). Barriers include high program costs, weak health systems, limited geographic access to vaccination centres, and competition that constrains supply.

Strengthening immunization information systems is also essential. Secure, audited, and up-to-date data systems promote transparency, informed decision-making, and equitable allocation, ensuring no one is left behind.

A Growing Global Movement for Coordinated Action

On February 11, 2021, the WFPHA convened leaders from international NGOs for a historic meeting to collaborate on equitable access to COVID-19 vaccines and treatments. This coalition aims to build long-term equity in global public health by advocating for social protection, sustainable development, and more substantial support for vulnerable communities.

Leaders also emphasized the importance of environmentally responsible vaccine development and distribution. Protecting planetary health must go hand in hand with protecting human health to avoid exacerbating climate impacts that deepen inequities.

The coalition is committed to sharing evidence-based practices, compiling resources, engaging diverse communities, and amplifying the voices of those disproportionately affected, including chronically ill patients, marginalized populations, and individuals lacking access to quality healthcare.

Key Priorities for Achieving COVID-19 Vaccine Equity

The WFPHA Global Immunization Taskforce, alongside coalition partners, calls on the World Health Assembly, the G20, every national government, and all organizations working in public health and social development to take urgent, coordinated action.

Their recommendations include:

Support Research, Development, and Global Preparedness

• Strengthen international collaboration to advance research and development of effective vaccines across multiple centers.

• Continue supporting the World Health Organization’s leadership in coordinating the global COVID-19 response.

Ensure Equitable Access to Vaccines

• Establish a global COVID-19 vaccination fund to assist resource-constrained countries.

• Support the COVAX initiative to ensure equitable vaccine distribution worldwide, with particular attention to vulnerable populations.

Strengthen Health and Social Protection Systems

• Invest in national health systems with a focus on sustainable immunization programs.

• Expand and support the healthcare, public health, and social protection workforce.

• Address social, economic, and health system barriers that hinder vaccine uptake and distribution.

Promote Sustainability and Environmental Responsibility

• Guarantee environmentally and economically sustainable vaccine production and distribution.

• Encourage climate-conscious approaches that do not compound existing inequities.

Engage Communities, Youth, and Civil Society

• Involve youth, young professionals, patient organizations, community groups, and health professionals in decision-making and implementation.

• Enhance risk communication, combat misinformation, and address vaccine hesitancy across diverse communities.

Moving Forward Together

The COVID-19 pandemic has revealed how tightly interconnected the world is and how inequities in one region reverberate globally. Building a fairer and more resilient future requires continued collaboration, shared responsibility, and unwavering commitment to vaccine equity.

This growing coalition of global health leaders has immense potential to strengthen our collective response to inequity during the pandemic and throughout the years of recovery ahead. By working together to prioritize equitable access, invest in sustainable systems, and ensure no one is left behind, we can chart a path toward a healthier, more just world for all.

Treaty on the Prohibition of Nuclear Weapons: A Historic Step for Global Health, Humanitarian Protection, and Planetary Security

As the Treaty on the Prohibition of Nuclear Weapons (TPNW) officially enters into force, international health and humanitarian organizations mark this moment as a historic victory for nuclear disarmament, humanitarian protection, and planetary health. This milestone represents a decisive move toward preventing the catastrophic health and environmental consequences caused by nuclear weapons.

Organizations including International Physicians for the Prevention of Nuclear War (IPPNW), The International Committee of the Red Cross (ICRC), International Council of Nurses (ICN), International Federation of Medical Student Associations (IFMSA), and World Medical Association (WMA),  proudly welcome the world’s first comprehensive, legally binding international prohibition of nuclear weapons.

A Strong Treaty Built on Evidence, Expertise, and Humanitarian Imperatives

Our organizations have long contributed scientific evidence, health expertise, and field-based humanitarian experience to expose the devastating consequences of nuclear weapons. The reality is apparent:

• Any nuclear weapons detonation would cause unspeakable human suffering, radiation exposure, and long-term environmental destruction.

• No nation or health system has the capacity to provide adequate medical or humanitarian response.

• Prevention is the only possible cure.

With the TPNW now part of international law, all ratifying states are legally bound by its provisions, establishing an essential new global standard against the world’s most destructive weapons.

Proven Success: How Prohibition Treaties Reduce Weapons and Save Lives

History shows that prohibition works. Treaties banning biological weapons, chemical weapons, antipersonnel landmines, and cluster munitions have all reduced use, stigmatized possession, and influenced even states that have not yet joined.

The TPNW is already shaping global behavior. Financial institutions worldwide, including banks, pension funds, and insurance companies, are increasingly divesting from nuclear weapons manufacturers, signaling a decisive shift toward ethical and sustainable investment.

Nuclear Weapons: The Greatest Immediate Threat to Human Health

The World Health Organization identified nuclear weapons as “the greatest immediate threat to the health and welfare of humankind” as early as 1983. Experts today warn that the risk of nuclear war is as high (or even higher) than during the Cold War.

Recent trends are deeply alarming:

• Critical arms-control treaties have been dismantled.

• Nuclear-armed states are investing heavily in new, more sophisticated weapons.

• Cyber vulnerabilities threaten nuclear command-and-control systems.

• Rising geopolitical tensions and climate-driven instability increase the risk of escalation.

Climate scientists warn that even a limited nuclear war, using less than 2% of the global arsenal, would inject massive amounts of smoke into the atmosphere, disrupt global climate patterns, and cause a global nuclear famine threatening billions of lives.

The TPNW: A Necessary Pathway to Eliminate Nuclear Weapons

The Treaty on the Prohibition of Nuclear Weapons offers a pragmatic and inclusive framework for the complete elimination of nuclear weapons, fulfilling the legal obligations of all states, whether nuclear-armed or not.

Supporting Survivors and Restoring Contaminated Environments

For the first time, an international agreement requires states to:

• Assist victims of nuclear weapons use and testing

• Remediate contaminated environments

• Advance long-overdue humanitarian and environmental recovery

Even states not yet prepared to join the Treaty are encouraged to contribute to these critical efforts.

Why Global Cooperation Is Urgent Now

The COVID-19 pandemic and the accelerating climate crisis have underscored the necessity of rapid, evidence-driven international collaboration. Nuclear weapons are entirely human-made; preventing their use is within humanity’s control.

Ending nuclear weapons before they end humanity is a public health, humanitarian, and planetary imperative.

A Call to Action

The TPNW represents an extraordinary opportunity to build a safer, healthier, and more sustainable future. We urge all nations to:

• Sign the Treaty

• Ratify the Treaty

• Fully implement its provisions

Eliminating nuclear weapons is essential to safeguarding global health, protecting future generations, and preserving life on Earth.

About Our Organizations

International Committee of the Red Cross (ICRC)

A neutral, impartial, and independent humanitarian organization dedicated to protecting the lives and dignity of victims of armed conflict and promoting international humanitarian law.

International Council of Nurses (ICN)

A federation of more than 130 national nurses’ associations representing over 20 million nurses worldwide.

International Federation of Medical Student Associations (IFMSA)

One of the world’s largest student-run organizations, representing 1.3 million medical students across 134 countries, is committed to global health leadership.

International Physicians for the Prevention of Nuclear War (IPPNW)

A federation of medical organizations in 63 countries dedicated to the eradication of nuclear weapons; recipient of the 1985 Nobel Peace Prize.

World Federation of Public Health Associations (WFPHA)

The global voice for public health, representing 130 national and regional associations and 5 million public health professionals.

World Medical Association (WMA)

An international organization representing physicians through 115 national associations and thousands of individual members worldwide.

Why Public Health Organizations Must Reject All Collaborations with the Tobacco Industry

The global tobacco epidemic continues to be one of the most urgent and preventable public health threats of our time. With more than 8 million deaths each year, tobacco use disproportionately harms low- and middle-income countries, regions aggressively targeted by the tobacco industry marketing. Despite decades of evidence-based strategies proven to reduce smoking rates, progress is consistently undermined by the influence, funding, and strategic interference of the tobacco industry.

This article explores why public health organizations must categorically reject collaboration with the tobacco industry, the global framework guiding this stance, and how the public health community can strengthen its collective commitment to a tobacco-free world.

The Global Burden of Tobacco and the Need for Strong Public Health Action

Tobacco remains one of the world’s leading causes of preventable disease and death. Beyond the 8 million lives lost annually, millions more suffer from chronic conditions such as cardiovascular disease, cancer, and respiratory illnesses attributed to tobacco use.

Although effective interventions exist (including taxation, restrictions on marketing, and cessation support), their success depends on consistent and uncompromised implementation. Tobacco companies continue to obstruct these efforts by promoting misleading narratives, funding front groups, and attempting to partner with public health entities to improve their public image.

The WHO Framework Convention on Tobacco Control: A Global Mandate

A significant turning point in global tobacco control came in 2003 with the adoption of the WHO Framework Convention on Tobacco Control (WHO FCTC). As the first international treaty designed to combat the tobacco epidemic, it establishes legally binding obligations for countries that ratify it.

Key FCTC principles relevant to public health organizations

• No partnerships or collaborations with the tobacco industry

• No engagement with organizations funded by the tobacco industry

• Implementation of proven interventions such as:

  • Tobacco taxation

  • Graphic warning labels

  • Comprehensive advertising bans

These policies have repeatedly demonstrated their effectiveness in reducing demand, preventing initiation, especially among youth, and supporting cessation.

The WHO also explicitly urges all public health organizations to avoid any action that could create the impression of partnership with the tobacco industry.

Why Collaboration with the Tobacco Industry Undermines Public Health

The tobacco industry has a long history of using sponsorships, grants, and corporate social responsibility initiatives to gain credibility and influence. Such collaborations:

• Provide the industry with a platform to shape and weaken public policy

• Create conflicts of interest that compromise public health objectives

• Mislead the public into believing tobacco companies are acting in good faith

• Undermine global efforts toward a tobacco-free future

Allowing these partnerships, even indirectly, opens the door to manipulation and obstructs evidence-based public health initiatives.

WFPHA’s Position: A Clear Call for Independence from Tobacco Influence

The World Federation of Public Health Associations (WFPHA), together with the Global Coalition for Circulatory Health and the World Heart Federation, has long condemned the tobacco industry’s attempts to subvert tobacco control policies.

The WFPHA applauds the majority of public health organizations worldwide that already reject any form of collaboration with the tobacco industry. However, the organization emphasizes that more must be done.

WFPHA urges all public health associations to:

• Develop and adopt strong internal policies preventing collaboration with the tobacco industry

• Initiate open, transparent discussions within their organizations about tobacco influence

• Raise awareness among members, partners, and communities

• Advocate consistently for a tobacco-free world

• Recognize the disproportionate harm tobacco causes to vulnerable populations

Public health organizations have a responsibility not only to protect their independence but also to expose and challenge the tobacco industry’s pervasive influence on global health.

Moving Forward: Strengthening the Path Toward a Tobacco-Free World

Ending the tobacco epidemic requires unwavering commitment. Public health groups must remain vigilant against tactics designed to weaken tobacco control policies, distract from harmful products, or position the industry as a stakeholder in health solutions.

By rejecting all collaborations with the tobacco industry, public health organizations preserve the integrity of their work and strengthen global efforts to protect the world’s most vulnerable communities.

A healthier, tobacco-free future is within reach, but only if the public health community continues to stand united, independent, and uncompromised.