Oral Health Working Group Chair Interview: Dr. Hyewon Lee

Oral health is a crucial component of public health, affecting overall well-being and quality of life. Poor oral health can lead to significant health issues, including cardiovascular diseases, diabetes, and respiratory infections. Ensuring good oral health practices and integrating them into broader public health strategies is essential for promoting health equity and preventing diseases. 

In this interview, we speak with Hyewon Lee, Chair of the Oral Health Working Group for the World Federation of Public Health Associations (WFPHA), to gain insights into her career, the activities of her working group, and the importance of oral health in the public health sector.

Please introduce yourself.

Hyewon Lee: My name is Hyewon Lee. I’m the chair of the Oral Health Working Group of the World Federation of Public Health Associations and a pediatric dentist.

What motivated you to pursue a career in the public health sector

Hyewon Lee: As a pediatric dentist, I often see young patients with severe dental caries who require dental treatment under general anesthesia. A prevention-centered care approach is crucial to alleviating families’ financial burden and emotional stress. This led me to focus on early prevention, starting with pregnant women. About 12 years ago, I worked on the U.S. national guideline for pregnant women’s oral health, which sparked my interest in public health and preventive care.

How long have you been associated with the World Federation of Public Health Associations?

Hyewon Lee: This year marks my 13th year with the WFPHA. I joined in 2012 as an intern, progressed to vice chair, and now serve as chair. I’ve really grown with the Public Health Association throughout my career.

Could you elaborate on your working group’s current activities and share your vision and plans for the future?

Hyewon Lee: Our working group is unique because we collaborate extensively with other groups, such as the Tobacco Control, the Women, Children, and Youth Health, Non-Communicable Diseases, and Young Working Groups, to advance our shared health agendas. We’ve worked on several policy resolutions endorsed by the General Council of the WFPHA and published articles highlighting oral health in primary healthcare and beyond, including the WFPHA Maternal and Child Oral Health Initiative.

How do the working group’s activities align with the Association’s strategic plan?

Hyewon Lee: About ten years ago, I was involved in rolling out the Global Charter, which emphasizes promoting health, preventing diseases, and amplifying the voices of people and health professionals. The Oral Health Workgroup focuses on prevention and promotion rather than just treatment, which aligns with the core values of the WFPHA. We also catalyze insights and collaborations among our diverse group of 30 members across 17 countries.

How has being part of the Association and its network enhanced your working group’s activities and expanded its reach?

Hyewon Lee: One of our significant achievements is the WFPHA Maternal and Child Oral Health Initiative, launched in 2023 during the World Congress on Public Health. This initiative, developed in collaboration with various international and national organizations, aims to integrate oral health into antenatal and primary healthcare. Endorsed by over 50 international and national entities, including ministries of health and health professional organizations, it aims to expand our collaboration and highlight oral health in maternal and child healthcare systems.

How has being part of the Federation enhanced your group’s ability to advocate for dental public health globally?

Hyewon Lee: We recently conducted a global oral health workforce survey to identify the primary oral health workforce’s challenges. Our findings shared at the International Federation of Dental Hygiene Associations Conference emphasized the need for a broader definition of the primary oral health workforce. We are also in the process of highlighting various school-based oral healthcare models in the form of a casebook later this year, and we have published an editorial in the Journal of School Health. We envision that oral health is integrated into the health sector and, beyond that, in education and other fields so that oral health becomes an integral part of people’s lives.

How does your working group plan to engage communities in oral health initiatives?

Hyewon Lee: Engaging communities depends on how we define them. We have reached out to public health professionals in the past. To truly measure our impact, we need to involve community members, especially caretakers, as integral parts of the primary healthcare systems. We plan to include more youth and junior members in our working group, as their perspectives and innovative ideas can revitalize our efforts. For example, we’re proposing a networking event, collaborating with other public health organizations during the UN General Assembly Meeting later this year to discuss current oral health challenges and innovative solutions in the view of future oral health professionals.

What unique opportunities has your group gained from the Federation network and resources?

Hyewon Lee: Being part of the WFPHA allows us to collaborate with other work groups and integrate oral health into broader health discussions. We’re currently teaming up with the Non-Communicable Diseases (NCD) Prevention Working Group to develop a podcast series on the link between oral health and NCDs. This collaboration, made possible by the nurturing environment of the WFPHA, helps us promote oral health as an essential component of overall health and well-being.

The work of Hyewon Lee and the Oral Health Work Group highlights the critical role of oral health in public health. They are making significant strides in integrating oral health into broader health strategies through collaboration, innovative models, and community engagement. Their efforts underscore the importance of preventive care and the need for a comprehensive approach to health that includes oral health as a fundamental component.

Working group members:

Abiola Adeniyi (Vice-chair), Assistant Professor, Fairleigh Dickinson University Vancouver, Canada.

Aarthi Shanmugavel BDS, MPH, Manager, PhD Candidate, American Dental Association, USA.

Cleopatra Matanhire-Zihanzu BDS, MPH, PhD Candidate, University of Zimbabwe Department of Oral Health, Zimbabwe.

Dorjan Hysi DDS, MsC, PhD, Associate Professor, University of Medicine Tirana, Faculty of Dental Medicine, Albania.

Gloria Ha Young Ahn DDS, Intern, WFPHA, USA.

Hyewon Lee (Chair) DrPH, DMD, Director,  the Seoul National University Global Maternal and Child Oral Health Center,  South Korea.

Irene Adyatmaka DDS, PhD, Senior Lecturer, the Maranatha Christian University, Faculty of Dentistry, Indonesia.

Woo Jung Yang, DDS, Endodontist,  Seoul Leaders Dental Clinic, South Korea.

Jemima Khabiso Ramphoma BChD, MChD Dental Public Health, Senior Lecturer, the University of the Western Cape, Department of Community Dentistry, South Africa.

Kenneth Eaton, MSc, PhD, Chair of the Platform for Better Oral Health in Europe, The Council of European Chief Dental Officers, UK.

Kiran P. Nagdeo (Vice-chair) BDS, MPH, PhD Candidate,  Department of Epidemiology, NYU School of Global Public Health, USA.

Leonie Short, MHP, Director, Seniors Dental Care, Australia, Australia.

Lynn Bethel Short, RDH, MHP, Communications Director, American Fluoridation Institute, USA.

Myron Allukian Jr., DDS, MPH, Former APHA President, American Public Health Association, USA.

Pascaline Kengne Talla, PhD, Professor, McGill University, Canada. 

Puneet Gupta, MDS, Associate Professor, the Government College of Dentistry, Indore, India. 

Rachel Martin, BDSc, MPH, Director, the Network for the Integration of Oral Health, Australia.

Rahimah Abdul-Kadir, DrPH, DDS, Professor, the University Malaya Center for Addiction Sciences, Malaysia.

Ramprasad Vasthare, MDS, FAIMER fellow, Professor, the Manipal College of Dental Sciences, Manipal, India.

Seema Lal-Kumar, BDS, MSc Paed, Dental Specialist, Te Marae Ora, Ministry of Health, Cook Islands.

Sonia Groisman, PhD, Post PhD, DNA Lab Diagnosis, State University of Rio de Janeiro, Brazil.

Valerie Wordley, BDS, MPH, Clinical Advisor, NHS England, United Kingdom.

Vyhari Chandrasorupan, MPH, Intern, WFPHA, Australia.

Global School Oral Health: Innovative Programs for Lifelong Well-Being

The World Federation of Public Health Associations (WFPHA) Oral Health Working Group has developed a casebook showcasing successful global school oral health programs. These initiatives play a vital role in children’s development and overall well-being, addressing a significant public health issue—untreated oral diseases, which affect half of the world’s population. Educators and health professionals can integrate oral health into children’s daily lives by implementing school-based programs, setting the foundation for lifelong healthy habits.

The casebook highlights eight programs from diverse regions: Canada, Brazil, Scotland, the Cook Islands, South Africa, Tonga, Indonesia, and Armenia. While each program is unique, they share common themes: prevention, cultural sensitivity, stakeholder engagement, and innovation in service delivery. Successes include reduced dental caries rates, improved oral hygiene, and broader community awareness. However, challenges such as funding inconsistencies and reaching out-of-school children persist.

The casebook emphasizes strengthening collaboration, developing scalable models, and advocating for consistent funding and policies to ensure future programs are effective and sustainable. School-based oral health programs are essential in improving children’s health and have long-term benefits that extend into adulthood.

The Importance of Oral Health in Schools

Oral health is a fundamental aspect of overall well-being, yet untreated oral diseases remain a widespread issue, particularly in children. According to the WHO’s 2022 Global Oral Health Status Report, untreated dental caries are the most prevalent disease among children globally. Poor oral health impacts school attendance and academic performance, leading to health inequities. Integrating oral health education into school systems can address these issues early, benefiting children’s health and development.

The WHO, UNESCO, and World Bank’s 2022 School Health Report highlights the significance of school-based health programs in promoting children’s physical and mental health. Schools offer an ideal environment for oral health programs, providing cost-effective, accessible, and equitable interventions. By engaging teachers, parents, healthcare providers, and community leaders, schools create supportive environments for promoting oral health and establishing healthy behaviors.

Global Case Studies in School Oral Health Programs

The casebook features innovative school oral health programs across various socioeconomic and geographic contexts. These programs demonstrate effective strategies for improving children’s oral health:

• Canada (Quebec): A focus on prevention through community engagement and culturally tailored interventions.
• Brazil (Paraty): Leveraging partnerships with local health authorities to integrate oral health into existing school health programs.
• Scotland (Childsmile): A comprehensive approach that includes training non-dental professionals to deliver oral health education.
• The Cook Islands: A culturally sensitive program designed to reach children in remote areas.
• South Africa (Gogos Give Smiles): Community elders are trained to educate children on oral hygiene, bridging generational gaps.
• Tonga: A government-backed initiative that prioritizes policy integration and consistent funding for oral health services.
• Indonesia: Builds a community empowerment approach to service underserved communities.
• Armenia: Legislative advocacy for oral health policies that ensure long-term sustainability.

These case studies reveal that prevention, cultural adaptation, and community engagement are critical to the success of school-based oral health initiatives. By fostering collaboration between educators, healthcare providers, and families, these programs create environments that encourage healthy behaviors and improve oral health outcomes.

Strategies for Future School-Based Oral Health Programs

To enhance the effectiveness of future programs, the following strategies are recommended:

1. Strengthen intersectoral collaboration: Partnering across health, education, and community sectors will lead to a more integrated approach to oral health promotion.
2. Develop scalable models: Programs should be adaptable to different cultural and economic contexts, ensuring accessibility and relevance.
3. Expand training programs: As demonstrated by Scotland’s and South Africa’s initiatives, include non-dental professionals in oral health promotion.
4. Advocate for consistent funding: Programs need stable financial support and robust evaluation mechanisms to evolve and meet changing needs.
5. Use policies as tools: As Armenia’s legislative efforts have shown, integrating oral health into school health policies can ensure long-term sustainability.

Conclusion

School-based oral health programs are instrumental in improving children’s oral health and overall well-being. These programs focus on prevention, engaging communities, and innovative service delivery. To build on the success of current initiatives, future programs must address funding gaps, enhance collaboration, and develop scalable models that can adapt to diverse contexts. By prioritizing oral health education in schools, we can create healthier future generations and promote global health equity.

This casebook offers valuable insights for policymakers, educators, and health professionals seeking to design and implement effective school-based oral health programs. These programs can transform children’s health worldwide with continued innovation and advocacy.

Read the full casebook here.

Non-communicable Diseases (NCDs) Working Group Chair Interview: Dr. Jeremiah Mutwalante Twa-Twa and Dr. Prajjwal Pyakurel

Few challenges in the dynamic world of public health are as daunting as preventing and managing non-communicable diseases (NCDs). We sat down with two remarkable leaders in this field: Dr. Jeremiah Mutwalante Twa-Twa from Uganda and Dr. Prajjwal Pyakurel from Nepal. They serve as the Working Group Co-Chairs for NCD Prevention and Health Promotion within the World Federation of Public Health Associations (WFPHA). 

NCDs, which include cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes, are responsible for a significant portion of global mortality. Unlike infectious diseases, NCDs are often driven by lifestyle factors such as poor diet, lack of exercise, tobacco use, and excessive alcohol consumption. Addressing these requires a comprehensive approach involving policy change, community engagement, and ongoing research.

Can you both introduce yourselves

Dr. Twa-Twa: I’m Dr. Jeremiah Mutwalante Twa-Twa from Uganda. I’m a medical doctor by training, with additional qualifications in public health, demography, and biostatistics. I’m a member of the Uganda National Association of Community and Occupational Health, which brought me into the World Federation of Public Health Associations (WFPHA). I am the Dean of the School of Health Sciences and lecturer at Kampala University. I’ve worked with the Ministry of Health since 1980, initially as a hospital manager and later as a district health manager. I served on the team that started the Uganda AIDS Control Program in the Ministry of Health. Later, I served as the Registrar of the Uganda Medical and Dental Practitioners Council and finally headed the Child Health Division of the Ministry of Health until 2010. After that, I ventured into politics, serving in the Parliament of Uganda for five years. In Parliament, I served as Vice Chairperson of the HIV/AIDS Standing Committee of Parliament for four years. I’m the Co-Chair of the WFPHA’s NCD Prevention and Health Promotion Working Group.

Dr. Pyakurel: I’m Dr. Prajjwal Pyakurel from Nepal. I am the General Secretary of the Nepalese Society of Community Medicine. We have over 200 members dedicated to public health in Nepal. I have a deep passion for NCD prevention globally. I was a visiting Lown Scholar at Harvard T.H. Chan School of Public Health, Boston, MA, USA, 2016 and a fellow of the International Society of Cardiovascular Epidemiology and Prevention, Nadi, Fiji. I’ve been working in NCD prevention since 2011, starting as a resident in Community Medicine. This journey led me to the WFPHA, where I was honored to be nominated as co-chair of the NCD Working Group in April 2024.

What motivated you to pursue a career in the public health sector?

Dr. Pyakurel: Serving humanity has always been my primary motivation. As an academician, service is paramount. My journey into public health began in 2011 during my residency in Community Medicine and Tropical diseases at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. I researched Cardiovascular risk factors among industrial workers in Eastern Nepal. Working with these underserved populations fueled my passion for public health. They often have low education levels and face numerous challenges, making it vital for public health professionals to advocate for and support them. My goal is to conduct research that informs policy and practice changes, ultimately contributing to NCD prevention on a global scale.

Dr. Twa-Twa: My interest in public health was sparked during my medical training in the 1970s by a professor who taught preventive medicine at Makerere Medical School when I was still an undergraduate student. My career in public health began in earnest in 1980, during a period of political turmoil in Uganda. Many healthcare workers had left the country, and I was deployed to a remote hospital, quickly moving into a management role. This experience necessitated further training in public health, which the Ministry of Health facilitated. Over time, I held various administrative roles, including being part of the team that started the Uganda AIDS Control Programme in the mid-1980s and heading the Child Health Division of the Ministry of Health. These experiences solidified my commitment to public health, although I am still interested in clinical work.

How long have you been associated with the World Federation of Public Health Associations?

Dr. Pyakurel: I officially joined the WFPHA on September 29, 2022, as a working group member. I became a Chair of the NCD Working Group on April 3, 2024, alongside Dr. Twa-Twa. We’ve been actively contributing as co-chairs for the past three months.

Dr. Twa-Twa: My association with the WFPHA extends back through my involvement with the Uganda National Association of Community and Occupational Health, a member organization of the WFPHA. Our former Executive Director and founder member of UNACOH, Dr. Deogratius Kaheru Sekimpi, has been on the WFPHA board for some time. Through this connection, I was nominated to join the WFPHA, leading to my current role as co-chair of the NCD Prevention and Health Promotion Working Group.

Could you detail your working group’s current activities and share your vision and plans for the future

Dr. Pyakurel: Despite being only three months old as co-chairs of the World Federation of Public Health Associations (WFPHA) NCD Prevention and Health Promotion Working Group, we’ve hit the ground running. We’re launching monthly webinars starting July 18, 2024, and planning policy brief trainings beginning October 2024. Regular meetings are set for the third week of each month, and we’ve drafted an action plan for 2024-2026, which includes a one-year plan to be implemented from July to December 2024.

We are also seeking collaborations and funding opportunities to conduct global capacity-building programs for NCD prevention. Our vision aligns with WFPHA’s seven goals: advancing public health knowledge and promoting systematic change. For instance, we plan to conduct mass awareness campaigns, develop health promotion materials, and offer research and capacity-building training for young public health professionals worldwide. Our three-year action plan is set to be endorsed on July 25, 2024, after which we’ll begin implementing our activities.

Dr. Twa-Twa: We’re developing an inclusive action plan incorporating member feedback to address NCDs over the next three years. Our vision aligns with WFPHA’s goals and mission. I envision a vibrant working group that supports national public health associations at the grassroots level, providing guidance and coordination. Effective advocacy and addressing NCD problems through coordinated efforts will be our focus. We wish for the NCD prevention and control initiatives to take a first-line position on the health agenda at all levels globally.

How do your activities align with supporting and implementing WFPHA’s strategic plan?

Dr. Twa-Twa: Our activities are structured to address all aspects of NCDs along the WFPHA’s mission and goals. For instance, under Goal 1, we aim to develop policy briefs on issues like alcohol, drugs, and diet. Goal 2: we plan to advocate for systematic change and sustainable funding for NCDs. We’re working on strengthening the prevention and control of NCDs through robust mechanisms under Goal 3. For Goal 4, we plan to advance public health knowledge through education and research initiatives. We’re also focused on building partnerships, working closely with national Public Health Associations, and ensuring regular communication and coordination to achieve our WFPHA goals. Above all, we shall work closely with sister WFPHA-WGs to form a solid, formidable, and vibrant WFPHA team. 

How has being part of WFPHA and its network enhanced your working group’s activities and expanded its reach?

Dr. Pyakurel: WFPHA’s extensive network of over 5 million colleagues globally offers immense opportunities for collaboration and learning. Our working group benefits from this diverse pool of expertise, fostering partnerships and collaboration that enhance our efforts. Leading this group from an LMIC setup, like Nepal, is a privilege and provides us with unique perspectives to address global public health issues. This network enables us to leverage international knowledge and best practices, which can be adapted and applied to our local contexts.

Dr. Twa-Twa: We value the experience of those who have previously contributed to WFPHA-NCD-WG. In this respect, we have recently discussed with Prof Miguel Angel Royo, former Chair NCD-WG, and Professor Iidefonso Hermandez Aquado, currently Chair Policy Committee WFPHA, who have offered valuable insights. Collaboration with experienced individuals and organizations at national and international levels shall strengthen our efforts. This collective wisdom and support will help us to advocate for NCD control and prevention effectively. 

How does being part of WFPHA support your group’s efforts to promote healthy nutrition policies worldwide?

Dr. Pyakurel: Our group’s mission extends beyond nutritional policies to a broader NCD prevention and health promotion context. While we focus on food policies and healthy diets, we also aim to address other risk factors for NCDs. We plan to design vital policy documents on five major risk factors for NCDs to be advocated at the Fourth High-Level Meeting of the UN General Assembly on preventing and controlling NCDs in 2025. Raising mass awareness, especially among younger generations, about the dangers of junk food and the benefits of nutritious diets is crucial. Implementing nutritional labeling and banning unhealthy food advertisements are part of our strategy to improve global health outcomes.

Dr. Twa-Twa: Our predecessors prepared policy briefs, which we plan to continue and expand. National public health associations are crucial in influencing food standards and policies at the country level. By developing solid nutritional policies and promoting healthy eating habits, we aim to impact global health significantly. Mass awareness campaigns and educational initiatives targeting children will be essential in shifting dietary behaviors and reducing the prevalence of NCDs.

How does your working group collaborate with governments and international bodies to influence NCD prevention policies?

Dr. Pyakurel: In line with Goal 5 of the World Federation of Public Health Associations (WFPHA), we focus on strengthening partnerships with groups that share our values. Our upcoming three-year action plan includes engaging national governments, parliamentarians, and UN agencies in collaborative dialogs to control NCDs and implement relevant protocols. We aim to prepare comprehensive engagement reports, follow-up actions, and policy briefs to present to the WFPHA leadership for further advocacy at the UN Assembly. This will help elevate NCD prevention on a global scale. We’re actively involving parliamentarians, UN agencies, and government officials in our discussions to create a collaboration network for impactful work across various regions.

Dr. Twa-Twa: We’ve started this journey by engaging essential NCD control and prevention stakeholders. For example, I’ve connected with the Ministry of Health in Uganda and have been welcome to join the team developing the national NCD action plan. We’re exploring synergies at both national and international levels, seeking collaboration and partnerships with all key stakeholders to address NCDs effectively.

Dr. Pyakurel: In Nepal, I’ve worked with the Kathmandu Metropolitan City as a technical advisory group member for NCD prevention. We’re enforcing tobacco control laws and partnering with the WHO country office in Nepal for Anti-Tobacco Campaigns. Our efforts include mass school campaigns, reviewing tobacco laws, and ensuring legal coherence to counter tobacco industry challenges. 

How does the Association’s membership facilitate your group’s work with international bodies?

Dr. Pyakurel: While our focus extends beyond food labeling, we aim to engage with FAO and other bodies on broader NCD prevention policies. We plan to discuss food policies and nutritional labeling with FAO soon, ensuring our initiatives are incorporated globally.

Dr. Twa Twa: Building on past efforts, we plan to influence food policies and all NCD modifiable risk factor policy-related issues at national and international levels. This includes writing policy briefs, engaging national authorities, and ensuring the implementation of protocols for universal health coverage. NCDs and food-related issues like diet and marketing will be central to our activities.

Any last words?

Dr. Pyakurel: As part of the WFPHA’s NCD working group, our success relies heavily on team effort and leadership facilitation. We can offer technical expertise, communicate effectively, and draft proposals, but we need support from the leadership of WFPHA for collaborative initiatives and securing funding. Collaborative efforts are essential for global public health advancement.

Dr. Twa-Twa: The world must recognize that NCDs represent one of the most severe epidemics. Unlike infectious diseases, NCDs require long-term strategies to reverse their impact. International organizations, including UN agencies and the WFPHA, have a mandate and moral obligation to guide global efforts in NCD control. Immediate action is crucial, and our working group’s initiatives need the attention and support of those in positions to make a difference, not for personal gain but for the betterment of global health. Action is needed now rather than later.

In this enlightening interview, Dr. Twa-Twa and Dr. Pyakurel share their profound commitment to public health and their strategic vision for tackling NCDs. Their combined expertise and passion drive the global fight against these pervasive diseases, ensuring a healthier future for all.

Working Group Members:

Jeremiah M. Twa-Twa, Co-Chair of NCD Working Group, Member of Parliament of Uganda.

Prajjwal Pyakurel, Co-Chair of NCD Working Group, B. P. Koirala Institute of Health Sciences Nepal.

Aron Troen, member of The Hebrew University of Jerusalem, Israel.

Lidya Genene Abebe, Addis Ababa University | AAU · Department of Epidemiology and Public Health, Ethiopia.

Abigiya Wondimagegnehu Tilahun, Addis Ababa University, AAU · School of Public Health, Master of Public Health, PhD student at Martin Luther University, Ethiopia.

Abiot Mitiku Gosa, Ethiopian Red Cross Society, Addis Ababa, Ethiopia.

Sefonias Getachew, Chairperson of the research and community service committees of the public health department in Debre Berhan University (DBU), Ethiopia.

Muluken Gizaw, Addis Ababa University, AAU, Department of Preventive Medicine, School of Public Health, Ethiopia.

Zaccheous Achidi Asanga, BCH Africa.

Julienne Ngo Likeng, Governing Council of WFPHA and Executive Director of the Cameroon Public Health Association, Cameroon.

Prince T. Lamin-Boima, Njala University, Sierra Leone.

Rana Al Hamawi, Eastern Mediterranean Public Health Network, EMPHNET · Public health programs, Jordan.

Randa Saad, Eastern Mediterranean Public Health Network, EMPHNET, Center for Excellence in Applied Epidemiology BSc, MD, Lebanon.

Monika Brovč, Nacionalni inštitut za javno zdravje NIJZ, slovenia

Matthew Spiteri, (BFA) (Hons)(Melit.) in Digital Arts, University of Malta.

Nuha Fofana, Serrekunda, Kanifing Municipal Council, The Gambia Epidemiology and Disease Surveillance Officer,  Ministry of Health, The Gambia.

Ronan Payinda,  Young Health Programme (YHP) Impact Fellowship, New Zealand.

James Mckeown Amoah, national organizer for the Ghana Public Health Association.

Muhammad Aziz Rahman, a lecturer in the Institute of Health and Wellbeing at the Federation University Berwick Campus, Australia.

Sanghamitra Ghosh, Secretary General, Indian Public Health Association, India.

George Nonas, BistroMD, LLC, The Australian National University, Australia.

Expanding HPV Vaccination in Cameroon: An Interview with Chief Dominique Kondji Kondji; President, Cameroon Public Health Association (CAMPHA) and Diplomat of the Global Charter for the Public’s Health (WFPHA)

The Human Papillomavirus (HPV) is a group of viruses of more than 100 strains and is the leading cause of cervical cancer in women. HPV also causes other malignancies, including oropharyngeal, anal, penile, vulvar and vaginal. Traditionally, HPV programs take a girls-focused approach, but increasing evidence highlights the importance of vaccinating boys as well. HPV gender-neutral vaccination (GNV) provides comprehensive community protection, builds herd immunity, and improves health outcomes.

The World Federation of Public Health Associations (WFPHA) has been at the forefront of promoting HPV GNV and developing various initiatives to advance this cause. In May 2024, the WFPHA organized a high-level side event alongside the 77th World Health Assembly (WHA) in Geneva, focusing on gender-neutral HPV vaccination strategies, advocating for global implementation, and raising awareness of the critical need for these programs. Additionally, the WFPHA has expanded its outreach by launching a series of online trainings in native languages for select countries, ensuring their message reaches a broader and more diverse audience. 

Although HPV gender-neutral vaccination is standard in many high-income countries, this is not the reality in many low- and middle-income countries (LMICs). This is particularly true in Africa, where only a few countries include boys in their HPV vaccination programs. Cameroon stands out as one of the few LMICs to have successfully implemented gender-neutral HPV vaccination. In a recent conversation with Chief Dominique Kondji Kondji, President of the Cameroon Public Health Association, we delved into the country’s progressive HPV vaccination program. 

Can you tell us about the origins of the HPV vaccination program in Cameroon?

Dominique: The HPV vaccination initiative began for girls in the Cameroon Baptist Convention HospitalsServices (CBCHS) between 2010 and 2012. Good cultural influences and good support for the program led to its success in the two Anglophone regions where the vaccinations were first initiated. The Cameroon government, with the support of its partners, subsequently took over the program and conducted a successful pilot in two health districts (Edéa in the Littoral region and Foumban in the West region), both with positive results (2014-2016). The expansion of this program was mainly supported by Gavi, who played a crucial role. 

When did the program start targeting a broader population?

Dominique: In 2020, Cameroon introduced nationwide HPV vaccination for girls within its Expanded Program on Immunization (EPI). The following year, in 2022, the Cameroon government extended the vaccination program to include boys. This marked the shift towards a gender-neutral approach. Cameroon has been practising HPV Gender-Neutral Vaccination since 2022. 

What challenges did Cameroon face during the implementation

Dominique: Several problems were identified during the initial stages of the implementation process. Firstly, communities were poorly informed and did not understand the need for HPV vaccination. Secondly, the vaccination program was met with resistance from some stakeholders, including several religious institutions. The Ministry of Public Health addressed these challenges through advocacy endeavors and dialogues with stakeholders and communities, helping them understand the need for HPV gender-neutral vaccination and its benefits. GAVI-sponsored projects conducted by its local partners contributed to promoting the introduction of the HPV vaccine for girls and boys. Furthermore, the Parliament actively promoted addressing these issues by highlighting the significance of HPV vaccination and effectively communicating its importance to the public. 

How is the HPV vaccination program funded? 

Dominique: The Cameroon government provides partial funding for the HPV vaccination program. In addition, Cameroon receives support from Gavi, UNICEF, WHO, and the World Bank. Of these, Gavi is a crucial supporter of Cameroon’s HPV vaccination program, including the procurement of vaccines for boys. 

How is the vaccination program currently being implemented

Dominique: When the HPV vaccination program began, it was rolled out through schools. This lasted for about six months to 1 year. After that, we transitioned to delivering vaccinations through health facilities. The vaccination program leverages mass media, schools, decentralized councils, the Ministry of Public Health, and other allied ministries such as Education, Social Affairs, and Women’s Empowerment to ensure that parents and caregivers are advised and encouraged to get vaccinated their children and girls and boys adolescents at these health facilities. 

What improvements are needed moving forward?

Dominique: We need to enhance our communication strategies, particularly locally. Although central communication plans and materials are developed, they need to be adapted to fit local contexts to be more effective. This can be further improved to enhance understanding at a peripheral level and, in turn, vaccination rates. 

Cameroon’s experience expanding its HPV vaccination program to align with gender-neutral vaccination practices is a compelling example for other low- and middle-income countries hoping to broaden their HPV vaccination programs. By navigating cultural, logistical, and educational challenges, Cameroon has demonstrated that with strong governmental commitment, international collaboration, and community engagement, it is possible to implement inclusive and effective vaccination programs to protect populations from preventable diseases. 

Professionals’ Education and Training Working Group Chair Interview: Leanne Coombe and Priscilla Robinson

We are delighted to introduce Priscilla Robinson and Leanne Coombe, the co-chairs of the World Federation of Public Health Associations (WFPHA) Working Group on Professionals’ Education and Training. This group is dedicated to enhancing the standards of public health education globally. 

Let’s dive into their insights on the group’s formation, achievements, and future goals.

Please introduce yourselves

Priscilla Robinson: My name is Priscilla Robinson. I’ve been associated with the WFPHA for about ten years and a member of the Public Health Association of Australia for nearly 35 years. I am an Adjunct Associate Professor at La Trobe University in Australia, co-chairing this working group. My career began in nursing, with training in various nursing specialties, and then moved into epidemiology and infectious disease in public health and public health education.

Leanne Coombe: I’m Leanne Coombe, employed as the Policy and Advocacy Manager at the Public Health Association of Australia, and I also co-chair the Professional Education and Training Working Group. I’ve been involved with the WFPHA and this working group since 2018. I’m also an Honorary Associate Professor at The University of Queensland. My background is in oral health, but I have focused extensively on public health, particularly Indigenous health. My career has always been oriented toward preventive health, naturally leading me to public health.

How did this working group come about?

Priscilla Robinson: About 14 years ago, during one of its strategic reviews, the Federation identified the need for a professional education and training working group. I was the second Chair of the group and later invited Leanne to co-chair, given her expertise and enthusiasm. Since then, we have focused on addressing the educational needs identified by the Federation and have made significant contributions to its overall mission.

Can you describe the current involvement and membership of the working group?

Leanne Coombe: When I joined as co-chair in 2018, the group was relatively small and inactive. Since then, we’ve garnered interest from academics worldwide and have consciously expanded our membership by recruiting early-career public health professionals, experienced practitioners, and academics. We’ve also established a successful internship program, engaging young professionals who often stay on after their internships.

Priscilla Robinson: It’s important to note that our group is also diverse globally and ethnically. We maintain an informal structure where members feel comfortable contributing regardless of their education level, significantly enhancing our work. This approach allows us to leverage the expertise and energy of our members very appropriately and effectively.

How has the working group contributed to the development of public health education?

Priscilla Robinson: Our primary focus is public health education for professional practice. We have published several peer-reviewed papers, such as analyzing public health competencies commonly used in the field. Additionally, we have been involved with the WHO’s Public Health and Emergencies Workforce Roadmap Project, contributing to its competency framework. This work will guide the development of public health education worldwide for years to come.

What initiatives is the group currently working on?

Leanne Coombe: We’re currently working on two major projects. First, we are contributing to the implementation phase of the WHO Roadmap, focusing on standardizing public health education globally. We’re engaging accrediting and regulatory agencies to adopt the competency framework. Second, we’re benchmarking public health education worldwide, analyzing course content, delivery methods, faculty training, and support. This research will inform our efforts to standardize education across different regions.

What are your plans for the future

Priscilla Robinson: Post-pandemic, we need to ensure that the advancements in public health education and workforce training remain and evolve. Only about one-fifth of the global public health workforce is formally trained in public health, which can lead to significant shortfalls in expertise. Our goal is to improve accreditation and regulation, ensuring that all professionals involved in public health understand its principles and their role in it. 

Leanne Coombe: We’re also looking to support other WFPHA working groups in implementing the WHO Roadmap within their disciplines, such as Indigenous, One Health, and Environmental health. We will continue contributing and adapting to emerging needs as the roadmap project progresses. We welcome anyone interested in joining us and helping with our mission.

Priscilla Robinson and Leanne Coombe have shown immense dedication and vision in leading the WFPHA Working Group on Professionals’ Education and Training. Their efforts are shaping the future of public health education and ensuring that the global workforce is better prepared for the challenges ahead. Their inclusive and collaborative approach invites all interested professionals to join and contribute to this vital work.

Working group members: 

Christina Severinsen, School of Health Sciences, Massey University, Palmerston North, New Zealand

Dorothy Biberman, Manager Global Health Programs ASPPH, USA

Elisabeth Mukendi, medical doctor from the Democratic Republic of Congo

Elsheikh Badr, President of the Sudanese Public Health Association, Sudan

Geri Kemper Seeley, Program Manager, Applied Public Health, Office of Applied Public Health, Milken Institute School of Public Health, The George Washington University, USA. 

Haitham Bashier, Director at The Eastern Mediterranean Public Health Network (EMPHNET), Amman, Jordan

Harsha Somaroo, Public Health Association of South Africa, South Africa

Kasia Czabanowska, Professor in Public Health Leadership and Workforce Development and International Health School CAPHRI, Care & Publ Health Res In Fac. Health, Medicine and Life Sciences, the Netherlands

Laura King EdD, MPH, MCHES serves as the Executive Director of the Council on Education for Public Health, USA

Laura Magaña, PhD, MS, President and Chief Executive Officer, Association of Schools and Programs of Public Health, USA

Leanne Coombe, Faculty of Medicine, University of Queensland, Herston, Queensland

Linda Murray, Senior Lecturer at Massey University, New Zealand

Priscilla Robinson, School of Psychology and Public Health, La Trobe University, Melbourne

Saskia Jaenecke, Fulda University of Applied Sciences, Fulda, Germany