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.)

Child Oral Health as a Human Right: Why Global Action Can’t Wait

Below, we examine why child oral health is at a critical crossroads, what past global declarations have achieved, and how integrating oral health into general health systems can drive meaningful, long-lasting change.

The Global Burden: Why Child Oral Health Needs Immediate Attention

More than 60–90% of children worldwide have dental cavities, and most remain untreated, especially in early childhood. Despite being preventable, dental caries remain one of the most widespread public health issues globally.

Several factors continue to fuel this crisis:

• Limited access to dental care
• High sugar consumption in diets
• Lack of preventive oral health programs
• Increasing marketing of sugary foods to children
• Insufficient integration between oral health and general health systems

The Lancet Series and WHO have repeatedly highlighted these issues, yet progress has been uneven across countries.

What Global Declarations Have Achieved and Where They Fell Short

Early Milestones in Child Oral Health Advocacy

One of the earliest landmark efforts came in 2006, when a central Declaration on Child Oral Health urged countries to:

1. Increase focus on children’s oral health
2. Establish a global task force

This sparked significant collaborations, such as:

• The Senior Dental Leadership Program, supported by Colgate-Palmolive, Henry Schein, Harvard School of Dental Medicine, and King’s College London.
• National campaigns such as the Philippines’ “7 o’clock Toothbrushing Habit.”
• Cambodia’s SEAL CAMBODIA, which ultimately provided fissure sealants, fluoride, education, and preventive supplies to 66,000 children.

While these efforts drove progress, many initiatives lost momentum with political turnover and shifting priorities.

The 2013 Declaration: Defining Oral Health as a Human Right

A central turning point occurred in 2013, when the World Federation of Public Health Associations (WFPHA) approved a Declaration that identified what the “human right to oral health” truly means for children.

It outlined four fundamental rights:

• Access to preventive materials like fluoride toothpaste and toothbrushes
• Preventive interventions such as fissure sealants, fluoride varnish, and water fluoridation
• Early treatment of dental caries
• Protection from the marketing of unhealthy foods

Countries such as Mexico strongly embraced this, making daily school toothbrushing a statutory requirement, reaching 30 million children.

Sugar, Infant Formula, and Missed Prevention Opportunities

Research continues to reveal that many infant formula products contain as much sugar as carbonated soft drinks. For infants and toddlers, this presents a serious and under-recognized risk to oral health.

At the same time, the global rollout of sugar taxes, while positive for obesity prevention, rarely included oral health components. This lack of integration highlights the often fragmented nature of public health strategies, even when addressing shared risk factors, such as sugar.

COVID-19’s Impact: A Turning Point for Child Oral Health

The pandemic amplified every risk factor for poor child oral health:

• Families faced economic hardship, which reduced their ability to afford essentials such as toothpaste, dental visits, and healthy foods.
• Public services and school-based programs had been interrupted.
• Higher consumption of low-cost, high-sugar foods became more common.
• Access to dental care became more limited.

All indicators suggest that child oral health, already at crisis levels, will decline further unless prevention is prioritized.

Why Integration is Essential for Sustainable Oral Health Solutions

One of the most persistent barriers to progress is the disconnect between oral health and the wider public health community. In many regions, particularly in Africa and certain parts of Asia, there is a limited number of dental public health professionals within ministries or national health systems. Most specialists work in academia, leaving a significant gap in policy leadership.

This is where integrated health strategies become vital.

The Taiwan Declaration: A Framework for Integration

Launched in 2019 by the WFPHA, the Taiwan Declaration lays out six core principles and six priority actions to integrate oral health into general health promotion. It recognizes shared risk factors and encourages “oral health in all policies.”

Examples of successful implementation include:

• Taiwan’s use of sin-tax funds from cigarette sales to support integrated oral health initiatives.
• Joint medical-dental education programs in the United States.
• Research in India shows links between diabetes, cardiovascular disease, and poor oral health.
• Ethiopia’s Community Health Extension Program demonstrates how multi-skilled health workers can successfully integrate dental care in low-resource settings.

These examples reveal that integration is practical, cost-effective, and scalable.

Three Key Priorities for Ensuring Child Oral Health as a Human Right

1. Address the Economic Fallout of the Pandemic

Financial hardship is expected to worsen diets, reduce access to care, and affect the affordability of basic essentials, such as fluoride toothpaste.

2. Refocus on Prevention and Innovate

Essential prevention measures include:

• Daily toothbrushing with fluoride toothpaste
• Fluoride varnish
• Fissure sealants
• Water fluoridation

Countries should also invest in innovative preventive technologies and structural solutions that can continue to operate even during lockdowns.

3. Build Strong, Cross-Sector Alliances

Alliances must extend beyond the dental community to include:

• Medical professionals
• Public health leaders
• Schools and educators
• Government agencies
• Community health workers

Working in silos has limited progress for decades. A unified approach is needed to accelerate action.

What are the Most Effective Prevention Investments Today?

In periods of economic pressure and limited public resources, the highest-impact, most cost-effective strategies include:

• Automatic prevention systems like water fluoridation
• Daily supervised toothbrushing in schools
• Population-wide sugar reduction measures
• Community-based preventive programs

Countries should also consider restructuring dental service budgets to incentivize prevention over treatment.

How Future Dental Professionals Can Support the Movement

Dentists-in-training often wonder how they can contribute to a global issue. The truth is: they play a vital role.

They can:

• Collaborate with general practitioners and local health providers
• Support school-based oral health education
• Introduce new preventive innovations within their practice
• Advocate for integrated care in their local communities

Every point of contact with a child or family is an opportunity to strengthen early prevention.

Raising the Profile of Oral Health in High-Burden Countries

In countries such as India, where the burden of disease is high and stakeholder engagement is low, progress depends on building strong relationships and unified advocacy.

Key steps include:

• Engaging both dental and medical professional bodies
• Educating policymakers on the consequences of poor child oral health
• Developing creative, feasible prevention programs
• Establishing consensus on early action areas

Alliances are formed through effective communication, shared goals, and a collective commitment.

Moving Forward: From Declarations to Action

The world does not need more declarations about child oral health. It needs implementation.

Upholding child oral health as a human right requires coordinated global action, centered on prevention, innovation, integration, and strong alliances. The lessons from past declarations, the urgency created by the pandemic, and the clarity offered by the Taiwan Declaration all point in the same direction:

Protecting children’s oral health is not optional. It is essential for their overall well-being, equity, and future.

Watch the original webinar here.

Global Cervical Cancer Vaccination: A Path to Eradication in the 21st Century

Cervical cancer remains a profound global public health challenge. Each year, 330,000 women die from cervical cancer, most of them in the developing world. While COVID-19 has heightened the need for a more precise understanding of vaccination, the Global Task Force continues working toward advancing global cervical cancer vaccination and supporting strategies that can prevent this entirely avoidable disease.

The Origins of Cervical Cancer Prevention

The history of cervical cancer control began with George Papanikolaou, who developed the first screening test for the disease. However, screening began to deliver measurable impact only after national call-recall screening programs were established. In the UK, for example, cervical cancer rates did not begin to decline until a sufficient proportion of women were reached through a structured national system in 1987.

A Breakthrough: Recognizing HPV as the Cause

A transformational development occurred in the 1980s, when Harald Zur Hausen and colleagues discovered that cervical cancer is caused by infection with human papillomavirus (HPV). This shifted the conversation from treating disease to preventing the infection that causes it.

Destroying affected tissue was the only treatment for HPV infection at the time, but preventing the infection itself was far more effective. Zur Hausen’s work revealed that multiple strains of HPV contribute to cervical cancer, and this knowledge laid the groundwork for developing a vaccine.

Creating the First HPV Vaccines

HPV vaccines were built using virus-like particles and alum adjuvant, a traditional and proven vaccine approach. A patented eukaryotic expression system helped attract industry investment, ultimately enabling a $2 billion development journey from 1991 to the 2006 vaccine launch.

Since then, virus-like particle technology has become widespread, with over 200 publications per year on this approach. The resulting vaccines have been shown to be long-lasting, safe, and highly effective in stimulating antibody-based protection.

Proving Real-World Effectiveness

Because only 1–2% of HPV infections progress to pre-cancer, large clinical trials were required to demonstrate vaccine effectiveness. Once introduced, the vaccines quickly showed dramatic real-world impact.

Australia: A Case Study in Success

In Australia, one of the earliest adopters of the vaccine:

• Genital warts virtually disappeared in vaccinated women under 21 between 2007 and 2011.

• Women over 30 (unvaccinated) saw no change, highlighting the vaccine’s impact.

• Unvaccinated male partners also saw significant declines in genital warts, demonstrating potent herd immunity.

Protection was strongest when vaccination occurred before sexual activity. Girls vaccinated at age 14 showed around 75% protection against cervical pre-cancer, while those vaccinated at 17, many of whom were already exposed to HPV, had lower protection. This confirms that vaccines prevent infection but do not treat existing disease.

Closing Global Disparities in Cervical Cancer Prevention

Early vaccination programs were primarily implemented in high-income countries, shown in green on early global maps, despite the greatest cervical cancer burden being concentrated in the developing world.

Vanuatu: Implementation in Limited Health Systems

Vanuatu, a country of 250,000 people across 50 islands:

• Had just 25 doctors and only one working vaccine refrigerator.

• Screening of 500 women over 30 found 5 with cervical cancer and 17 with pre-cancer, making Vanuatu one of the highest-incidence nations globally.

Yet, through school-based vaccination and community education led by local nurses, Vanuatu achieved:

• 80% first-dose coverage among girls

• 98% return for dose two

• 93% return for dose three

Vaccination succeeded even in remote environments when the delivery system was practical and community-driven.

Bhutan: The Power of School-Based Vaccination

Bhutan vaccinated nearly 100% of eligible girls (ages 10–12) in its first year. When the program temporarily shifted away from schools, coverage fell to about 60% until school delivery was reintroduced. The lesson: school-based programs increase vaccination success, especially in regions with limited healthcare access.

The Reality Behind Vaccination Impact

More than 300 million HPV vaccine doses have been delivered worldwide. In theory, this should have prevented 3 million future cervical cancer deaths, based on disease burden and lifetime risk. However, most vaccines were delivered in countries already equipped with screening programs, meaning the immediate incremental benefit is likely closer to 10,000 prevented cancer cases so far. To maximize global impact, vaccination must reach the regions with the highest burden.

How Many Doses Are Needed?

HPV vaccines were originally administered in three doses, but studies showed that for girls under 16:

• Two doses were as effective as three

• Even one dose may provide strong protection, though more research is needed

A successful future strategy may involve large-scale single-dose campaigns, increasing reach, and reducing logistical strain.

Who Should Be Vaccinated?

Girls Only, or Universal Vaccination?

While girls bear the highest cervical cancer risk, boys also suffer from HPV-related cancers, including the now-increasing oropharyngeal cancers, particularly in Australia. Universal vaccination:

• Leverages herd immunity

• Eliminates stigma

• Prevents disease in men

• Reduces transmission overall

Why the Nine-Valent Vaccine Matters

The nine-valent HPV vaccine covers additional virus types responsible for a significant portion of cervical cancers, offering a stronger foundation for eventual global disease elimination.

The Global Goal: Eradication in the 21st Century

The World Health Organization has now set a bold target: eradicate cervical cancer worldwide by 2100. Australia aims to reduce cervical cancer to a rare disease (4 cases per 100,000 per year) by 2020–2025 through combined screening and vaccination efforts.

Modeling shows:

• Vaccination alone leaves many already-infected women unprotected

• Combined screening plus nine-valent vaccination gives the strongest path to eradication

Learning from Polio: A Clear Parallel

Before vaccination:

• Polio infection lifetime risk: ~50%, with 0.1% mortality

• HPV infection lifetime risk: also ~50%, with 0.8% mortality without vaccination

In the U.S.:

• 1952 polio deaths: 3,100

• 2005 cervical cancer deaths: 3,900, even with screening programs in place

Cervical cancer in 2005 was deadlier than polio in 1952. Yet, public urgency toward HPV vaccination remains far lower.

HPV Vaccination Is Safe and Effective

With 97% effectiveness, and:

• Less than one in a million severe allergic reactions

• No other significant adverse effects

HPV vaccines are among the safest public health tools available today.

A Call to Action

Every year, 300,000 women die of cervical cancer, a largely preventable disease. The science is clear, the vaccine is proven, and the roadmap exists.

To eliminate cervical cancer globally, the world must commit to:

• Routine HPV vaccination

• Equitable access in high-burden countries

• Continued screening and nine-valent coverage

• Delivery models that reach girls before sexual activity

With sustained commitment, cervical cancer can be eradicated within this century.

Understanding National Barriers to Climate Change Adaptation for Public Health

Climate change is rapidly reshaping the global landscape, posing unprecedented risks to human health. From deteriorating air quality and increased infectious disease outbreaks to food and water insecurity, the health impacts of climate change are intensifying. These challenges disproportionately affect vulnerable populations, widening existing health inequities and threatening global progress on the Sustainable Development Goals (SDGs).

A recent mixed-methods study surveyed national public health representatives to identify the significant barriers to climate change adaptation for public health, offering critical insights into global institutional, economic, technical, and sociopolitical constraints.

Why Climate Change Adaptation for Public Health Matters

Climate change adaptation (CCA) is a core pillar of the global response to climate change, alongside mitigation. While climate mitigation reduces future emissions, adaptation strengthens resilience to the climate-driven risks already unfolding. Public health professionals have long warned that without effective adaptation strategies, climate change could reverse decades of health and development progress, especially in low- and middle-income countries.

Study Overview

The survey targeted public health associations and societies across 82 countries and evaluated:

• National progress toward public health-centered adaptation

• Impacts of governance, financial, technical, and political barriers

• Opportunities for global organizations to support more effective adaptation responses

Although responses came from 11 countries, the findings provide valuable cross-cutting perspectives.

Key Findings

National Commitment is Rising, But Not Fast Enough

Many countries have increased their commitment to climate-health policies compared with previous assessments. However, progress continues to fall short of what is needed to protect populations from climate-related health emergencies.

Major Barriers Slowing Adaptation

1. Poor Government Coordination

Fragmented governance structures limit effective planning, resource distribution, and implementation of adaptation strategies across sectors and regions.

2. Lack of Political Will

Despite growing awareness, climate-health adaptation often lacks the political prioritization needed to drive transformation at a national scale.

3. Inadequate Financial Investment

Public health adaptation frequently suffers from insufficient funding. Without stronger and more equitable financial support, particularly for climate-vulnerable nations, meaningful adaptation cannot take place.

Recommendations for Strengthening Climate Change Adaptation

Increase Global Collaboration

More international forums and coordinated agenda-setting platforms can help align priorities and accelerate progress in climate-health resilience.

Improve Multi-Stakeholder Engagement

Governments should invest in collaborative frameworks that allow more seamless cooperation among ministries, agencies, communities, and organizations.

Embed Adaptation Across Policy Sectors

Integrating climate-health adaptation into broader policy domains, supported by improved climate-health literacy among policymakers, can enhance buy-in and effectiveness.

Expand and Prioritize Funding

Investment should focus on evidence-driven, cost-effective adaptation pathways that reduce inequalities and protect high-risk groups.

Build Climate-Health Workforce Capacity

Knowledge translation hubs, technical training, and support from high-income countries can help expand the human capital required to manage climate-health risks.

Establish High-Level National Adaptation Agencies

Governments should designate dedicated climate-health bodies with the authority to coordinate across sectors and evaluate progress.

Enable Localized and Context-Responsive Action

Adaptation frameworks should allow flexibility for regions and communities to implement actions based on local scientific data and lived experience.

Study Limitations

While aligned with existing literature, the study was constrained by:

• Limited sample size (11 respondents)

• Closed-question survey structure

• Geographic gaps, including no responses from Pacific Island States, which are among the most climate-vulnerable regions globally

These limitations suggest the need for ongoing research and more inclusive survey participation to capture the realities of global adaptation fully.

Conclusion

Effective climate change adaptation for public health is essential to protecting populations from the accelerating health impacts of climate change. Despite growing national commitments, central governance, financial, and political barriers continue to slow progress.

By deepening understanding of these challenges, global health organizations, policymakers, and advocates can strengthen evidence-based strategies that improve national resilience and protect the most vulnerable communities. The road ahead requires stronger coordination, more equitable financing, and global collaboration, but the research shows that with focused action, meaningful progress is within reach.

Read the complete study to explore how addressing these barriers can unlock more effective, equitable, and health-focused climate adaptation at the national level.

Equitable Access to COVID-19 Vaccination: Why Global Solidarity Still Matters

As the world continues to learn from the COVID-19 pandemic, one lesson stands out: prevention must take precedence over treatment. Immunization has long stood alongside clean water as one of the most effective public health measures ever developed. It prevents millions of deaths each year, reduces hospitalizations, and strengthens the social and economic fabric of communities. Yet when global crises strike, equitable access to vaccines remains elusive.

Today, that challenge is resurfacing, not as a historical lesson, but as an urgent call.

The Power of Vaccination Across the Life Course

Vaccines protect more than infants. They are essential tools of healthy aging for adults and older people, reducing medical visits, treatments, and pressure on health systems. Their long-term impact extends well beyond direct health benefits. Vaccination supports education, productivity, and economic stability.

However, even before COVID-19 vaccines were developed, the WHO, UNICEF, and Gavi warned that 80 million children under one year of age were at risk of preventable diseases due to disrupted routine immunization programs. In many low-resource settings, access barriers (costs, geography, and supply limitations) have long created gaps in protection.

COVID-19 Vaccines: A Scarce and Politicized Global Good

The development of COVID-19 vaccines showcased remarkable scientific collaboration. But it also exposed geopolitical competition. Wealthy nations secured early vaccine doses through bilateral agreements, leaving low-income countries behind. As the World Federation of Public Health Associations (WFPHA) emphasized, the global race for procurement risked repeating a familiar pattern: the wealthiest nations benefit first, while the most vulnerable wait.

This dynamic undermines not only equity but global health security itself. Isolated national strategies cannot contain a virus that crosses borders.

Why Equitable COVID-19 Vaccination Is the Fastest Path Out of a Pandemic

Effective pandemic recovery hinges on fair vaccine distribution. Without coordinated global coverage, outbreaks persist, variants emerge, and the pandemic’s health, economic, and social impacts deepen.

International collaboration must prioritize:

Strengthening Global Support Mechanisms

Initiatives such as COVAX have sought to accelerate equitable access, yet global experience shows that low-income countries are often crowded out when demand surpasses supply. A dedicated COVID-19 vaccination fund to support resource-constrained nations would be a critical step toward preventing this.

Addressing Long-Standing Access Barriers

High program costs, limited health infrastructure, and logistical challenges all hinder equitable coverage. These issues require both immediate response and long-term investment in national health systems.

Recognizing Vaccination as a Global Public Good

Vaccines protect communities, economies, and global stability. As outlined in the Global Charter for the Public’s Health, prevention, including equitable immunization, is foundational to national prosperity and global resilience.

A Call to Action from the Global Public Health Community

Public health associations worldwide, including the Norwegian Public Health Association, have echoed WFPHA’s call for urgent, ethically grounded global policy action. They stress that no nation can protect itself alone. Even from a standpoint of national self-interest, vaccines must reach vulnerable populations in every region if the pandemic is to be controlled.

Norway’s long-standing leadership in global vaccination efforts serves as an example of the type of commitment required. Still, all nations must make it clear that equitable allocation is not an optional act of goodwill; it is a public health necessity.

Moving Forward With Purpose and Solidarity

COVID-19 has reshaped global health, economies, and societies. The choices made now will determine how the world recovers and how prepared we are for future threats. Equitable access to vaccination is more than a policy preference; it is a moral responsibility and a practical strategy for global stability.

Ensuring that every nation, regardless of wealth, can protect its population through vaccination is essential to ending the pandemic and strengthening universal health systems. The world has the tools, expertise, and capacity to act. What remains is the collective will to place equity at the center of global health.

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.