HPV Vaccination Across the Life Course: Protecting More People from Preventable Cancer

Human papillomavirus (HPV) is one of the world’s most common infections. WHO estimates that up to 80% of sexually active people will acquire HPV during their lifetime. Most infections clear naturally, but persistent infection with high-risk types can cause cancer.

The list is broader than many people realize. HPV can cause cervical, anal, penile, vulvar, vaginal, and oropharyngeal cancers. In 2019, HPV was estimated to cause around 620,000 cancer cases in women and 70,000 in men worldwide.

That is why the conversation around HPV vaccination needs to evolve. HPV prevention has long been associated primarily with adolescent girls and cervical cancer. Those programs remain essential, but they do not represent the full HPV disease burden or the full population that may benefit from prevention.

HPV-related cancer is not a women’s health issue alone

Cervical cancer remains the most significant HPV-related cancer globally and is a major health equity challenge. Yet HPV affects people of all genders.

Among men, HPV can cause anal, penile, and oropharyngeal cancers. Oropharyngeal cancer has become one of the most common HPV-associated cancers in men in several high-income countries, illustrating how an approach focused exclusively on cervical cancer can leave important gaps in public understanding. 

The way HPV is discussed is critical. When the virus is presented only in relation to women’s health, men may not recognize their own risk or understand why vaccination is relevant to them.

HPV prevention should therefore be communicated as what it is: cancer prevention for people of all genders.

Why consider HPV vaccination beyond adolescence?

Routine vaccination before exposure to HPV remains the foundation of prevention. 

However, a large number of adults were never offered HPV vaccination when they were younger.

The reasons differ. Some were already beyond the age groups targeted when national programs were introduced. Others faced eligibility, access, or cost barriers. HPV vaccines were introduced at different times across countries, creating significant differences between generations.

Adults can continue to encounter new HPV exposure risks throughout life. Previous infection does not necessarily mean previous exposure to every HPV type covered by a vaccine. Vaccination does not treat an existing infection, but it can provide protection against HPV types a person has not encountered. 

National recommendations for adult HPV vaccination vary. A life-course approach is therefore not a single global vaccination schedule. It is a public health framework that asks whether current programs are reaching the populations they are designed to protect and what happens to those who were missed.

What is a life-course approach to HPV immunization?

A life-course approach recognizes that prevention does not happen at one point in time.

For HPV, it begins with strong vaccination programs for adolescents and continues by creating opportunities for catch-up and adult vaccination where national policies, evidence, and health systems support them.

A comprehensive approach can include:

• Routine vaccination for adolescents
• Catch-up vaccination for eligible populations
• Consideration of adult vaccination
• Inclusive policies covering people of different genders
• Convenient access through appropriate healthcare and community settings
• Clear communication from trusted health professionals

The principle is simple: a person’s age should not be the only lens through which prevention opportunities are considered.

The vaccination access gap

Having an effective vaccine is only one part of a successful immunization program.

People need to know that vaccination is available, understand why it matters, and be able to access it without unnecessary barriers.

For adults, this may mean offering vaccination through services they already use. Primary care, pharmacies, sexual health services, specialist clinics, workplaces and community programs can all provide potential access points depending on the national context.

Healthcare professionals are equally important. A recommendation from a trusted clinician can help people make informed decisions, particularly where misinformation has created uncertainty about vaccines.

Access strategies must also reflect local realities. A program designed for a large urban health system may not work in a rural community. Cost, distance, language, and trust can all determine whether prevention reaches the people it is intended to serve.

A global conversation that includes LMICs

Low- and middle-income countries carry a disproportionate burden of HPV-related disease. According to WHO, around 94% of the approximately 350,000 cervical cancer deaths recorded in 2022 occurred in low- and middle-income countries.

This imbalance should shape the global conversation about HPV prevention.

Countries facing the greatest burden must be represented in decisions about vaccine access, financing, delivery, and policy. A global life-course approach cannot simply export models developed elsewhere. It needs to account for different health systems, disease burdens and access challenges.

The goal is shared, but implementation will look different from one country to another.

From evidence to action

The World Federation of Public Health Associations (WFPHA), together with more than 60 supporting organizations, is calling for greater attention to adult HPV vaccination through its Advancing Adult HPV Vaccination: From Evidence to Action initiative.

The Call to Action focuses on strengthening prevention across the life course and addressing populations that earlier vaccination programs may have missed. It calls for:

• Greater consideration of adult HPV vaccination
• Broader and more inclusive prevention strategies
• Better integration of vaccination into healthcare systems
• Stronger public and professional awareness
• Policies that address gaps in access
• Meaningful participation from low- and middle-income countries in shaping global approaches

It’s not shifting attention or resources away from adolescent vaccination; it examines the gaps that remain once those programs are in place.

The public health opportunity is clear: protect adolescents early, close gaps where they exist, and avoid treating previous missed opportunities as permanent.

Protecting people across the life course

HPV vaccination has already changed what is possible in cancer prevention. The next challenge is ensuring that prevention strategies reflect the full reality of HPV-related disease.

That means recognizing cancers affecting women and men. It means strengthening routine programs while considering those who were never reached. It means designing access around people rather than expecting people to navigate complex systems.

Most importantly, it means changing the question.

Instead of asking only: Who is the vaccine traditionally offered to?

Public health leaders should also ask: Who remains unprotected, and what can be done about it?

The WFPHA’s Advancing Adult HPV Vaccination: From Evidence to Action Call to Action brings this question to the forefront.

HPV-related cancers are preventable. The evidence is there. The tools are available.

The next step is to expand prevention.

Watch the video here

Preventing death and disease from Respiratory Syncytial Virus (RSV) and Pneumococcal Disease in all our children

RSV and pneumococcal disease are longstanding threats to child health, but we are at a turning point: after decades of research, we now have safe and effective tools that can greatly reduce severe disease and hospitalization in young children.

With this Call to Action, the World Federation of Public Health Associations (WFPHA) and supporting leaders and organizations aim to catalyze urgent, equitable, and sustained investment in protecting every child against preventable respiratory disease.

By doing so, we take a decisive first step in a broader, lifelong commitment: a life-course approach to immunization that safeguards health not just in the first months of life, but at every stage.

Preventing RSV and Pneumococcal Disease in Every Child

Pneumonia is preventable

Pneumonia is the leading infectious killer of children under five. It is not inevitable; it is preventable.

RSV is the single most important cause of severe pneumonia in infants globally. Pneumococcal disease is the second. Together they account for the majority of childhood pneumonia deaths. Both are preventable.

RSV also causes bronchiolitis and other RSV-attributable respiratory illnesses.

Yet the children who bear the greatest burden have the least access to prevention.

We have the tools to prevent severe respiratory disease

We have the tools. We need the political will. We need to act urgently.

Two WHO SAGE-endorsed approaches can prevent severe RSV disease in infants:

• RSV prevention: RSV long-acting monoclonal antibody interventions or RSV maternal vaccination must be introduced and expanded.
• Pneumococcal disease prevention: The pneumococcal conjugate vaccine (PCV), already widely available, must be maintained and expanded.

Particular emphasis is needed on RSV because PCV is already included in many national immunization programs, while an advocacy gap remains for RSV.

The burden of RSV in children

More than 3.6 million children under five are hospitalized each year because of RSV, creating recurring strain on pediatric wards and ICU capacity, especially during seasonal peaks.

Approximately 100,000 children under five die from RSV-attributable respiratory illness annually, and 97% of RSV deaths occur in low- and middle-income countries.

Pneumonia also claims the lives of approximately 700,000 children under five each year.

Countries should make evidence-based immunization policy decisions based on local epidemiology, disease burden, health system readiness, and national public health goals.

Immunization is an investment

Prevention is one of the most cost-effective government investments.

Immunization programs overall are estimated to return $20–$52 for every $1 invested.

Evidence from different settings demonstrates the potential economic value of RSV prevention. In Chile, nirsevimab was cost-saving. In Spain, a universal long-acting monoclonal antibody program averted 215,878 RSV events and saved approximately €48 million in direct costs. In Canada, approximately 47,609 RSV health-related events were averted, with around CAD$45 million in healthcare savings.

The key takeaway is clear: prevention is an investment, not a cost. A major barrier is budget silos, where vaccine and drug budgets may sit in separate ministries or funding streams.

Results can be visible within one year

Act today.

In one year:

• Pediatric RSV hospitalizations can fall by up to 88%.
• ICU admissions can drop by up to 90%.

Results are visible, measurable, and politically rewarding.

Every country needs an approach suited to its context

There is no one-size-fits-all approach. Every country must select the approach best suited to its context, products, and system.

WHO recommends long-acting monoclonal antibody or maternal vaccination for universal implementation. The choice depends on infrastructure and delivery capacity, and some countries may use both.

RSV seasonality varies by region and climate. Local epidemiology and timing should guide strategy.

Alongside PCV, RSV immunization provides a synergistic shield against two leading infectious causes of severe childhood pneumonia.

A Call to Action for RSV Immunization and PCV

Governments and policymakers

WFPHA calls on all stakeholders, including government ministers, politicians and policymakers, health professionals, funders, industry, community leaders and civil society, to act urgently and decisively to make RSV immunization a national priority in every country, for every child, while maintaining, simplifying and strengthening PCV immunization.

Politicians and policymakers should:

• Prioritize RSV prevention alongside PCV.
• Allocate funding and bridge vaccine and drug budget silos.
• Set a national target for RSV coverage for every infant by next season.
• Enhance surveillance.
• Enhance real-world evidence.

Health professionals

Health professionals have a critical role in integrating RSV and PCV prevention into care pathways and advocating for national action.

They should:

• Integrate RSV and PCV into antenatal, neonatal and pediatric pathways as appropriate.
• Advocate for NITAG and HTA consideration.
• Engage professional societies and trusted voices.
• Monitor hesitancy toward long-acting monoclonal antibodies.
• Strengthen training.
• Combine RSV and PCV advocacy in every vaccination engagement.

Experience from Murcia, Stanford and Zurich demonstrates how health-system integration, continuous training, parent education, eligibility checks and opportunities for discussion can support high uptake and reduce equity gaps.

Funders, industry and interest groups

Funders, industry and interest groups should:

• Fund country-level economic analyses and budget impact models.
• Invest in production capacity when appropriate.
• Finance surveillance and real-world data.
• Close access gaps through tiered pricing, expanded LMIC regulatory filings, and manufacturing and supply commitments.
• Ensure RSV and PCV financing fit coherent investment strategies.

Access depends on functioning markets and predictable supply. Clear demand forecasting, healthy markets, multiple products, appropriate manufacturing capacity, and market-shaping mechanisms are important to ensuring that children can benefit from available prevention tools.

Civil society and community leaders

Civil society, community leaders, and community health workers can translate evidence into accessible language, build awareness and acceptability, and elevate the prioritization of infant pneumonia prevention.

They should:

• Amplify demand for infant pneumonia prevention.
• Counter misinformation with accessible and culturally appropriate narratives.
• Advocate to elected representatives through patient associations.
• Engage faith and community leaders.
• Champion equity so no child is unprotected by geography, income, or ethnicity.

Measure the burden. Measure the impact. Make success visible.

Surveillance is not universal, making robust RSV and PCV surveillance an immediate priority.

Countries should:

• Build baseline burden estimates.
• Establish standardized reporting, case detection, and laboratory confirmation.
• Monitor serotypes where appropriate.
• Conduct post-introduction monitoring.
• Collect first-season impact data.
• Maintain pharmacovigilance.
• Share national data globally.
• Communicate results publicly.
• Advocate for RSV to be included on notifiable disease lists where appropriate.
• Maintain virological surveillance, including monitoring of mutations.

A practical eight-step framework can support implementation:

1. Know your burden.
2. Assess your system.
3. Check product access.
4. Run the numbers.
5. Gauge community readiness.
6. Engage your NITAG.
7. Integrate and launch.
8. Measure and adapt.

Equity must remain at the center

Science alone does not drive policy. Advocacy requires clear, emotionally resonant narratives.

Every child, wherever born, deserves a first birthday free from vaccine-preventable disease.

RSV and PCV prevention together are a statement of equity. The burden falls hardest on families vulnerable to structural disadvantage, including differences related to ancestry, economic status, and other social factors.

Long-acting monoclonal antibodies are a new therapeutic class that parents and caregivers may not understand. For some hesitant families, this can also become a communication asset when the approach is explained clearly.

The data are strong. The tools exist.

Every day without action means preventable deaths.

This is a rare, urgent, and timely opportunity to protect countless children from severe respiratory disease.

The WFPHA and those who recognize the importance of this opportunity call on all organizations, professionals and citizens who seek fairer, healthier and more equitable societies to join us by signing this document and committing to drive the changes outlined in the Call to Action.

Learn more: WHO: Respiratory syncytial virus (RSV) | UNICEF: Pneumonia in children

Read the original call to action

Watch the call to action video with Michael Moore, Chair of the Global Taskforce on Immunization Policy

Advancing Adult HPV Vaccination: From Evidence to Action

Human papillomavirus (HPV) is one of the most prevalent infections in the world, affecting up to 80% of individuals at some point in their lives. While the immune system clears most infections naturally, persistent high-risk HPV oncogenic genotypes can lead to serious health outcomes, including cervical, anal, vaginal, vulvar, penile, and oropharyngeal cancers. 

Even with highly effective vaccines authorized for adults and available in sufficient supply, vaccination rates among adults remain far too low. Expanding adult HPV vaccination offers a vital opportunity to reduce disease burden, strengthen long-term health outcomes, and accelerate progress toward broader cancer prevention goals.

Why Universal Vaccination Matters for Long-Term Cancer Prevention

Although early HPV prevention initiatives largely prioritized younger age groups, there is now broad recognition that universal HPV vaccination across adulthood is a crucial component of comprehensive disease prevention. Adults continue to face new exposure risks throughout their lives, and vaccination can protect them against HPV types they have not yet encountered. 

Importantly, natural immunity from previous infections does not offer complete protection against other high-risk genotypes, meaning adults with prior HPV exposure still gain meaningful benefit from vaccination. Emerging evidence also highlights positive outcomes when vaccination is delivered before or after cervical conization, reinforcing its value across different stages of adult care.

Barriers Limiting Adult Vaccine Uptake and Why They Must Be Overcome

Although clinical and economic advantages are well-established, adult vaccine uptake remains low due to:

• Lack of awareness and misconceptions about vaccine efficacy
• Limited access and insufficient provider recommendations
• Policy and funding gaps within national immunization programs

Many adults were not vaccinated during adolescence due to eligibility criteria, vaccine availability, or limitations in the healthcare system. Expanding eligibility can close this gap. 

Policymakers are key to establishing sustainable vaccination programs by embedding HPV vaccination for medically or socially vulnerable adults into routine healthcare and ensuring adequate funding and equitable access. Adult programs should not compromise coverage in younger populations. Cultural and linguistic sensitivity must also be part of these strategies to support trust and acceptance.

Accelerating Progress Toward WHO Elimination Goals

WHO has set ambitious goals for cervical cancer elimination, prioritizing adolescent girls as the primary target group, but extending vaccination to boys and adults whenever feasible. National programs should move forward using emerging evidence and practical implementation models. 

Strengthened vaccination systems can help reduce HPV-related cancers, improve health equity, and support progress toward global elimination.

Strengthening Policy and Practice for Adult HPV Vaccination

This call to action emphasizes the value of adult HPV vaccination from public health and economic perspectives. It highlights the global burden of HPV-related diseases and successful policy models from multiple countries. 

Key recommendations include integrating adult vaccination into routine care, expanding national immunization guidelines, strengthening awareness efforts, and adopting universal and inclusive approaches that span ages, genders, and geographies.

Risk Stratification Isn’t Enough, Adults Still Need Protection

Risk-based approaches are limited due to the widespread nature of HPV and varied exposure patterns. Several key considerations support universal adult vaccination:

Adults Remain at Ongoing Risk

Individuals continue to face new exposure risk throughout adulthood.

Men Are Disproportionately Underserved

Without access to established screening programs and often acquiring infections later, adult males represent a highly vulnerable group.

Ending Transmission Requires Addressing the Viral Reservoir

To eliminate HPV-related cancers, transmission must be stopped at its source, requiring immunization of both women and men.

Vaccination Works Even After Exposure

Adults previously exposed to certain HPV types still benefit from protection against other genotypes.

Public Health Outcomes Are Significant

Adult vaccination provides direct protection while reducing transmission and decreasing overall disease burden.

Current Age-Restricted Funding Leaves People Behind

Many national funding systems exclude adults who are still at risk.

Vaccination Must Be Easy to Access

Success depends on convenience, such as pharmacies, workplaces, and community hubs serving as vaccination sites.

A Consensus on Adult Vaccination Is Needed

Clear and unified policy guidance is essential to strengthen recommendations and drive adoption.

Low- and Middle-Income Countries Must Help Shape Global Policy

These regions carry the highest disease burden and must be active contributors to ensure global equity.

Faster Elimination Is Achievable

Countries like Sweden demonstrate that vaccinating adults can accelerate the elimination of HPV-related cancers.

Clear, Inclusive Communication Matters

Language such as “universal vaccination” promotes gender equity and reduces stigma.

A Global Call to Action for Policymakers and Health Leaders

Governments, global health organizations, and national public health associations are urged to expand HPV vaccination programs, particularly for adults and males, mobilize resources, and embed evidence-based strategies into national immunization plans. 

By committing to these priorities today, countries can accelerate cancer prevention and move closer to eliminating HPV-related disease.

Moving Forward Toward Global Health Equity

Expanding HPV vaccination to adults is a critical, evidence-based strategy to reduce HPV-related disease and advance global cancer prevention. Universal adult vaccination delivers individual and population-level benefits, especially in regions with limited access to screening and care. Progress requires collaboration among policymakers and health leaders to address gaps in access, awareness, and coverage. 

Integration into routine healthcare, stigma-free and inclusive communication, and a focus on vulnerable populations, such as individuals living with conditions like HIV, are essential. Taking timely action will drive progress toward eliminating HPV-related cancers and building a more equitable global health future.

Read our original call to action here.

Watch our video on this HPV call to action here.

Leer la llamada en español.

The 2025-2026 World Federation of Public Health Associations (WFPHA) Annual Report

Our 2025-2026 Annual Report is now available. This yearly report showcases the WFPHA’s key initiatives and activities aimed at protecting people, preventing diseases, and promoting global health and well-being. As always, we thank our members, sponsors, partners, colleagues, and friends for promoting public health.

Previous Annual Reports from the WFPHA

Life Course Immunization: Why Lifelong Vaccination is Essential for Public Health

Immunization is a lifelong shield that goes beyond childhood. While pediatric vaccination programs have seen tremendous success, adult and adolescent immunization remains a dangerously overlooked pillar of global health. This critical gap leaves populations vulnerable to preventable diseases, pandemics, and needless suffering at every stage of life.

For decades, vaccination has been rightly celebrated for its role in conquering infectious diseases. A powerful new consensus from the world’s top health organization is expanding its mission: vaccination is a cornerstone of preventing non-communicable diseases (NCDS) like heart attacks, strokes, and diabetic complications.

The urgency to close this gap has never been greater. This paradigm shift is the driving force behind a new global initiative.

The 2024 Geneva Accord: A New Strategy for a New Health Reality

In November 2024, a pivotal meeting in Geneva, convened by the world’s most influential health and community NGOs, aimed to address a silent crisis: the alarming decline in adult vaccination rates and its cascading impact on global health.

The result was a Call to Action: International Health and Community NGOs Advocate for Life-Course Vaccination. This document represents a consensus among organizations that collectively represent millions of health professionals and citizens worldwide. It moves the conversation from why life-course immunization is essential to how we must achieve it. Now, with a vital new concept, life-course vaccination is necessary for NCD prevention and healthy aging.

Supported by a Coalition of Global Health Leaders.

This call to action is endorsed by the following organizations, representing millions of doctors, nurses, pharmacists, public health experts, medical students, and aging advocates worldwide.

The Growing Immunization Gap: How Vaccines Prevent Chronic Disease

The traditional benefits of vaccination, such as preventing outbreaks, reducing healthcare costs, and protecting the vulnerable, remain critically important. Yet, recent data reveal a concerning decline in vaccination rates, posing a threat to global health security.

Reports from the WHO, UNICEF, and other bodies show:

• Adult vaccination rates have stagnated or dropped since the pandemic, particularly among aging and at-risk populations.
• Measles outbreaks are resurging in countries where the disease was previously controlled.
• Low uptake of flu, COVID-19, and RSV vaccines in high-risk groups leads to preventable hospitalizations and deaths, straining healthcare systems.

This evidence underscores the urgent need for the coordinated strategy outlined in the new Call to Action.

What does this mean in practice?

• Influenza & COVID-19 increase heart attacks and strokes: These viral infections cause severe inflammation, which can destabilize arterial plaque, leading to cardiovascular events, risks that vaccinations can reduce.
• RSV & pneumonia can lead to respiratory decline: In older adults or those with COPD, a severe respiratory infection can result in permanent lung damage and a significant decline in functional health.
• HPV & cancer: The human papillomavirus (HPV) is a leading cause of cervical, oropharyngeal, and other cancers. HPV vaccination is, quite literally, a form of cancer prevention.
• Shingles & chronic pain: Reactivation of the varicella-zoster virus, the cause of chickenpox, can lead to debilitating, long-term nerve pain, drastically reducing quality of life.

By preventing the initial infection, vaccines directly prevent the chronic conditions that follow.

The 10-Point Plan: A Roadmap to Integrate Vaccination and NCD Prevention

The coalition’s document provides a clear roadmap. Here are the 10 critical actions it urges advocates and policymakers to implement:

1. Protect Health and Social Care Workers: Ensure they are prioritized to prevent the spread of disease to vulnerable patients.
2. Guarantee Equitable Access: Tailor vaccine access to every stage of life, removing financial and logistical barriers.
3. Mobilize the Health Workforce: Provide tools and resources for vaccine delivery across all care settings.
4. Establish Adult Vaccine Schedules: Develop clear, comprehensive, and equitable vaccination schedules for adults that complement existing pediatric programs.
5. Develop Robust Immunization Registries: Implement interoperable systems to track vaccine uptake in real-time.
6. Integrate Vaccination with NCD Prevention: Recognize the strategic role of vaccination in preventing complications from non-communicable diseases, such as heart disease and diabetes.
7. Expand and Simplify Vaccination Pathways: Make getting vaccinated easier through community-based and mobile clinics.
8. Raise Awareness and Build Confidence: Run public campaigns highlighting the value of vaccination throughout one’s life.
9. Embed Community Engagement: Involve communities in vaccine program design and development to ensure they meet real needs.
10. Leverage the Health Workforce: Empower health professionals, from students to retirees, to be champions for vaccination.

The Tangible Benefits of a Life-Course Immunization Approach

Adopting this framework offers profound advantages that strengthen societies:

• Prevents Deadly Outbreaks: High vaccination coverage across all ages creates a stronger herd immunity, protecting those who can’t be vaccinated.
• Dramatically Reduces Healthcare Costs: Preventing diseases such as shingles, pneumonia, and HPV-related cancers reduces hospitalizations, long-term care needs, and lost productivity.
• Protects Vulnerable Populations: A vaccinated community is a safer environment for older people, newborns, and individuals with weakened immune systems.
• Builds Resilient Health Systems: By preventing illness, health systems are less burdened and better able to handle other crises.
• Promotes Healthy Communities: Lifelong immunization supports well-being at every age and helps entire communities live healthier, more active lives.

From Call to Action to Reality: How We Can All Participate

Implementing this vision requires a commitment from all sectors. The Call to Action provides the blueprint, but we all have a role to play in its implementation.

• Policymakers: Must prioritize funding, establish national adult schedules, and remove regulatory barriers.
• Healthcare Providers: Can integrate vaccine discussions into every routine care visit, for every age group.
• Individuals & Communities: Should stay informed, advocate for access, and get recommended vaccines.
• Organizations: Can sign on to support the call to action and promote their messages internally and externally.

A Healthier Future for All Generations

Life-course immunization is a fundamental right and a shared societal responsibility. We can no longer silo infectious disease and chronic disease efforts. We must unite these two pillars of health.

Life-course immunization is the powerful and practical link that ties it all together. The 2024 Geneva Call to Action provides the definitive framework for achieving this goal. By embracing this strategy, we aren’t just preventing the flu or shingles; we are preventing heart failure, debilitating pain, and cancer. We aim to promote health throughout a person’s lifetime, rather than just treating a specific illness or condition.

By uniting behind this powerful consensus from the world’s leading health authorities, we can build healthier, more equitable, and more resilient communities for generations to come.

If your organization would like to endorse our Call to Action and join us in this effort, please get in touch with us at secretariat@wfpha.org

Click here to read the full, official Call to Action document supported by international NGOs

Global Public Health Policies: Public Health Associations’ Perspectives

Why Public Health Advocacy Matters

The definition of advocacy may vary slightly across disciplines. According to the World Health Organization (WHO), health advocacy is a combination of social actions aimed at securing political commitment, policy support, social acceptance, and systems support for a particular goal or program. Advocacy is identified as one of the core functions of public health and is a key tool for achieving the Sustainable Development Goals (SDGs).

In global public health, advocacy involves engaging diverse stakeholders in decision-making to improve population health. National public health associations and international non-governmental organizations (NGOs) play a vital role in advocating, advising decision-makers, guiding initiatives, and raising citizens’ awareness. Advocacy initiatives and campaigns, joint position statements, resolutions, and internal policies are recognized as the primary tools for influencing public health policy.

As countries continue to address challenges ranging from climate change and emerging infectious diseases to health inequities and workforce shortages, understanding the role of public health associations in shaping policy has become increasingly important. Their advocacy efforts help translate evidence into action and ensure that public health remains a priority within national and international decision-making processes.

Study Overview: Mapping Public Health Advocacy Across 12 Countries

In a recent study by researchers from the World Federation of Public Health Associations (WFPHA), public health advocacy activities conducted by national public health associations between 2018 and 2021 were examined to identify strengths, gaps, and opportunities to strengthen future policy development.

The study included 12 national public health associations representing:

• Ethiopia
• Cameroon
• South Africa
• Nigeria
• Canada
• United States
• Brazil
• Spain
• France
• United Kingdom
• Australia
• New Zealand

A total of 220 officially approved policy documents were analyzed, including position statements, internal policies, white papers, and official submissions to government bodies.

Key Findings on Global Public Health Policies

According to the study, the largest number of policy documents originated from high-income countries and focused primarily on environmental health and communicable diseases, including COVID-19. However, significant regional differences emerged.

Africa: Focus on Health System Strengthening

In the African region, public health advocacy focused primarily on strengthening health systems. This emphasis reflects the importance of building resilient health infrastructure, expanding access to services, and improving population health outcomes.

Women’s and child health also emerged as an important area of advocacy, particularly in Nigeria.

Europe and South America: Pandemic Preparedness and Communicable Diseases

Public health associations in Europe and South America devoted much of their advocacy work to communicable diseases and pandemic management.

The COVID-19 pandemic highlighted the importance of preparedness, surveillance systems, evidence-informed policymaking, and coordinated responses to public health emergencies.

North America and the Western Pacific: Climate and Environmental Health

In North America and the Western Pacific region, climate change and environmental health were dominant advocacy themes.

This reflects growing recognition that environmental determinants—including air quality, extreme weather events, biodiversity loss, and climate-related health risks—have profound implications for population health.

Major Public Health Advocacy Themes Identified

The analysis identified 11 major advocacy themes across all participating public health associations:

Communicable Diseases

Including COVID-19 preparedness, prevention, response, and vaccination policies.

Environmental Health

Including climate change, pollution, sustainability, and planetary health.

Health Equity

Advocating for fair access to health services and addressing social determinants of health.

Health System Strengthening

Supporting stronger healthcare systems, workforce development, financing, and service delivery.

Human Rights and Health

Promoting health as a human right and protecting vulnerable populations.

Mental Health and Substance Use

Addressing growing mental health challenges and substance-related harms.

Non-Communicable Diseases

Including cardiovascular disease, cancer, diabetes, and other chronic conditions.

Women and Child Health

Supporting maternal, newborn, and child health outcomes.

Nutrition

Advocating for healthier food systems and improved nutrition policies.

Injury Prevention and Violence Reduction

Addressing preventable injuries and violence-related health burdens.

International Health

Promoting cross-border collaboration and global health cooperation.

A Critical Gap: Limited Attention to International Health and Human Rights

One of the most important findings of the study was that relatively limited attention was paid to international health and health as a human right across all regions.

Given the interconnected nature of modern public health challenges—including pandemics, climate change, migration, and health inequities—there is a growing need for more internationally focused advocacy efforts.

The study suggests that future advocacy should be more strongly rooted in:

• Health as a human right
• Global solidarity
• International cooperation
• Intersectoral policymaking
• Sustainable Development Goals implementation

Strengthening Public Health Advocacy for the Future

The study revealed that public health associations are active advocates across a broad range of health issues. However, additional efforts are needed to strengthen the effectiveness of advocacy and policy impact.

According to the researchers, several priorities could improve future advocacy efforts:

Better Use of Evidence

Evidence-based policymaking remains essential for designing effective health interventions and demonstrating impact.

Improved Access to Data

Making public health data more accessible to policymakers and decision-makers can support faster and more informed policy responses.

Sustainable Funding Mechanisms

Adequate resources are necessary to maintain advocacy efforts and implement long-term public health strategies.

Increased Public Awareness

Citizen engagement and awareness can help build support for public health policies and strengthen accountability.

Expanding the Public Health Advocacy Coalition

The study also recommends broadening advocacy efforts beyond traditional public health stakeholders.

Future advocacy initiatives could involve:

• Academics
• Journalists
• Media organizations
• Influencers
• Civil society organizations
• Public health professionals

Working together as a unified voice may help strengthen policy influence, increase public awareness, and support the adoption of evidence-informed health policies.

Why Public Health Associations Matter in Global Health Policy

Public health associations serve as a critical bridge between research, policy, and practice. By translating scientific evidence into policy recommendations, they help governments and institutions respond to evolving health challenges.

As the world continues to confront climate change, future pandemics, health inequities, and emerging global threats, strong advocacy from public health associations will remain essential to advancing health equity, strengthening health systems, and ensuring that health is considered across all sectors of society.

Conclusion

This study demonstrates that public health associations play a vital role in shaping global public health policies through advocacy, evidence-informed recommendations, and stakeholder engagement.

While advocacy efforts between 2018 and 2021 focused heavily on environmental health, communicable diseases, and health system strengthening, the findings also highlight opportunities for a more international and intersectoral approach grounded in the recognition of health as a human right and aligned with the Sustainable Development Goals.

Moving forward, stronger collaboration among public health associations, policymakers, researchers, journalists, and civil society will be essential to building healthier, more equitable, and more resilient societies worldwide.