Climate Change and Public Health: Why the Climate Emergency Is a Health Emergency

Climate change is no longer a distant threat. It is a present and accelerating crisis undermining health, safety, and well-being worldwide. As extreme weather intensifies, global temperatures rise, and environmental systems destabilize, the consequences for human health grow more severe. The World Federation of Public Health Associations (WFPHA) issues this call to action to highlight the urgent need for governments, institutions, and health leaders to confront the accelerating climate emergency with decisive, health-centered policies.

The Climate Crisis: A Global Failure With Human Consequences

Since the adoption of the Sustainable Development Goals (SDGs) in 2015, progress has been significantly hindered by accelerating climate change. Although solutions exist, global action has been too slow, fragmented, and insufficient to safeguard population health. Scientific evidence shows that:

• Global warming is accelerating, driving extreme heat, catastrophic fires, severe storms, droughts, and flooding.

• Disruptions across land, water, and ecosystems are worsening faster than anticipated.

• Opportunities for meaningful intervention are narrowing, as climate extremes become more frequent and intense.

The health risks are profound. Climate change affects food security, water quality, air quality, housing stability, and economic livelihoods, all of which are critical determinants of health.

Children: The Most Vulnerable Victims of Climate Change

UNICEF calls climate change the defining challenge for children’s rights. Nearly 1 billion children live in areas at extremely high risk from climate impacts. Many face overlapping threats such as:

• Flooding

• Heatwaves

• Water scarcity

• Disease outbreaks

• Poor air quality

Because children will experience climate impacts for longer and more intensively than adults, climate inaction constitutes severe intergenerational injustice.

Scientific Consensus: Human Influence Is Unmistakable

Despite decades of warnings, global emissions continue to rise. The IPCC confirms:

• Each of the last four decades has been warmer than the one before.

• Global temperatures have already increased by about 1.1°C above pre-industrial levels.

• Warming over land is even higher, posing heightened threats to health and safety.

Recent climate disasters, including heatwaves, fires, and severe storms, would be nearly impossible without human-induced warming.

The Mounting Toll: Water Scarcity, Disasters, and Economic Loss

Freshwater scarcity, already affecting billions, is expected to worsen dramatically. Extreme weather events have increased fivefold in the past 50 years, causing:

• 2.06 million deaths

• $3.6 trillion USD in economic losses

• Disproportionate impacts on developing nations

These inequities represent a profound moral and public health failure.

A Clear Path Forward: Mitigation and Adaptation

Even if emissions stopped today, warming would continue due to high atmospheric CO₂ levels. Therefore, climate resilience requires:

• Mitigation – drastically reducing greenhouse gas emissions.

• Adaptation – preparing health systems, communities, and infrastructure for unavoidable impacts.

Renewable energy, sustainable food systems, water preservation, and reduced consumption are essential pathways to a healthier, more resilient world.

The Economic Case for Climate Action

Climate mitigation not only protects lives but also yields immense economic benefits. Research shows that limiting warming to 2°C could prevent trillions in GDP losses annually and save millions of lives through:

• Cleaner air

• Healthier diets

• Increased physical activity

• Reduced climate-related disasters

The cost of inaction vastly outweighs the cost of solutions already available.

Global Inequity: Those Most Affected Contribute the Least

Low-income and climate-vulnerable countries face the most significant climate risks despite having contributed least to global emissions. Wealthier nations must:

• Provide financial support

• Honor climate finance commitments

• Invest in research and adaptation

• Address climate-related loss and damage

Mechanisms like the Green Climate Fund were designed for this purpose, yet contributions fall drastically short.

Strengthening the Public Health Response

Evidence gaps persist, especially in mental health, maternal health, child health, and impacts in low-income countries. Increased funding and research are urgently needed to guide effective interventions and support the world’s most vulnerable populations.

Why Immediate Action Is Essential

Climate change is harming health today and threatens to undermine the prosperity, safety, and stability of future generations. Governments, public health leaders, and community organizations must prioritize:

• Strong emissions reduction targets

• Rapid decarbonization

• Climate-resilient health systems

• Protection for vulnerable populations

• Public health leadership at every level

The science is unequivocal: human activity is driving climate change, and political inaction threatens catastrophic outcomes.

A Call for Health-Centered Climate Leadership

Health must be at the center of climate policy. Governments hold a responsibility not only to their citizens but to the global community and to future generations. Climate change is a health emergency—and addressing it is both a moral and practical imperative.

The WFPHA reaffirms its commitment to advocate for a healthier future and urges all partners, organizations, and health professionals to join in the effort.

Who Must Act Now

This call to action is directed toward:

• National and multilateral policymakers

• Local and regional government officials

• Public health associations and agencies

• Health care leaders and emergency planners

• Community organizations and NGOs

• Urban planners, infrastructure specialists, and social service providers

• Educational leaders and private-sector partners

These groups play essential roles in designing and implementing climate-healthy policies, reducing emissions, strengthening resilience, and protecting vulnerable populations.

Key Recommendations for Immediate Progress

• Set and enforce ambitious emission-reduction targets.

• Increase commitments to the Green Climate Fund and ensure contributions are fulfilled.

• Hold governments accountable for policies affecting health.

• Support decarbonization across energy, transportation, food systems, and investment markets.

• Advocate for equitable compensation for climate-driven loss and damage.

• Engage communities in developing localized resilience strategies.

• Restore ecosystems critical to water, food, and mental well-being.

• Integrate health considerations into all public policies.

Moving Forward Together

Climate change and public health are inseparable.

Recognizing this connection is essential to protecting lives and shaping a healthier, more equitable future. The WFPHA stands with global partners to demand immediate, effective, and equitable climate action, because the climate emergency is unequivocally a health emergency.

Policy Statement on Polio Eradication: The Last Battle?

Understanding Poliomyelitis and Its Global Impact

Poliomyelitis (polio) is an infectious viral disease that predominantly affects children under 5 years old. The virus spreads through person-to-person contact, primarily via the fecal-oral route or, less frequently, through contaminated food and water. It multiplies in the intestines and can invade the nervous system, causing permanent paralysis.

Approximately 1 in 200 infections results in irreversible paralysis, and 5–10% of paralyzed individuals die due to respiratory muscle immobilization. Despite this, 90% of infected individuals remain asymptomatic carriers.

There is no cure for polio; it is preventable only through routine childhood immunization.

Global Progress Toward Polio Eradication

In 1988, the World Health Assembly adopted a resolution calling for the worldwide eradication of polio, leading to the creation of the Global Polio Eradication Initiative (GPEI). National governments, the WHO, Rotary International, the CDC, UNICEF, the Bill & Melinda Gates Foundation, and Gavi, the Vaccine Alliance support this effort.

Since then, global cases of wild poliovirus have decreased by over 99%, from an estimated 350,000 cases in 2019 to 175 in 2020, and just 2 cases reported by mid-September 2021.

Countries Where Polio Remains Endemic

Polio remains endemic in Afghanistan and Pakistan (wild polio type 1, WPV1).

• In Pakistan, 72 of 468 (15%) environmental samples tested positive in 2017. In 2020, 84 cases of WPV1 were reported, and by mid-September 2021, one case had been recorded.

• In Afghanistan, WPV1 cases increased from 21 (2018) to 29 (2019) and 56 (2020). By mid-September 2021, one wild polio case had been reported.

WHO estimates that successful polio eradication will save USD $40–50 billion, while failure could result in 200,000 new cases annually within the next decade.

Recommendations to Address Current Challenges in Polio Eradication

Strengthen International Relations with Pakistan and Afghanistan

Pakistan and Afghanistan function as a single epidemiological zone due to significant cross-border population movements. Both countries have collaborated through joint Technical Advisory Group (TAG) meetings and have agreed to vaccinate children under ten at border points on the same day.

Further strategic efforts should include:

• High-quality, large-scale vaccination campaigns targeting core reservoir areas.

• Policies are shaped through collaboration between government and public-private partners, such as the National Highway Authority and media networks.

• Support for ongoing WHO and partner engagement with the new Afghan government and authorities in Pakistan.

Reach Under-Immunized Children Using Innovative Approaches

Reaching under-immunized children remains a significant challenge due to vaccine refusals, operational gaps, difficulties in tracking mobile populations, and challenges in following up when children are not at home.

To strengthen reach and immunization quality:

• Use digital tools such as GIS mapping and mobile-based monitoring to track outbreaks.

• Redesign door-to-door campaigns to prioritize border entry and exit points.

• Expand vaccination efforts to include non-health workers and migrant populations.

Maintain Continuity of Operations Across the Pakistan–Afghanistan Region

Although GPEI operations in Pakistan are well funded, efficiency is hindered by gaps in documentation within the public health delivery system. A lack of electronic immunization records complicates accurate tracking.

Key steps include:

• Conduct all external reviews within the immunization indicator’s 28-day average lifespan.

• Supplement finger-marking with immunization cards and digital records.

• Integrate polio surveillance with broader health services across both countries.

• Provide community services (such as hygiene kits and maternal/child care supplies) during polio campaigns.

Address the Dual Challenge of Polio and COVID-19

In 2020, GPEI paused polio activities to redirect resources to the COVID-19 response, during which polio cases resurged (84 in Pakistan, 56 in Afghanistan).

To address this dual burden, revised operational procedures should include:

• Water, Sanitation, and Hygiene (WASH) promotion

• Non-pharmaceutical infection control (masks, sanitizers, thermometers)

• Enhanced staff training for safe campaign implementation

Summary

Eradicating poliovirus in Afghanistan and Pakistan requires unified action across military, religious, governmental, and social institutions. It demands trans-disciplinary leadership that ensures transparent processes and upholds both security and primary health objectives. Strong national capacity is essential to meet global commitments and to ensure every child receives lifesaving vaccinations.

Key Messages

• Polio is a highly infectious viral disease that attacks the nervous system and can cause irreversible paralysis and death.

• There is no cure for polio; it can only be prevented through immunization.

• Polio remains endemic in two countries: Afghanistan and Pakistan.

• Failure to stop polio could result in as many as 200,000 new cases every year, for up to 10 years, across the world.

• Eradicating polio will save lives and could save USD $50 billion in low-to middle-income countries.

• Continued coordination among international organizations, NGOs, philanthropists, religious institutions, and governments is essential to eradicate polio finally.

References

1. World Health Organization. (2019, July 22). Poliomyelitis.

2. Global Polio Eradication Initiative. (2021, May 25). Polio + Prevention.

3. Elhamidi, Y., Mahamud, A., Safdar, M., Al Tamimi, W., Jorba, J., Mbaeyi, C., Hsu, C. H., Wadood, Z., Sharif, S., & Ehrhardt, D. (2017). Progress Toward Poliomyelitis Eradication – Pakistan, January 2016-September 2017. MMWR. Morbidity and mortality weekly report, 66(46), 1276–1280.

4. Polio Eradication Initiative. (2021). National Emergency Action Plan 2021.

5. Shah, S., Saad, M., Rizwan, M., Haidari, A., & Idrees, F. (2016). Why We Could Not Eradicate Polio from Pakistan and How Can We? Journal of Ayub Medical College Abbottabad – Pakistan, 28(2), 423-425.

6. Hussain, S.F., Boyle, P., Patel, P. et al. Eradicating Polio in Pakistan: an Analysis of the Challenges and Solutions to this Security and Health Issue. (2016). Global Health 12(63).

7. Pakistan, Pakistan Polio Eradication Programme, National Emergency Operations Centre. (n.d.). National Emergency Action Plan for Polio Eradication 2020.

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.