Oral diseases and NCDs in the Western Pacific Region need to be prioritised

Peng et al. (2024) expertly outline the significant burden of non-communicable diseases (NCDs) in the Western Pacific Region (WPR).¹ However, oral diseases as a key group of NCDs are absent from the review. The WPR faces unprecedented oral health challenges with 800 million people suffering from diseases such as caries, severe periodontal disease, oral cancer, and edentulism, as highlighted in last year's regional summary of the WHO Global Oral Health Status Report.² Like for all NCDs, the burden of oral diseases is especially high for Pacific Island countries, including some of the highest rates of oral cancer globally.

The region's governments show mixed responses towards these challenges. Some WPR high-income countries are providing comprehensive oral healthcare across the life-course, such as Japan by including its super-ageing populations,³ or Australia and New Zealand by expanding the oral health workforce to enhance access for children and vulnerable groups.⁴ At the same time, most Pacific Island countries struggle to provide even essential services, with limited or no access for rural, remote, or socioeconomically disadvantaged communities. Over half of the region's countries spend less than $10 USD per person annually on oral health.² The stark underfunding of public oral healthcare is a major barrier to universal health coverage (UHC) for oral health through inadequate healthcare infrastructure, low workforce numbers, lack of essential supplies, and low-quality services.

The recent WHO Global Oral Health Action Plan (2023–2030) provides crucial guidance and leadership,⁵ especially since more than half of the region's countries have no oral health policy, and more than a quarter have no dedicated oral health staff at the Ministry of Health to support planning, service delivery, monitoring, and evaluation.

In response to the region's oral health needs, a coalition of heads of oral health services established the Oral Health Pacific Islands Alliance (OPIA).⁶ Their Suva Declaration provides a strategic framework to guide and support the political and health system prioritization of oral diseases in all WPR countries.⁷ The initiative aims to facilitate future strategies, health policies, service improvements, and research that can transform national oral disease responses and contribute to the broader goals of UHC. We encourage WHO WPRO, as well as all WPRO member states to accelerate integration of oral diseases into the regional NCD and UHC agendas, guided by the technical consensus of the Suva Declaration. Progress in advancing knowledge, capacities and supporting policies for oral health at government and community levels across the region is crucial for achieving health equity in the region.

Contributors

All authors conceptualized the manuscript, HB developed the first draft; all authors critically revised and approved the final manuscript.

Declaration of interests

LM, SP, LT and KT are founding members of the Oral Health Pacific Islands Alliance (OPIA) and members of the OPIA executive committee. SP is married to the WHO WPRO director. LM and HB are members of the Lancet Commission on Oral Health; HB is Co-Director of the New York University WHO Collaborating Centre for Quality Improvement and Evidence-based Dentistry and policy advisor for OPIA. No funding has been received for drafting this correspondence.