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African health ministers have endorsed a new regional framework to combat oral diseases that affect over 42 per cent of the population.
The initiative aims to make oral health services universally accessible by 2030, aligning with global health plans.
The framework addresses funding, workforce shortages and access to essential products.
It also urges countries to integrate oral infections such as noma into their health strategies.
More than 42 per cent of Africa’s population suffers from oral diseases, yet the issue has long remained neglected. In response, ministers of health from across the continent have endorsed a new regional framework on oral health aimed at scaling up prevention and treatment.
The framework is built on the Regional Oral Health Strategy (2016-2025) and aligns with the Global Oral Health Action Plan 2023-2030, with the goal of making oral health services a universal right by 2030.
“Oral diseases have been largely neglected, making them among the most prevalent in our region,” said Mohamed Yakub Janabi, WHO Regional Director for Africa. “Countries must now ensure adequate financing, workforce and leadership to protect and promote oral health through an integrated, people-centred approach.”
The oral health framework for the region, approved during the 75th session of the WHO Regional Committee for Africa in Lusaka, Zambia, sets regional goals to be met by 2030, along with significant milestones to reach these targets.
For example, by 2030, at least 50 per cent of each country's population should have access to essential oral health services, a significant increase from only 17 per cent in 2024.
Oral health diseases affect around 42 per cent of the region’s population, according to the document and the framework seeks to achieve a 10 per cent reduction in the prevalence of major oral diseases.
As of 2024, 30 per cent of countries have national oral health policies with dedicated budgets and staff. By 2028, this share is expected to increase to 60 per cent, according to the framework.
In December 2023, WHO added noma, a dangerous gangrenous infection of the mouth, to its list of Neglected Tropical Diseases, a move expected to increase global awareness, funding and research.
The framework calls for at least half of the endemic countries, including Nigeria, Niger, Chad and Ethiopia, to integrate noma into their national health strategies. Often fatal, the infection primarily affects malnourished children living in extreme poverty.
Chronic underfunding for oral health remains one of the biggest hurdles in the region, according to the framework. In 2019, more than 70 per cent of African countries spent less than $1 per capita on oral health, compared with the global average of $50.
A lack of oral health workers, including dentists, dental assistants and therapists, further adds to the challenge. As of 2022, there were only 56,772 oral health workers (3.7 per 100,000), representing just 1.1 per cent of the region’s estimated health workforce of 5.1 million. This is far below the estimated requirement of 158,916 oral health workers (13.3 per 100,000) needed to meet service demands.
So, the framework urges governments to address these gaps by adopting task-sharing approaches, expanding training, increasing access to medicines and enhancing disease surveillance.
Access to affordable oral health products also remains limited. For example, only three African nations — Central African Republic, Mauritius and Senegal — currently classify fluoride toothpaste as affordable. To close this gap, health ministers have called for essential oral health products, including fluoride toothpaste, silver diamine fluoride and glass ionomer cements, to be integrated into national essential medicines lists. Measures such as removing value-added tax and enabling bulk procurement could help reduce costs.
The framework highlights the importance of oral health in tackling non-communicable diseases by addressing key risk factors and system-level gaps. It suggests taxing high-sugar foods and using that money for oral health programmes, while also protecting policies from misleading marketing and industry pressures.
To address the growing threat of antimicrobial resistance, it emphasises the need to monitor antibiotic use in oral care settings. In addition, the framework promotes environmentally sustainable practices, encouraging the adoption of eco-friendly oral health products and a phasedown of mercury-containing amalgam in line with the Minamata Convention.
To implement the framework, health ministers agreed to boost political commitment, provide technical guidance, mobilise both local and global resources, and guarantee adequate human and logistical support.
