口腔指南共识汇总

Global strategy

and action plan

on oral health

2023–2030

Global strategy

and action plan

on oral health

2023–2030

Global strategy and action plan on oral health 2023–2030

ISBN 978-92-4-009053-8 (electronic version)

ISBN 978-92-4-009054-5 (print version)

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Contents

Foreword

v

Acknowledgements

vi

Purpose 

vii

Global oral health action plan (2023-2030) 

1

Background 

2

Scope, aim and overarching targets of the global oral health action plan (2023–2030)

5

Action areas of the global oral health action plan

6

▶ Action area for strategic objective 1: oral health governance 

7

Proposed actions for member states

8

Actions for the WHO secretariat

10

Proposed actions for international partners

11

Proposed actions for civil society organizations

12

Proposed actions for the private sector

12

▶ Action area for strategic objective 2: oral health promotion and oral disease prevention  13

Proposed actions for member states

14

Actions for the WHO secretariat

17

Proposed actions for international partners

17

Proposed actions for civil society organizations

18

Proposed actions for the private sector

18

▶ Action area for strategic objective 3: health workforce 

21

Proposed actions for member states

22

Actions for the WHO secretariat

24

Proposed actions for international partners

24

Proposed actions for civil society organizations

25

Proposed actions for the private sector

25

▶ Action area for strategic objective 4: oral health care 

27

Proposed actions for member states

28

Actions for the WHO secretariat

31

Proposed actions for international partners

31

Proposed actions for civil society organizations

31

Proposed actions for the private sector

32

▶ Action area for strategic objective 5: oral health information systems 

33

Proposed actions for member states

34

Actions for the WHO secretariat

35

Proposed actions for international partners

36

Proposed actions for civil society organizations

36

Proposed actions for the private sector

36

▶ Action area for strategic objective 6: oral health research agendas 

37

Proposed actions for member states

38

Actions for the WHO secretariat

39

Proposed actions for international partners

39

Proposed actions for civil society organizations

39

Proposed actions for the private sector

40

Monitoring implementation progress of the global oral health action plan 

41

Appendix 1 

43

Monitoring framework of the global oral health action plan 

44

Core indicators 

48

Appendix 2 

61

Complementary indicators 

62

Annex 1: Global strategy on oral health WHA75(11) 

73

Annex 2: Resolution on oral health WHA74.5

85

v

Foreword

Oral diseases are among the most common noncommunicable diseases

worldwide, affecting an estimated 3.5 billion people. The burden is increasing,

particularly in low- and middle-income countries. Good oral health is essential for

eating, breathing and speaking, and contributes to overall health. The pain and

discomfort associated with oral diseases make concentrating difficult, can cause

people to miss school or work, and can lead to social isolation. Left untreated, the

health-related impact of oral diseases can be severe.

Unfortunately, access to oral health care is often limited due to an over-reliance on specialised care

using high-tech equipment, the cost of which is prohibitive for many families and communities. In

fact, many oral diseases are largely preventable and can be treated using simple and non-invasive

procedures at the primary health care level. Improving access and affordability to essential oral health

care services can be achieved through integrating oral health promotion and care into primary health

care and universal health coverage benefit packages.

Member States have demonstrated their commitment to improving oral health in recent years by

adopting the landmark Resolution on oral health in 2021 and the Global strategy on oral health in 2022.

This was followed in 2023 by the development of the Global oral health action plan 2023–2030, which

translates the vision, goal and strategic objectives of the global strategy into a series of 100 actions for

stronger and more coordinated action on oral health. The action plan also includes a set of 11 global

targets to track progress on oral health for all individuals and communities by 2030.

The Global strategy and action plan on oral health 2023-2030 contains the complete set of policy

documents that define WHO’s global oral health agenda. Together, these policy documents lay out the

path to tackle the challenges faced by communities worldwide, and make the case for integrating oral

health into noncommunicable disease and universal health coverage benefit packages. The action plan

is a practical tool to support Member States in the adaptation of global oral health policies to national

contexts. It outlines a set of priority actions for Member States, the WHO Secretariat, international

partners, civil society organisations and the private sector in moving towards our shared commitment

to equitable access to oral health for all.

WHO supports Member States in the implementation of these policies, within their own national context.

Together, we can reverse the pattern of neglect in oral health, and improve coverage and access around

the world, and make sure that everybody gets the care they need for preventable and treatable oral

diseases.

There is no health without oral health.

Dr Tedros Adhanom Ghebreyesus

Director-General

World Health Organization

vi

Global strategy and action plan on oral health 2023–2030

Acknowledgements

WHO is grateful for the contributions and collaboration with Member States especially the Member

States that supported the Resolution on oral health in 2021 (WHA 74.5) led by Sri Lanka, along with oth-

er co-sponsoring countries including Bangladesh, Bhutan, Botswana, Eswatini, India, Indonesia, Israel,

Japan, Jamaica, Kenya, Myanmar, Peru, Qatar, Thailand and the Member States of the European Un-

ion. The resolution provided a mandate to the WHO Secretariat to develop the Global strategy on oral

health, adopted in May 2022 (decision WHA75(11)), and the Global oral health action plan 2023‒2030

in the report on noncommunicable diseases NCDs, noted by the Seventy-sixth World Health Assembly

(WHA 76(9)).

WHO extends sincere gratitude to the many individuals, organizations, and professional bodies who

contributed to the development of the Global strategy on oral health and Global oral health action

plan 2023-2030. These global oral health policy documents are the result of a highly consultative and

participatory process involving Member States, international and national non-governmental organi-

zations, related global health networks, partners, stakeholders, and the entire oral health community

and beyond. WHO is extremely grateful to all for their valuable feedback and contributions received

throughout the development process, including the regional consultations.

Particularly, WHO would like to thank all Members States, UN organizations, and non-State actors that

participated in a global web-based consultation. Appreciation also goes to McGill University, Canada,

and the International Health Policy Programme, Foundation of the Ministry of Public Health in Thai-

land. Additionally, WHO appreciates the efforts of the informal expert group and WHO Collaborating

Centres on oral health who were part of the development of the global oral health monitoring frame-

work of the Global oral health action plan 2023-2030.

Finally, WHO acknowledges the WHO staff and consultants of WHO headquarters and WHO Regional

Office for Africa, WHO Regional Office for the Americas, WHO Regional Office for South-East Asia, WHO

Regional Office for Europe, WHO Regional Office for the Eastern Mediterranean, and WHO Regional

Office for the Western Pacific, who have valuably contributed to producing these global oral health

policy documents.

WHO acknowledges with gratitude the funds received from the WHO voluntary contributions of the

Borrow Foundation towards the development and publication of these global oral health policy docu-

ments.

vii

Purpose

This document incorporates all key policy documents that inform and define the renewed global oral

health agenda towards 2030:

• the Resolution on oral health (WHA74.5, 2021)1

• the Global strategy on oral health (WHA75 (11), 2022)2

• the Global oral health action plan 2023–2030 (WHA76 (9), 2023)3.

Underlying the global oral health agenda are six guiding principles presented in detail in the Global

strategy on oral health. These principles underpin the approach taken to develop the strategy and

the Global oral health action plan 2023–2030 and can be applied when implementing the agenda in

Member States. They are:

• a public health approach to oral health

• integration of oral health into primary health care

• innovative workforce models to respond to population needs for oral health

• people-centred oral health care

• tailored oral health interventions across the life course

• optimizing digital technologies for oral health.

The action plan provides detailed action-oriented guidance for different stakeholder groups. As such,

it is the focus of this document, as it translates how to achieve the ambition set out in the strategy and

the mandate of the Resolution on oral health. Combined, these policy documents set the global oral

health agenda towards 2030.

The global oral health agenda paves the way towards improved accessibility and affordability of

oral health care, in line with UHC, and serves to support cooperation among countries and different

sectors. Countries are invited to consider the strategic objectives and actions as a source of ideas and

concrete guidance as part of their national oral health policy development. The concepts presented

here for implementation have huge potential to reorient oral health care to a patient-centred model

as part of a primary health care approach. In doing so, countries will further contribute to their UHC

ambition and add value to their efforts in tackling NCDs.

Resolution on oral health: pioneering a new perspective

The World Health Assembly Resolution on oral health (WHA74.5) was a clear milestone in establishing

a renewed global oral health policy agenda. It recognized the urgent need for a paradigm shift from

the traditional curative approach towards a preventive approach, with improved integration of oral

health services within more mainstream health system structures.

1 Resolution WHA74.5. Oral health. In: Seventy-fourth World Health Assembly, Geneva, 24 May–1 June 2021. Resolutions and

decisions, annexes. Geneva: World Health Organization; 2021 (WHA74/2021/ REC/1; https://apps.who.int/gb/ebwha/pdf_files/

WHA74-REC1/A74_REC1-en.pdf#page=1).

2 A75/10 Add.1. Draft global strategy on oral health. In: Seventy-fifth World Health Assembly, Geneva, 22–28 May 2022.

Provisional agenda item 14.1. Geneva: World Health Organization; 2022 (https://apps.who.int/gb/ebwha/pdf_files/WHA75/

A75_10Add1-en.pdf).

3 Draft global oral health action plan (2023–2030). Geneva: World Health Organization; 2023 (https://cdn.who.

int/media/docs/default-source/ncds/mnd/oral-health/eb152-draft-global-oral-health-action-plan-2023-2030-en.

pdf?sfvrsn=2f348123_19&download=true).

viii

Global strategy and action plan on oral health 2023–2030

By endorsing this resolution, Member States signaled their commitment to prioritize oral health as an

integral part of the global health agenda in the context of NCD and UHC agendas, elevating it to the

global forefront.

Global strategy on oral health

As a first step to implementing the mandate given to the WHO Secretariat through the resolution,

WHO developed the Global strategy on oral health (WHA75(11)). The vision of the global strategy is

UHC for oral health for all individuals and communities by 2030, thereby aligning it with the ambition

of the Sustainable Development Goals. This vision means that all individuals and communities have

access to essential, quality health services that respond to their needs and that they can use without

suffering financial hardship. The strategy was developed through an extensive consultation process

that included Member States, other United Nations organizations and non-State actors. The strategy

outlines six strategic objectives:

1. Oral health governance

2. Oral health promotion and oral disease prevention

3. Health workforce

4. Oral health care

5. Oral health information systems

6. Oral health research agendas.

Additionally, the strategy introduces the respective roles of the WHO Secretariat, Member States

and other partners emphasizing a collective responsibility to take action and the importance of

collaboration within and outside of the oral health community. Coordination among efforts to

bridge gaps, tackle NCDs using a common risk factor approach and progressing the UHC agenda

through improved affordability and accessibility to oral health services will enable individuals

and communities to enjoy the highest attainable state of oral health, contributing to healthy and

productive lives.

Global oral health action plan: translating vision into action

Guided by the Global strategy on oral health, the Global oral health action plan 2023-2030 translates

the vision, goal and strategic objectives into action-oriented guidance on interventions for stronger

and more coordinated action on oral health. It is the main practical tool for adaptation of the global

oral health policy agenda to national contexts. It is structured according to 11 global targets, 6

strategic objectives and 100 actions for Member States, WHO secretariat, international partners, civil

society organisation and the private sector. The proposed actions can be adapted and prioritized

depending on individual country context, taking into consideration available resources, population

needs and social, economic and political factors.

Methods

The Global strategy on oral health was developed through a series of consultative processes, which

included a global web-based consultation with Member States, UN organizations, and non-State

ix

actors from August to September 2021. Furthermore, WHO conducted the Member States information

sessions and technical consultation with UN organizations, and non-State actors in official relations

with WHO.

Similarly, the development of the Global oral health action plan 2023-2030 involved a series of

consultative processes. Specifically, WHO conducted a Delphi process, engaging a global informal

expert group that included WHO Collaborating Centres on oral health to inform the global oral

health monitoring framework. Subsequently, informal regional consultations took place between

May and July 2022. This was followed by a global web-based consultation with Member States,

UN organizations, and non-State actors between August and September 2022. Furthermore, WHO

organized Member States information session and technical consultation with UN organizations, and

non-State actors in official relations with WHO.

As we move forward with this ambitious global oral health agenda towards 2030, this document

will serve as the basis for collective action and country support. By embracing the vision, goal and

strategic objectives, we all have a role to play in uniting around a shared commitment to equitable

access to oral health for all.

Global

oral health

action plan

(2023-2030)

World health assembly

WHA76(9)

■

Background

■

Scope, aim and overarching targets of the global oral health action plan (2023–2030)

■

Action areas of the global oral health action plan

2

Global strategy and action plan on oral health 2023–2030

Background

Setting the scene

1. In the Political Declaration of the High-Level Meeting of the General Assembly on the Prevention

and Control of Noncommunicable Diseases (2011), the United Nations General Assembly recog-

nized that oral diseases are major global health burdens and share common risk factors with other

noncommunicable diseases (NCDs). In the Political Declaration of the High-Level Meeting on Uni-

versal Health Coverage (2019), the General Assembly reaffirmed its strong commitment to the pre-

vention and control of NCDs, including strengthening and scaling up efforts to address oral health

as part of universal health coverage (UHC).

2. Oral health is the state of the mouth, teeth and orofacial structures that enables individuals to per-

form essential functions, such as eating, breathing and speaking, and encompasses psychosocial

dimensions, such as self-confidence, well-being and the ability to socialize and work without pain,

discomfort and embarrassment. Oral health varies over the life course from early life to old age, is

integral to general health and supports individuals in participating in society and achieving their

potential.

3. Oral health encompasses a range of diseases and conditions. Those with highest public health rel-

evance include dental caries, severe periodontal (gum) disease, complete tooth loss (edentulism),

oral cancer, oro-dental trauma, noma and congenital malformations such as cleft lip and palate,

most of which are preventable. The main oral diseases and conditions are estimated to affect close

to 3.5 billion people worldwide.1 These conditions combined have an estimated global prevalence

of 45%, which is higher than the prevalence of any other NCD1.

4. The global burden of oral diseases and conditions is an urgent public health challenge with so-

cial, economic and environmental impacts.2 Oral diseases and conditions disproportionately affect

poor, vulnerable and/or marginalized members of societies, often including people who are on low

incomes; people living with disability; older people living alone or in care homes; people who are

refugees, in prison or living in remote and rural communities; and people from minority and/or

other socially marginalized groups. There is a strong and consistent association between socioec-

onomic status and the prevalence and severity of oral diseases and conditions.1 Public and private

expenditures for oral health care have reached an estimated 387 billion US dollars globally, with

very unequal distribution across regions and countries.1

5. Oral diseases and conditions share risk factors common to the leading NCDs, including all forms

of tobacco use, harmful alcohol use, high intake of free sugars and lack of exclusive breastfeeding.

Other risk factors include insufficient oral hygiene for dental caries and severe periodontal diseas-

es; human papillomavirus for oropharyngeal cancers; traffic accidents, interpersonal violence and

sports injuries for traumatic dental injuries; and coinfections, malnutrition and poor water, sanita-

tion and hygiene for noma.

6. Oral diseases and conditions are influenced by social determinants of oral health, which comprise

the social, economic and political conditions that influence oral diseases, including access to safe

1 Global oral health status report: towards universal health coverage for oral health by 2030. Geneva: World Health Organization;

2022. Licence: CC BY-NC-SA 3.0 IGO.

2 Seventy-fifth World Health Assembly, Provisional agenda item 14.1, 27 April 2022, https://apps.who.int/gb/ebwha/pdf_files/

WHA75/A75_10Add1-en.pdf.

Global oral health action plan (2023-2030)

3

water, sanitation and hygiene. They are also affected by commercial determinants, which are the

strategies used by some private-sector actors to promote products and choices that are detrimental

to health. This includes marketing, advertising and sale of products that cause oral diseases and

conditions, such as tobacco products and food and beverages that are high in free sugars.

7. Essential oral health care covers a defined set of safe, cost-effective interventions at individual and

community levels that promote oral health and prevent and treat the most prevalent and/or severe

oral diseases and conditions, including appropriate rehabilitative services and referral.

8. Availability and coverage of oral health care are highly variable within and between countries. As a

result, millions of people still do not have access to and financial coverage for essential oral health

care, leading to high out-of-pocket payments for patients.3 The COVID-19 pandemic has significant-

ly affected oral health services and worsened inequalities for disadvantaged population groups,

highlighting the need for continued essential oral health services in emergency situations.

9. Environmental challenges related to oral health care include the efficient use of natural resources,

such as water and energy; the use of safe and environmentally sound oral health supplies and con-

sumables and oral care products; sustainable waste management; reduction of carbon emissions;

and the need to accelerate the phase down in use of mercury-containing dental amalgam.

10. Most oral diseases and conditions are preventable and can be effectively addressed through pop-

ulation-based public health measures. Upstream policy interventions, such as those targeting

social and commercial determinants, are cost-effective with high population reach and impact.

Midstream initiatives include creating more supportive conditions in key settings like households,

schools, workplaces, long-term care facilities and community venues. Downstream interventions

are also critical, including essential prevention and evidence-based clinical oral health care.

The 2021 resolution on oral health and its mandate

11. Recognizing the global public health importance of major oral diseases and conditions, the World

Health Assembly adopted a resolution on oral health (WHA74.5) in May 2021, requesting that oral

health be embedded within the NCD and UHC agendas.

12. In the resolution on oral health, Member States also requested the Director-General to develop

a draft global strategy on tackling oral diseases, in consultation with Member States, by 2022; to

translate this global strategy, by 2023, into an action plan for public oral health, including a frame-

work for tracking progress with clear measurable targets to be achieved by 2030; to develop techni-

cal guidance on environmentally friendly and less invasive dentistry to support countries with their

implementation of the Minamata Convention on Mercury; to continue to update technical guidance

to ensure safe and uninterrupted dental services, including under circumstances of health emer-

gencies; to develop “best buy” interventions on oral health by 2024, as part of the updated Appen-

dix 3 of the Global Action Plan of NCDs 2013-2030 and integrated into the WHO UHC Compendium

of health interventions; to include noma in the planned WHO 2023 review process to consider the

classification of additional diseases within the road map for neglected tropical diseases 2021–2030;

and to report back on progress and results until 2031 as part of the consolidated report on NCDs.

3 Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after

the 2007 World Health Assembly statement on oral health. Community Dent Oral Epidemiol. 2020; 48:338–348. doi: 10.1111/

cdoe.12538.

4

Global strategy and action plan on oral health 2023–2030

13. The resolution on oral health is aligned with and builds on other relevant global commitments, in-

cluding the 2030 Agenda for Sustainable Development, particularly Sustainable Development Goal

3 (Ensure healthy lives and promote well-being for all at all ages) and its target 3.8 on achieving

UHC, as well as Pillars 1 and 3 of WHO’s Thirteenth General Programme of Work, 2019–2023.

The global strategy on oral health

14. As a first step in the implementation of the resolution on oral health, Member States adopted the

Global Strategy on Oral Health in May 2022 at the Seventy-fifth World Health Assembly (A75/10

Add.1 and WHA75(11)). The strategy is aligned to the Operational Framework for Primary Health

Care (2020); the Global Competency and Outcomes Framework for Universal Health Coverage

(2022); the Global Strategy on Human Resources for Health: Workforce 2030 (2016); the Global Ac-

tion Plan for the Prevention and Control of NCDs 2013–2020; the WHO Framework Convention on

Tobacco Control adopted in 2003; resolution WHA74.16 (2021) on social determinants of health;

decision WHA73(12) (2020) on the United Nations Decade of Healthy Ageing 2021–2030; and reso-

lution WHA67.11 (2014) on public health impacts of exposure to mercury and mercury compounds:

the role of WHO and ministries of public health in the implementation of the Minamata Convention.

15. The vision of the Global Strategy on Oral Health is UHC for oral health for all individuals and com-

munities by 2030, enabling them to enjoy the highest attainable state of oral health and contribut-

ing to healthy and active lives. Universal health coverage means that all individuals and commu-

nities have access to essential, quality health services that respond to their needs and that they

can use without suffering financial hardship. These services should include oral health promotion

and prevention as well as treatment and rehabilitation interventions related to oral diseases and

conditions across the life course. Achieving the highest attainable standard of oral health is a fun-

damental right of every human being.

16. The goal of the Global Strategy on Oral Health is to guide Member States to: (a) develop ambitious

national responses to promote oral health; (b) reduce oral diseases, other oral conditions and oral

health inequalities; (c) strengthen efforts to address oral diseases and conditions as part of UHC;

and (d) consider the development of national and subnational targets and indicators, in order to

prioritize efforts and assess progress made by 2030.

17. The six guiding principles of the Global Strategy on Oral Health are:

•

a public health approach to oral health

•

integration of oral health into primary health care

•

innovative workforce models to respond to population needs for oral health

•

people-centred oral health care

•

tailored oral health interventions across the life course

•

optimizing digital technologies for oral health.

18. The six strategic objectives of the Global Strategy on Oral Health are:

•

Strategic objective 1: Oral health governance – Improve political and resource commitment

to oral health, strengthen leadership and create win–win partnerships within and outside the

health sector.

•

Strategic objective 2: Oral health promotion and oral disease prevention – Enable all people

to achieve the best possible oral health and address the social and commercial determinants

and risk factors of oral diseases and conditions.

•

Strategic objective 3: Health workforce - Develop innovative workforce models and revise and

Global oral health action plan (2023-2030)

5

expand competency-based education to respond to population oral health needs.

•

Strategic objective 4: Oral health care – Integrate essential oral health care and ensure related

financial protection and essential supplies in primary health care.

•

Strategic objective 5: Oral health information systems – Enhance surveillance and health in-

formation systems to provide timely and relevant feedback on oral health to decision-makers

for evidence-based policy-making.

•

Strategic objective 6: Oral health research agendas – Create and continuously update context-

and needs-specific research that is focused on the public health aspects of oral health.

Scope, aim and overarching targets of the global oral health action plan (2023–

2030)

19. The Global Oral Health Action Plan (2023–2030) is a critical step in the implementation of both the

resolution on oral health and the Global Strategy on Oral Health. It is grounded in the strategy’s

vision, goal, guiding principles, strategic objectives and the roles it outlines for Member States, the

WHO Secretariat, international partners, civil society and the private sector.

20. The aim of the Global Oral Health Action Plan is to translate the six strategic objectives of the Global

Strategy on Oral Health into a set of evidence-informed actions that can be adapted to national and

sub-national contexts, including proposed actions for Member States, the WHO Secretariat, inter-

national partners, civil society organizations and the private sector. The proposed actions for Mem-

ber States should be adapted and prioritized depending on national circumstances, taking into

consideration available resources, population needs and social, economic and political contexts.

21. The monitoring framework of the Global Oral Health Action Plan provides two overarching global

targets and nine global targets related to the strategic objectives, including a set of core indicators

to assess implementation progress. Information on the core indicators (Appendix 1) will be report-

ed regularly by WHO, using data provided by Member States. A set of complementary indicators

(Appendix 2) is also proposed as part of the monitoring framework. Member States are encouraged

to use the complementary indicators to monitor other oral health data at the national level for evi-

dence-informed policy development and decision-making.

22. The Global Oral Health Action Plan has two overarching global targets to be achieved by 2030:

By 2030, 80% of the global population is entitled to

essential oral health care services.

Overarching global target A: Oral health services are part of UHC

OVERARCHING GLOBAL TARGETS

By 2030, the combined global prevalence of the main

oral diseases and conditions over the life course

shows a relative reduction of 10%.

Overarching global target B: Reduced oral disease burden

-10%

A

B

80%

6

Global strategy and action plan on oral health 2023–2030

Action areas of the global oral health action plan

23. The action areas of the Global Oral Health Action Plan are aligned with the six strategic objectives

of the Global Strategy on Oral Health. Generally, a public health and population-level approach

should be taken when implementing these actions, including consideration of equity for poor, vul-

nerable and/or marginalized members of societies.

■Proposed actions for member states

■Actions for the WHO secretariat

■Proposed actions for international partners

■Proposed actions for civil society organizations

■Proposed actions for the private sector

Action area for

strategic objective 1:

oral health governance

8

Global strategy and action plan on oral health 2023–2030

Action area for strategic objective 1:

oral health governance

24. Strategic objective 1 aims to improve political and resource commitments to oral health, strengthen

leadership and create win–win partnerships within and outside of the health sector. This objective

seeks the recognition and integration of oral health in all relevant policies and public health pro-

grammes as part of the broader national NCD and UHC agendas. Increased political and resource

commitment to oral health is vital at the national and subnational levels, as is reform of health and

education systems. Central to this process is establishing or strengthening the capacity of a nation-

al oral health unit with professionals trained in public health. A dedicated, qualified, functional,

well-resourced and accountable oral health unit should be established or reinforced within NCD

structures and other relevant public health and education services.

25. Sustainable partnerships within and outside of the health sector, as well as engagement with com-

munities, civil society and the private sector, are essential to mobilize resources, target the social

and commercial determinants of oral health and implement reforms.

Proposed actions for member states

Action 1.

Develop and implement a national oral health policy, strategy or action plan:

Develop a new national oral health policy or review the existing policy to ensure

its alignment with the Global Strategy on Oral Health and its integration with na-

tional NCD and UHC policies. Ensure the policy promotes oral health equity and

prioritizes public health. Confirm that the policy coordinates oral health efforts

and management across relevant national agencies and subnational levels, in-

cluding safe and uninterrupted oral health services during health emergencies.

Prepare national implementation guidance, including a monitoring framework

aligned with the monitoring framework of the Global Oral Health Action Plan. A

periodic review of the policy should be undertaken within five years of its onset.

1

GLOBAL TARGETS FOR STRATEGIC OBJECTIVE 1

By 2030, 90% of countries have implemented

measures to phase down the use of dental amalgam as

stipulated in the Minamata Convention on Mercury or

have phased it out.

Global target 1.1: National leadership for oral health

Global target 1.2: Environmentally sound oral health care

90%

80%

By 2030, 80% of countries have an operational

national oral health policy, strategy or action plan and

dedicated staff for oral health at the Ministry of Health

or other national governmental health agency.

Action area for strategic objective 1: oral health governance

9

Action 2.

Strengthen national oral health leadership: Institute or reinforce an oral health

unit at the Ministry of Health or another appropriate national governmental

health agency to oversee national policy, technical, surveillance, management,

coordination and advocacy functions. Appoint an officer to lead the oral health

unit. Consider, as appropriate for the national context, active integration and/

or coordination mechanisms between the oral health unit and the NCD depart-

ment or other technical programmes. Support capacities of oral health unit staff

by assessing training needs and providing training and coaching opportunities,

including management, leadership and public health skills, as appropriate. Em-

power national regulatory agencies to ensure ethical standards of professional

conduct and quality oral health care.

Action 3.

Create and sustain dedicated oral health budgets: Explore, as appropriate

for national context, establishing dedicated oral health budgets at national and

subnational levels covering policy, public service staff, programme and supply

costs. Examine sustainable domestic sources of financial support, such as taxa-

tion policies. Consider directing public health expenditure towards oral health

promotion, prevention and care as a distinct budget and a first step towards es-

tablishing a guaranteed minimum share of public health expenditure dedicated

exclusively to oral health.

Action 4.

Integrate oral health into broader policies: Advocate for UHC as a means of

improving prevention and control of oral diseases and conditions for the whole

population. Facilitate and operationalize the inclusion of oral health in all related

national policies, strategies and programmes, particularly in the context of NCDs,

primary health care, health equity and UHC. Include sectors beyond health,

such as education, development, environment, water, sanitation and hygiene,

finance, telecommunications or social protection.

Action 5.

Forge strategic partnerships for oral health: Explore the potential for strategic

partnerships to implement policies, mobilize resources, target social and com-

mercial determinants and accelerate required reforms. Engage policy-makers,

researchers, oral health professionals and the general public at the earliest stag-

es of policy and research development to ensure they have the greatest positive

impact on national oral health and beyond. Develop and enforce policies on en-

gagement with partners to eliminate conflicts of interest and undue influence.

Initiate or strengthen ministerial coordination and oversight mechanisms relat-

ed to partnerships, including public-private partnerships. Collaborate with in-

ternational and development partners to support implementation of oral health

policies in national health plans.

Action 6.

Engage with civil society about oral health: Ensure participation of civil society

organizations and patient support groups and empowerment of the community

in planning, implementing and monitoring appropriate programmes. Provide

platforms for engagement and actively seek representation from poor, vulnera-

ble and/or marginalized members of societies. Involve national oral health, med-

ical and public health associations and community-based organizations in oral

health policy and guideline development as well as implementation and integra-

tion of oral health in wider health care and social services.

10

Global strategy and action plan on oral health 2023–2030

Action 7.

Phase down the use of dental amalgam: Ratify the Minamata Convention on

Mercury and support related national assessments and implementation plans.

Accelerate implementation of measures to phase down the use of dental amal-

gam in accordance with existing and future decisions of the Conference of the

Parties to the Minamata Convention on Mercury.

Action 8.

Strengthen health emergency preparedness and response: Include oral health

in national emergency preparedness and response plans. Ensure safe and unin-

terrupted essential oral health services during health emergencies or other hu-

manitarian crises, in accordance with WHO operational guidance on maintaining

essential health and oral health services.

Action 9.

Bolster response to noma, where relevant: In countries affected by noma, de-

velop and implement a national noma action plan that is integrated with existing

regional or national programmes, such as those targeting neglected tropical dis-

eases, vaccination and/or nutrition.

Actions for the WHO secretariat

Action 10.

Lead and coordinate the Global Oral Health Agenda: Drive initiatives to de-

fine and update the Global Oral Health Agenda and monitor its implementation.

Coordinate the work of other relevant entities of the United Nations system, de-

velopment banks and regional and international organizations related to oral

health. Set the general direction and priorities for global oral health advocacy,

partnerships and networking. Advocate for oral health at relevant high-level

meetings and platforms, such as the WHO Global NCD Platform, the United Na-

tions High-Level Meeting on Universal Health Coverage and the High-Level Meet-

ing of the United Nations General Assembly on the Prevention and Control of

NCDs. Accelerate implementation of the action plan by organizing a WHO global

oral health summit involving key stakeholders.

Action 11.

Mobilize resources and funding for oral health: Explore and pursue funding op-

tions to strengthen WHO capacities in oral health at global, regional and country

levels and enable timely and appropriate technical support to countries. Strive

to increase the number of dedicated staff at all levels of the organization, includ-

ing operational budgets for programmatic work at global, regional and country

levels. Advocate to increase resource allocation to oral health within the NCD

agenda to ensure adequate staffing and programmatic activities. Include oral

health in bi- and multi-lateral conversations with Member States and partners

to mobilize resources for WHO oral health activities. Follow WHO’s Framework of

Engagement with Non-State Actors and engage with nongovernmental organiza-

tions and philanthropic foundations to increase resources for implementing the

Global Oral Health Action Plan, particularly in low- and middle-income settings.

Action 12.

Support implementation of the Global Oral Health Agenda: Provide techni-

cal assistance upon request of Member States and prioritize support to low- and

middle-income settings for developing, implementing and sustaining of their na-

tional oral health plans. Create a global technical advisory group on oral health

to strengthen international and national action and accelerate implementation

Action area for strategic objective 1: oral health governance

11

of the Global Oral Health Agenda. Continue working with global partners, includ-

ing the United Nations Interagency Task Force on the Prevention and Control of

NCDs, WHO collaborating centres and non-State actors in official relation with

WHO, to establish networks for building capacity in oral health promotion, care,

research and training. Establish or strengthen regional oral health policy, plan-

ning and support capacities to address countries’ technical support needs for

implementation of the Global Oral Health Action Plan, including data collection

for its monitoring framework.

Action 13.

Fulfil the mandates given to the WHO Secretariat in the resolution on oral

health: Continue to update technical guidance to ensure safe and uninterrupted

dental services, including in health emergencies. By 2024, develop “best buy” in-

terventions on oral health, as part of the updated Appendix 3 of the Global Action

Plan for the Prevention and Control of NCDs 2013–2030 and integrated into the

WHO UHC Compendium of health interventions. By 2023, include noma in the

planned WHO review process to consider the classification of additional diseas-

es within the road map for neglected tropical diseases 2021–2030. By 2025, de-

velop technical guidance on environmentally friendly and less invasive dentistry

to support countries with their implementation of the Minamata Convention on

Mercury. Report back to the WHO governing bodies on progress and results until

2031 as part of the consolidated report on NCDs.

Proposed actions for international partners

Action 14.

Advocate for the Global Oral Health Action Plan: Develop technical expertise

related to oral health as part of the support mandate of development partners

and donor organizations. Promote oral health in alignment with the Global Oral

Health Action Plan by including it as a topic in meetings within and outside of the

health sector, such as donor, bi- and multi-lateral government meetings, confer-

ences and other forums.

Action 15.

Increase resources for oral health: Intensify efforts by development partner

and donor organizations to address oral health and other NCDs as part of the

global NCD and UHC agendas. Expand financial, technical and human resource

support. Use innovative financial mechanisms in programming for health, edu-

cation and social protection.

Action 16.

Support country implementation of the Global Oral Health Action Plan: Re-

inforce national capacities and resources for oral health through provision of

technical and financial support. Help establish and sustain national technical

working groups on oral health involving donors, development partners and the

national government. Strengthen capacities of academic institutions and other

non-State actors to act and advocate effectively. Prioritize support to low- and

middle-income countries for developing, implementing and sustaining their na-

tional oral health plans.

12

Global strategy and action plan on oral health 2023–2030

Proposed actions for civil society organizations

Action 17.

Promote a whole-of-government approach to oral health: Advocate for inte-

grating management of oral diseases and other NCDs into primary health care.

Engage in multisectoral coordination mechanisms to deliver on oral health and

other NCD targets within and beyond the health sector.

Action 18.

Advance oral health as a public good: Collaborate among civil society organi-

zations, including oral health professional associations, to promote and protect

oral health as a public good. Monitor and raise awareness of inappropriate part-

nerships in which there are conflicts of interest or undue influence. Participate

in the development of government guidance on private sector engagement in

oral health and NCD programmes. Advocate for governments to phase out subsi-

dies for unhealthy foods and drinks. Support taxation of unhealthy commodities,

such as tobacco, alcohol and food and beverages with high free sugars content,

in line with the provisions of the Framework Convention on Tobacco Control, the

WHO Global Strategy to Reduce the Harmful Use of Alcohol and other WHO guid-

ance documents. Promote a holistic approach to tackling antimicrobial resist-

ance based on the United Nations Sustainable Development Cooperation Frame-

work. Include the oral health workforce in such measures.

Action 19.

Hold governments accountable to global oral health targets: Participate in

regular monitoring of national NCD and UHC work, including development and

use of oral health targets and indicators. Strengthen independent accountability

efforts related to oral health. Advocate for the operationalization of oral health

services as part of UHC.

Action 20.

Include people affected by oral diseases and conditions: Call for and partici-

pate in inclusive oral health governance mechanisms. Ensure that institutional-

ized oral health decision-making processes engage people living with oral dis-

eases, special care needs or disabilities as well as oral health professionals.

Proposed actions for the private sector

Action 21.

Align activities with global and national public health priorities: Use the

Global Oral Health Action Plan and relevant regional and national policy guid-

ance to incorporate public health principles and priorities in private sector activ-

ities to promote oral health.

Action 22.

Support implementation of the Global Oral Health Action Plan: Identify areas

for meaningful and appropriate engagement to support oral health public health

priorities at the global, regional or national level. Respect rules of engagement

set by public entities and government partners, including voluntary commit-

ments and mandatory measures, such as advertising for children. Ensure envi-

ronmental and social responsibility and accountability in oral health practices.

■Proposed actions for member states

■Actions for the WHO secretariat

■Proposed actions for international partners

■Proposed actions for civil society organizations

■Proposed actions for the private sector

Action area for

strategic objective 2:

oral health promotion

and oral disease prevention

14

Global strategy and action plan on oral health 2023–2030

Action area for strategic objective 2:

oral health promotion and oral disease prevention

26. Strategic objective 2 aims to address the social and commercial determinants and risk factors of

oral diseases and conditions, with the goal of enabling all people to achieve the best possible oral

health. This objective calls for evidence-based, cost-effective and sustainable interventions to

promote oral health and prevent oral diseases and conditions. At the upstream level, oral health

promotion includes creating public policies and fostering community action to improve people’s

control over their oral health and to promote oral health equity. At the midstream level, oral health

promotion and oral disease prevention interventions can be implemented in key settings, such as

educational venues, schools, workplaces and care homes. At the downstream level, oral health ed-

ucation supports the development of personal, social and political skills that enable all people to

achieve their full potential for oral health self-care.

27. Prevention efforts target key risk factors and the social and commercial determinants of oral dis-

eases and conditions. These initiatives should be fully integrated and mutually reinforcing with

other relevant strategies to prevent NCDs and regulatory policies to reduce or eliminate tobacco

use, harmful alcohol use, unhealthy diets and high intake of free sugars. Prevention efforts should

also include safe and cost-effective community-based methods to prevent dental caries, such as

the use of quality fluoride toothpaste, topical fluoride application and access to systemic fluoride,

where appropriate.

Proposed actions for member states

Action 23.

Intensify upstream health promotion and prevention approaches: Ensure

that a national oral health policy addresses common risk factors as well as social

and commercial determinants of dental caries, severe periodontal disease, tooth

loss, oral cancer, oro-dental trauma, cleft lip and palate and noma, where it is

prevalent. Support initiatives to coordinate and accelerate the response to oral

diseases and conditions and other NCDs, including health promotion and dis-

ease prevention focusing on common risk factors, determinants and inequalities

across the life course.

2

GLOBAL TARGETS FOR STRATEGIC OBJECTIVE 2

By 2030, 50% of countries have national guidance

on optimal fluoride delivery for oral health of the

population.

By 2030, 50% of countries implement policy measures

aiming to reduce free sugars intake.

Global target 2.1: Policies to reduce free sugars intake

Global target 2.2: Optimal fluoride for population oral health

50%

50%

Action area for strategic objective 2: oral health promotion and oral disease prevention

15

Action 24.

Support policies and regulations to limit intake of free sugars: Accelerate ini-

tiatives to transform the food environment in line with WHO’s recommendations.

Implement policies to reduce consumption of free sugars. Promote availability

of healthy foods and beverages. Consider, when appropriate to national context,

implementing health taxes, particularly taxation of food and beverages with high

free sugars content. Advocate for earmarking such tax revenue for oral health care

and health promotion, depending on country context. Collaborate with other line

ministries: to limit package sizes; include more visible, simple and transparent la-

belling of unhealthy foods and beverages; strengthen regulation of marketing and

advertising of such products to children, adolescents and their parents; and avoid

sponsorship by related companies for public and sports events. Work with the pri-

vate sector to reduce portion sizes and reformulate products to decrease levels of

free sugars, including medicines for children with high free sugars content.

Action 25.

Support policies and regulations to reduce tobacco consumption and be-

tel-quid and areca-nut chewing: Accelerate full implementation of the WHO

Framework Convention on Tobacco Control. Implement the WHO MPOWER pack-

age of policies and interventions, including offering people help to quit tobacco

use; warning about the dangers of tobacco; enforcing bans on advertising, pro-

motion and sponsorship; and raising taxes on tobacco products. Integrate brief

interventions for tobacco use into oral health programmes in primary care. Reg-

ulate electronic cigarettes and all other nicotine-containing products in the same

way as tobacco products. Where relevant, develop or strengthen actions for re-

ducing betel-quid and areca-nut chewing, including advocating for legislation to

ban their sale.

Action 26.

Support policies and regulations to reduce the harmful use of alcohol: Im-

plement the WHO SAFER initiative of the five most cost-effective interventions

to reduce alcohol-related harm, including strengthening restrictions on alcohol

availability; advancing and enforcing drink-driving counter measures; facilitating

access to screening, brief interventions and treatment; enforcing bans or com-

prehensive restrictions on alcohol advertising, sponsorship and promotion; and

raising prices on alcohol through excise taxes and pricing policies.

Action 27.

Optimize the use of fluorides for oral health: Develop or update national guid-

ance related to optimal fluorides for population oral health that addresses the

universal availability of systemic fluorides (e.g., water, salt, milk) or topical flu-

orides (e.g., toothpastes, varnishes, gels, rinses). Take into consideration needs

and disease burdens across the life course, the fluoride levels present in natural

waters, available resources and technical, political and social factors. Depending

on the country context and feasibility, consider adjusting water fluoride to safe,

optimal levels for protection against dental caries, which may require adding or

removing fluoride from drinking water as recommended by national and interna-

tional guidance.

Action 28.

Advocate for fluoride toothpaste as an essential health product: Implement

measures to improve the affordability and availability of fluoride toothpaste. Re-

duce or eliminate taxes, tariffs and other fiscal measures. Explore bulk purchas-

ing or manufacturing agreements for use of fluoride toothpaste in community

16

Global strategy and action plan on oral health 2023–2030

settings. Strengthen quality and labelling of fluoride toothpaste in accordance

with ISO Standard 11609 by developing national standards and quality controls.

Enhance measures to protect consumers from low quality, harmful or counterfeit

products. Consider adopting norms that detail available fluoride content, includ-

ing methods for standardizing laboratory analysis to ensure product efficiency.

Advance environmentally sound practices along the fluoride-toothpaste produc-

tion and supply chain. Promote and incentivize effective self-care and oral hy-

giene by making affordable, quality fluoride toothpaste universally available.

Action 29.

Review and scale up mid-stream promotion and prevention measures: Col-

laborate in community development and action for oral health. Facilitate so-

cial mobilization and engage and empower a diverse range of actors, including

women as change agents in families and communities. Foster dialogue, catalyse

societal change and address oral diseases and conditions and their social, envi-

ronmental and economic determinants to improve oral health equity. Promote

and implement vaccination of girls and boys against human papillomavirus to

address cervical and oro-pharyngeal cancers, in accordance with national and

international guidance. Encourage early detection of oral cancer in high-risk

groups, linked with timely diagnostic work up and comprehensive cancer treat-

ment, in settings with a significant disease burden.

Action 30.

Expand oral health promotion in key settings: Integrate oral health in health

promotion programmes in schools, workplaces, long-term care facilities, hospi-

tal and other health care settings, community-based settings and public venues.

Partner in these efforts with key stakeholders across sectors, including city and

local authorities, professional organizations, community-based organizations

and civil society at large. Promote and consider establishing public settings

where consumption of free sugars is discouraged and sugar-sweetened beverag-

es are banned.

Action 31.

Achieve comprehensive promotion of oral health in schools: Create support-

ive environments for oral health promotion in schools, preschools and other

educational settings as part of comprehensive school health programming. Im-

prove access to clean water, sanitation and hygiene services; increase availabil-

ity of healthy food options; eliminate foods high in salt, free sugars and trans

fats; and ban sugar-sweetened beverages, tobacco use and alcohol use on and

around the premises. Collaborate in joint health and education ministry over-

sight of school health and feeding programmes, including creating an environ-

ment that supports healthy choices in schools and educational settings. Strive

for integrated monitoring of education, school health, and water, sanitation and

hygiene based on national, regional or international guidance and initiatives, in-

cluding the WHO health-promoting schools’ initiative and the WHO and UNESCO

Guidelines on School Health Services. Improve school linkages with the formal

health care system. Establish rules and regulations for ethical commercial sup-

port and sponsorship in schools.

Action 32.

Fortify and improve downstream promotion and prevention measures: De-

velop and implement evidence-based, cost-effective, sustainable, and age-ap-

propriate interventions to prevent oral diseases and promote oral health. Include

Action area for strategic objective 2: oral health promotion and oral disease prevention

17

oral health in broader health communication, health education and literacy cam-

paigns to raise awareness and empower people for prevention through self-care,

oral hygiene and early detection of oral diseases. Draw on the WHO Mobile Tech-

nologies for Oral Health implementation guide to promote oral health literacy

among individuals, communities, policy makers, the media and civil society us-

ing digital health technologies. Tailor interventions to address oral health along

the life course, such as programmes targeting children, adolescents, pregnant

women, parents and older adults, with special consideration for poor, vulnera-

ble and/or marginalized members of the society. Ensure quality monitoring and

evaluation of health promotion and prevention programmes.

Action 33.

Strengthen personal, social and political oral health skills: Support all peo-

ple to achieve their full potential for oral health self-care and oral health care of

others. Promote twice-daily tooth brushing with fluoride toothpaste and other

forms of oral health self-care and care for others. Employ skills-based oral hy-

giene education in communities, schools and primary care settings. Include oral

health in population health education campaigns and relevant digital and social

media platforms. Advocate for supportive policies to strengthen the availability

and affordability of fluoride toothpaste.

Actions for the WHO secretariat

Action 34.

Integrate oral health promotion in relevant WHO guidance: Consider estab-

lishing a WHO internal coordination mechanism to facilitate systematic integra-

tion of oral health in related policies, strategies and technical documents. Inte-

grate oral health in technical guidance on health taxes. Encourage research with

WHO collaborating centres and other research entities on interventions to effec-

tively address the social and commercial determinants of oral health.

Action 35.

Provide technical guidance for oral health promotion and oral disease pre-

vention: Recommend cost-effective, evidence-based interventions for oral

health promotion and disease prevention by 2024 as part of the updated Appen-

dix 3 of the Global Action Plan for the Prevention and Control of NCDs 2013–2030

and the WHO UHC Compendium of health interventions.

Action 36.

Hold to account economic operators in the production and trade of products

harmful to oral health: Strengthen technical support and guidance on nutri-

tion, labelling and fiscal measures to promote healthy food options. Encourage

private-sector transparency and alignment with mandatory regulations and vol-

untary codes of practice to reduce the marketing, advertising and sale of prod-

ucts harmful to oral health, such as tobacco products and food and beverages

that are high in free sugars.

Proposed actions for international partners

Action 37.

Target risk factors and determinants of oral health: Integrate oral health into

new or existing programmes that address NCDs more broadly, including com-

mon risk factors and determinants of health. Support and conduct research to

18

Global strategy and action plan on oral health 2023–2030

strengthen the evidence for interventions that effectively target the determi-

nants of oral health, including those that reduce oral health inequalities.

Action 38.

Consider oral health in policy impact assessments: Ensure that oral health is

considered when conducting health, inequality or environmental impact assess-

ments in trade, food, environment, finance and other sectors, so that unintended

health impacts can be avoided and mitigation measures are put in place.

Proposed actions for civil society organizations

Action 39.

Mobilize support for oral health promotion: Facilitate community action for

health promotion among diverse groups, such as nongovernmental organiza-

tions, academia, media, human rights agencies, faith-based organizations, la-

bour and trade unions and organizations working with poor, vulnerable and/or

marginalized people. Support the development of personal, social and advocacy

skills to enable all people to achieve their full potential for effective self-care and

comprehensive oral hygiene, including persons with impaired motor skills, such

as children, people with disabilities and older individuals.

Action 40.

Advocate for policies and regulations for oral disease prevention: Support

policies aimed at creating healthy environments and settings, such as healthy

school meals, tobacco-free environments and related sales restrictions for mi-

nors. Advocate for the implementation of health taxes, including those for foods

and beverages high in free sugars. Promote national action on the commercial

determinants of health, such as mandatory legislation and regulation to limit the

influence of food and drink corporations. Call for transparent conflict-of-interest

policies between commercial corporations and oral health policy-makers, dental

schools and oral health researchers to limit undue influences and safeguard pub-

lic health interests.

Action 41.

Ensure civil society inclusion in policy development: Advocate for including

professional, provider and patient organizations and diverse other civil socie-

ty organizations in the development and implementation of policies related to

oral health promotion, common risk factors and the determinants of oral dis-

eases and other NCDs. Strengthen transparency and commitment by holding all

stakeholders accountable to the Global Oral Health Action Plan’s actions on oral

health promotion and oral disease prevention.

Proposed actions for the private sector

Action 42.

Reduce marketing, advertising and sale of harmful products: Prioritize moni-

toring, transparency and compliance with voluntary and legally binding policies

and regulations related to healthy settings, protection of vulnerable population

groups, marketing, advertising and sponsorship, depending on country context.

Consider reformulation of products to reduce intake of free sugars.

Action 43.

Improve affordability and quality of fluoride products for oral health: Coop-

erate with governments to improve the affordability and quality of fluoride-con-

taining products for oral health. Ensure that tax reductions or subsidies applied

Action area for strategic objective 2: oral health promotion and oral disease prevention

19

to such products are entirely reflected in lower consumer prices.

Action 44.

Implement occupational oral health measures: Strengthen the commitment

and contribution to oral health by implementing measures at the workplace, in-

cluding through good corporate practices, workplace health and wellness pro-

grammes and health insurance coverage for employees, according to country

context.

■Proposed actions for member states

■Actions for the WHO secretariat

■Proposed actions for international partners

■Proposed actions for civil society organizations

■Proposed actions for the private sector

Action area for

strategic objective 3:

health workforce

22

Global strategy and action plan on oral health 2023–2030

Action area for strategic objective 3:

health workforce

28. Strategic objective 3 aims to develop innovative workforce models and to revise and expand com-

petency-based education to support new skill mixes. Progress towards oral health services as part

of UHC requires health workers who are educated and empowered to provide the oral health ser-

vices that populations need. Central to this objective is the availability of skilled health workers

in adequate numbers to ensure the delivery of an essential package of oral health care. Planning

and prioritization of oral health services must be included in all national health workforce policies,

plans or strategies and investment plans.

29. More effective, innovative workforce models will probably include health professionals who tra-

ditionally may not have been involved in oral health care working together with oral health pro-

fessionals to provide an essential package of oral health services. Developing and expanding the

role of oral health care providers working autonomously at the mid-level is particularly important.

Reform of intra- and inter-professional education and collaborative practice will be key to fully inte-

grating oral health services at the primary care level and into broader health systems. Professional

oral health education must go beyond developing a fundamental clinical skill set to incorporate

community health, public health, leadership and research competencies.

Proposed actions for member states

Action 45.

Foster innovative oral health workforce models: Develop and implement

workforce models that enable sufficient numbers of adequately trained, mo-

tivated and well-distributed health workers to provide oral health services as

members of collaborative and interprofessional primary health care teams at

all levels of care. Review and update national legislative and regulatory policies

for licensing, accreditation and scopes of practice to support flexible workforce

models and competency-based education and practice. Explore task shifting and

increase the number and availability of oral health providers working autono-

mously at the mid-level. Facilitate career-transition pathways between profes-

sional tracks to increase flexibility and deployment of oral health providers in un-

derserved areas. Include basic oral health promotion and preventive oral health

care as a core competency for key health care professionals, such as doctors,

nurses and pharmacists.

Action 46.

Increase capacity to deliver oral health services as part of UHC: Expand cov-

erage of essential oral health care by planning for the availability, accessibility,

3

GLOBAL TARGETS FOR STRATEGIC OBJECTIVE 3

Global target 3: Innovative workforce model for oral health

50%

By 2030, 50% of countries have an operational

national health workforce policy, plan or strategy that

includes workforce trained to respond to population

oral health needs.

Action area for strategic objective 3: health workforce

23

acceptability and quality of skilled health workers able to deliver an essential

package of oral health care for all, including for poor, vulnerable and/or margin-

alized populations. Ensure that investment in human resources for oral health is

efficient, sustainable and aligned with the current and future needs of the popu-

lation. Include oral health workforce planning within national health workforce

plans, policies and strategies. Develop comprehensive investment plans to scale

up the oral health workforce. Consider designing a standardized national com-

petency-based training curriculum for oral health aligned with the WHO Global

Competency and Outcomes Framework for Universal Health Coverage, which

guides the standards of education and practice for health workers in primary

care.

Action 47.

Strengthen collaborative, cross-sectoral workforce governance: Establish

and enable professional councils and associations at the national level to devel-

op, regularly review and adapt accreditation mechanisms and regulations. Pro-

mote portability of licensure across countries to support innovative oral health

workforce models. Include standards of practice and professional behaviour,

under the oversight of the Ministry of Health and fully integrated with national

health workforce planning. Leverage existing collaborations among the minis-

tries of health, labour, economy, finance and education and engage with relat-

ed professional councils and associations, to ensure occupational health and

safety, health worker rights, reduced biases in the workforce and appropriate

remuneration. Foster interprofessional collaboration, including interdisciplinary

teamwork in oral health care and scale-up of surveillance capacities for commu-

nicable and noncommunicable conditions.

Action 48.

Reform intra- and inter-professional oral health education: Prepare students

for collaborative practice and integrating oral health into primary health care.

Promote and safeguard equitable access to oral health professional education to

increase socio-economic, gender, disability, ethnic and geographic diversity and

cultural competency of the oral health workforce.

Action 49.

Improve oral health workforce curricula and training: Reform education to

prioritize competencies in public health, health promotion, disease prevention,

evidence-informed decision-making, digital oral health, service planning and

the social and commercial determinants of health. Ensure the curriculum pro-

vides oral health workers with clinical and public health competencies to pre-

vent and treat the most common oral diseases with essential oral health care and

rehabilitation measures in a primary care context. Encourage and consider mak-

ing it mandatory for professional organizations and dental schools to educate

and train oral health professionals and students on the use of evidence-based,

mercury-free alternatives for dental restoration and on best practices for waste

management in oral health care facilities. Support training on rational antimi-

crobial prescribing and infection control to prevent the spread of antimicrobial

resistance.

Action 50.

Strengthen oral health professional accreditation: In accordance with coun-

try regulations, create or improve accreditation mechanisms for public and pri-

vate oral health education and training institutions. Support effective oversight

24

Global strategy and action plan on oral health 2023–2030

bodies to ensure minimum quality standards of oral health education. Establish

standards for social accountability and social and commercial determinants of

health. Work with professional associations to define oral health specializations

and their training and accreditation requirements, recognizing the priority of es-

sential oral health care and public health specialists while balancing the demand

for advanced and specialist oral health care. Strengthen awareness of nonclin-

ical career pathways among students in public health, epidemiology, research

and other areas. Make life-long professional continuing education mandatory to

retain accreditation and license to practise.

Actions for the WHO secretariat

Action 51.

Explore innovative workforce models for oral health: Initiate regional and

national workforce assessments to inform the development of innovative work-

force models for oral health service delivery, based on the WHO Competency

Framework for Universal Health Coverage and the objectives of the Global Strat-

egy on Human Resources for Health: Workforce 2030. Consider developing ca-

pacity building programmes as part of institutional and educational workforce

reform, with the support of the WHO Academy.

Action 52.

Provide normative guidance and technical support for oral health workforce

reform: In collaboration with partners, disseminate best practices on assess-

ment of health system needs, reform of education policies, analysis of health

labour markets, and costing of national policies, plans and strategies on human

resources for health, taking into account the organization of the national oral

health team. Review and strengthen tools, guidelines and databases related to

human resources for NCDs, including oral diseases and conditions, in collabora-

tion with the WHO health workforce department.

Action 53.

Strengthen country-level reporting on human resources for oral health:

Gather, analyse and report public and private oral health workforce data as part

of the monitoring framework of the Global Oral Health Action Plan. Track pro-

gress on implementation of workforce-related actions. Support country-level

data collection on the oral health workforce, including leveraging the national

health workforce accounts reporting system.

Proposed actions for international partners

Action 54.

Champion the workforce reform agenda: Engage international professional,

research and dental education associations to align with the workforce reform

agenda and support regional and national member associations. Support inno-

vative oral health workforce models by focusing international and regional sup-

port on countries with the most critical workforce shortages. Consider financial

and grant support for assessing, strengthening and diversifying the oral health

workforce.

Action 55.

Advance data, information and accountability: Reinforce integrated health

and oral health workforce planning. Provide technical support for collecting,

Action area for strategic objective 3: health workforce

25

analysing and using data on the national oral health workforce for improved

planning and accountability. Align these efforts with the health labour market

framework and the national health workforce accounts reporting system.

Action 56.

Improve oral health training and accreditation: Under the oversight of the

Ministry of Health and in collaboration with professional associations, integrate

basic competencies for oral health in health worker training programmes on pre-

vention and management of major NCDs. Promote mutual recognition of profes-

sional diplomas and qualifications by regional and national accreditation entities

to enable free movement, license portability and practice between countries and

geographic areas of need for oral health professional, in accordance with the WHO

Global Code of Practice on the International Recruitment of Health Personnel.

Proposed actions for civil society organizations

Action 57.

Collaborate to accelerate oral health workforce reform: For dental councils

and oral health professional associations, develop appropriate task-sharing and

interprofessional collaboration models and strengthen effective accreditation

and regulation processes for improved workforce competency, quality and ef-

ficiency, under government leadership and through collaboration with commu-

nity and patient organizations, where appropriate. For academic training and

research institutions, train the workforce to minimize the environmental impact

of oral health services and prioritize oral health worker competencies in line with

the WHO Competency Framework for Universal Health Coverage and the Global

Strategy on Human Resources for Health: Workforce 2030.

Action 58.

Strengthen oral health in primary health care: For dental councils and oral

health professional associations, foster ongoing self-reflection of the dental

profession on the goal of improving access to and quality of oral health care in

primary health care and patient safety as a societal responsibility within and be-

yond dentistry.

Action 59.

Improve quality of oral health care through continuing education: For dental

councils and oral health professional associations, support continuing educa-

tion of the oral health workforce. Develop or review codes of practice and similar

frameworks to enhance management of potential conflicts of interest and undue

influences, including when dental and pharmaceutical companies and other pri-

vate-sector entities sponsor professional education and conferences.

Proposed actions for the private sector

Action 60.

Align private and public oral health workforce training: Ensure involvement

and alignment of public and private oral health workforce training institutions in

meeting the requirements of national health workforce policies, plans or strat-

egies aimed at addressing current and future population health needs. Adapt

concepts and programmes of private oral health education to include competen-

cy-based training. Strengthen oral health education in the public interest.

■Proposed actions for member states

■Actions for the WHO secretariat

■Proposed actions for international partners

■Proposed actions for civil society organizations

■Proposed actions for the private sector

Action area for

strategic objective 4:

oral health care

28

Global strategy and action plan on oral health 2023–2030

Action area for strategic objective 4:

oral health care

30. Strategic objective 4 aims to integrate essential oral health care into primary health care and en-

sure related financial protection and essential supplies. This objective seeks to increase access by

the entire population to safe, effective and affordable essential oral health care as part of national

UHC benefits packages. These promote oral health and prevent and treat the most prevalent and/

or severe oral diseases and conditions, including appropriate rehabilitative services and referral.

Health workers who provide oral health services should be active members of the primary health

care team.

31. Financial protection through expanded pre-payment financing arrangements supported by ade-

quate levels of public spending, is one of the cornerstones of UHC. Ensuring the reliable availability,

affordability and distribution of essential medical consumables, generic medicines and other den-

tal supplies is also important for the management of oral diseases and conditions in primary health

care and referral services. It is particularly important to explore ways to make oral health products

more affordable in low- and middle-income settings, where resources are limited and the burden

of oral diseases is increasing.

32. Digital health technologies should be examined for their potential role in delivering of accessible,

effective oral health promotion and essential oral health care. This may include developing pol-

icy, legislation and infrastructure to expand the use of digital health technologies. Digital health

technologies may also improve remote access and consultation for early detection and referral to

services for the management of oral diseases and conditions. The benefits of digital health tech-

nologies need to be balanced against potentially negative effects, including those related to digital

exclusion and the challenges of data protection.

Proposed actions for member states

Action 61.

Establish an essential oral health care package: Coordinate a national stake-

holder-engagement process to review evidence, assess current service capacity

4

GLOBAL TARGETS FOR STRATEGIC OBJECTIVE 4

By 2030, 50% of countries include dental preparations

listed in the WHO Model Lists of Essential Medicines in

their national essential medicines list.

By 2030, 80% of countries have oral health care

services generally available in primary health care

facilities.

Global target 4.1: Integration of oral health in primary care

Global target 4.2: Availability of essential dental medicines

50%

80%

Action area for strategic objective 4: oral health care

29

for oral health care and agree on cost-effective oral health interventions as part

of the national UHC benefits package. Ensure that the package includes emer-

gency care, prevention and treatment of common oral diseases and conditions

and essential rehabilitation. Prioritize the prevention and treatment of dental

caries with minimal intervention. Advocate that national UHC includes safe,

affordable essential oral health care based on the WHO UHC Compendium of

health interventions and oral health-related interventions in Appendix 3 of the

Global Action Plan for the Prevention and Control of NCDs 2013–2030. Using the

available evidence, support introducing remuneration systems that incentivize

prevention over treatment and models of good practice.

Action 62.

Integrate oral health care into primary health care: Develop and review all

aspects of primary health care services and plan to integrate oral health care at

all service levels, including required staffing, skill mix and competencies. Imple-

ment workforce models that produce sufficient numbers of adequately trained

health workers to provide oral health services within primary health care teams

at all levels of care. Establish referral pathways and support mechanisms that

streamline coordination of care with other areas of the health system. Consider

including private oral health providers through appropriate contracting and/or

reimbursement schemes. Explore how to optimize private oral health care pro-

viders’ engagement in such schemes, particularly in countries where they make

up a sizeable proportion of providers.

Action 63.

Work towards integrated oral health services as part of UHC: Expand cover-

age through on-demand care in primary care facilities using an essential oral

health care package. Assess, strengthen and rehabilitate infrastructure for oral

health services to support the quality and scope of needed oral health care. En-

sure that oral health care is of sufficient quality to be effective and safeguards pa-

tient safety. Establish an oral health quality monitoring and management system

for both the private and public sectors, including periodic quality-improvement

measures.

Action 64.

Guarantee financial protection for essential oral health care: Establish ap-

propriate financial protection for patients through expanded payment financing

arrangements supported by adequate levels of public spending, in accordance

with national UHC strategies. Promote and safeguard access of poor, vulnerable

and/or marginalized population groups to essential oral health care packages

without financial hardship. For such groups, consider appropriate co-payment

regulations supported by adequate levels of public spending.

Action 65.

Ensure essential oral health supplies: Prioritize the availability and distribu-

tion of essential oral health care supplies and consumables as part of public

procurement mechanisms for primary health care. Establish or update national

lists of essential medicines that include supplies and medicines required for oral

health services, aligned with the WHO Model Lists of Essential Medicines, which

encompass the medications considered to be effective and safe to meet the most

important needs in a health system.

30

Global strategy and action plan on oral health 2023–2030

Action 66.

Strengthen action against antimicrobial resistance: Promote stewardship and

engagement in initiatives to prevent and control the spread of antimicrobial re-

sistance. Develop guidance on rational antibiotic use for oral health profession-

als. Strengthen standard procedures for infection prevention and control in line

with WHO and other international and national guidance. Include oral health

professionals in initiatives to prevent and control the spread of antimicrobial re-

sistance.

Action 67.

Promote safe, environmentally sound, mercury-free products and minimal

intervention: Advocate for the prevention and treatment of dental caries with

minimal intervention. Restrict the use of dental amalgam to its encapsulated

form. Exclude or do not allow the use of mercury in bulk form by dental practi-

tioners. Exclude or do not allow or recommend against the use of dental amal-

gam for the dental treatment of deciduous teeth, patients under 15 years of age

and pregnant and breastfeeding women, except when considered necessary by

the dental practitioner based on the needs of the patient. Promote the use of

mercury‑free alternatives for dental restoration. Discourage insurance policies

and programmes that favour use of dental amalgam over mercury‑free dental

restoration.

Action 68.

Reinforce best environmental practices: In collaboration with the Ministry of

Environment, ensure that measures are in place to reduce the environmental

impact of oral health services. Minimize carbon emissions and the use and pro-

duction of waste from single-use plastic and nonbiodegradable materials. Use

natural resources, such as water and energy sources, in sustainable ways. Fol-

low best environmental practices in dental facilities to reduce releases of mer-

cury and mercury compounds to water and land. When expanding essential oral

health care services, explore ways to minimize their impact on the environment,

such as through promotion of oral health self-care and preventive lifestyle and

behavioural changes, as well as careful treatment planning and efficient use of

digital technologies.

Action 69.

Optimize digital technologies for oral health care: Support digital access and

consultation for oral disease early detection, management and referral. Monitor

and evaluate the effectiveness and impact of such interventions. Integrate digi-

tal access and consultation into interprofessional platforms to facilitate access

for patients. Draw on the WHO Mobile Technologies for Oral Health implemen-

tation guide to improve oral health literacy, health worker training, early detec-

tion of oral diseases and oral health surveillance within national health systems.

Develop and strengthen data protection and privacy policies to safeguard con-

fidentiality, patient access to personal data and appropriate consent to data

use. Strengthen access and capacity for using digital technologies to ensure that

digital health approaches do not increase inequalities and that services remain

accessible to all, aligned with the WHO–ITU Global Standard for Accessibility of

Telehealth Services.

Action area for strategic objective 4: oral health care

31

Actions for the WHO secretariat

Action 70.

Provide guidance on essential oral health care and cost-effective oral health

interventions: By 2024, recommend interventions as part of the updated Appen-

dix 3 of the Global Action Plan for the Prevention and Control of NCDs 2013–2030

and the WHO UHC Compendium of health interventions. Update interventions

periodically to consider the emergence of new evidence of cost–effectiveness.

Support Member States to develop specific definitions of essential oral health

care for their contexts and implement cost-effective interventions for oral health

as part of other NCD initiatives. Facilitate learning and sharing of best practices

related to UHC and oral health care in primary care.

Action 71.

Advocate for digital oral health: Drawing on the Global Strategy on Digital

Health 2020–2025 and the WHO Mobile Technologies for Oral Health implemen-

tation guide, provide technical guidance and support for digital oral health. En-

courage countries to share lessons learned and best practices related to digital

oral health technology.

Action 72.

Accelerate implementation of the Minamata Convention on Mercury: In col-

laboration with the Secretariat of the Minamata Convention on Mercury and the

United Nations Environment Programme, support countries with implementing

the provisions of the Convention, particularly those related to the phase down

in use of dental amalgam in Environment Facility 7 (GEF-7) project “Accelerate

implementation of dental amalgam provisions and strengthen country capaci-

ties in the environmentally sound management of associated wastes under the

Minamata Convention” and relevant future GEF projects. Develop technical guid-

ance on environmentally sound and less invasive dentistry.

Proposed actions for international partners

Action 73.

Strengthen oral health services as part of UHC: Consider including oral health

services in programmatic and budget planning for UHC. Support the develop-

ment and implementation of a package of essential oral health services, par-

ticularly in low- and middle-income settings. Provide platforms to share les-

sons learned and key success factors to integrate oral health services into UHC

schemes.

Proposed actions for civil society organizations

Action 74.

Mobilize stakeholders for oral health care: Consider establishing multistake-

holder advisory committees for NCDs, including oral diseases and conditions, at

national and local levels of government. Ensure representation of civil society

organizations to strengthen participation and ownership. Encourage new and

support existing civil society organizations to serve as advocates and catalysts to

increase access to essential oral health care and promote its inclusion in UHC.

Action 75.

Help mitigate environmental impacts of oral health care: Advocate for envi-

ronmentally sound practices and sustainable use of natural resources in the con-

32

Global strategy and action plan on oral health 2023–2030

text of oral health services, including accelerating the phase down in use of den-

tal amalgam and minimizing the use of single-use plastic and non-biodegradable

materials.

Proposed actions for the private sector

Action 76.

Invest in digital oral health for all: Amplify research on and development of

digital oral health care devices and technologies that are low-cost and simple to

use, in support of population-based interventions.

Action 77.

Commit to environmentally responsible manufacturing: Develop, produce

and market oral health care products and supplies that are cost-effective, envi-

ronmentally responsible and sustainable. Engage with governments to improve

availability and affordability of such products through bulk purchasing and other

cost-saving approaches to public procurement. Accelerate research on and de-

velopment of new mercury-free, safe and effective dental filling materials.

Action 78.

Establish sustainable public-–private partnerships: Engage manufacturers

and suppliers of oral care products in ethical, transparent and long-term part-

nership agreements with key national actors, in line with public health princi-

ples and the Global Oral Health Action Plan. Prioritize dental caries prevention

and health promotion, thereby minimizing the need for dental restoration. Im-

prove access to essential oral health care and supplies, particularly in low- and

middle-income settings, including supporting governmental initiatives to make

these products more affordable. Encourage insurance policies and programmes

that favour the use of quality alternatives to dental amalgam for dental restora-

tion.

■Proposed actions for member states

■Actions for the WHO secretariat

■Proposed actions for international partners

■Proposed actions for civil society organizations

■Proposed actions for the private sector

Action area for

strategic objective 5:

oral health information systems

34

Global strategy and action plan on oral health 2023–2030

Action area for strategic objective 5:

oral health information systems

33. Strategic objective 5 aims to enhance surveillance and health information systems to provide timely

and relevant feedback on oral health to decision-makers. This objective involves developing more

efficient and effective integrated health information systems that include oral health to inform

planning, management and policy-making. At the national and subnational levels, strengthening

information systems should include the systematic collection of data on oral health status, social

and commercial determinants, risk factors, workforce, oral health services readiness and resource

spending. These efforts should ensure that appropriate measures gather information on the oral

health needs of populations to inform service reforms. Development and implementation of oral

health information systems should be guided and supported by the monitoring framework of the

Global Oral Health Action Plan, as relevant to country context.

34. New oral health research methods, including high-resolution video, multispectral imaging and

mobile technologies, can be explored to improve the quality of population-based oral health data

while reducing costs and complexity. The improved systems should protect patient data, monitor

patterns and trends in oral health inequalities and track the implementation and impact of existing

policies and programmes related to oral health.

Proposed actions for member states

Action 79.

Strengthen oral health information systems: Support the development and

improvement of oral health information and surveillance systems. Depending

on country context, integrate oral health indicators into existing national health

information systems, such as facility-based service reporting. Integrate surveil-

lance of population health by incorporating oral health indicators into national

NCD and UHC monitoring frameworks. Monitor risk factors and the social and

commercial determinants of oral health inequalities. Improve oral health system

and policy data, evaluation of oral health programmes and information on the

oral health workforce in national health workforce accounts. Consider conduct-

ing population-based oral health surveys or other appropriate surveillance spe-

cific to oral diseases, including self-reported data collection and integration with

existing NCD surveillance systems.

Action 80.

Integrate electronic patient records and protect personal health data: En-

courage integration of electronic oral health patient records into medical and

5

GLOBAL TARGETS FOR STRATEGIC OBJECTIVE 5

By 2030, 80% of countries have a monitoring

framework for the national oral health policy, strategy

or action plan.

Global target 5: Monitoring implementation of the national

oral health policy

80%

Action area for strategic objective 5: oral health information systems

35

pharmacological records and sharing data among public and private providers,

to facilitate continuity of people-centred care as well as population-level health

monitoring. Establish data protection and confidentiality regulations that pro-

tect patient-related information while allowing anonymized data analysis and

reporting, in accordance with national context. Ensure that patients have access

to all information recorded and stored about them.

Action 81.

Use innovative methods for oral health data collection: Participate in periodic

global WHO surveys that collect health system, NCD and other health informa-

tion. Develop and standardize innovative methods for collecting and analysing

oral health and epidemiological data using digital technologies. Explore applica-

tions supported by artificial intelligence in mobile devices, opportunities provid-

ed by more complex and larger data sets from new sources, and novel approach-

es to generating comprehensive disease estimates.

Action 82.

Increase transparency and accessibility of oral health information: Make an-

onymized information and appropriately disaggregated data on population oral

health publicly available to inform research, analysis, planning, management,

policy decision-making and advocacy. Consider creating centralized reposito-

ries of data to promote standardization of data and reduce fragmentation across

databases. Ensure alignment of the national oral health monitoring framework

with the monitoring framework of the Global Oral Health Action Plan. Regularly

report national data to WHO as proposed in the framework.

Actions for the WHO secretariat

Action 83.

Track implementation and impact of the Global Oral Health Action Plan:

Gather and analyse country data for the monitoring framework of the Global Oral

Health Action Plan. Share findings as required within broader NCD reporting.

Create an oral health data portal as part of WHO’s data repository for health-re-

lated statistics. Compile health systems information from multiple data sources

to routinely update information on implementation of the Global Oral Health

Action Plan. Adapt and update existing global WHO surveys and tools to enable

tracking of progress implementing the Global Oral Health Action Plan.

Action 84.

Support integration of oral health in national health information systems:

Develop guidance documents for effective strengthening of oral health informa-

tion systems at global, regional, national and subnational levels. Engage with

WHO collaborating centres and international partners, such as the Institute for

Health Metrics and Evaluation’s Global Burden of Disease group, to improve indi-

cators, data collection and inclusion, analysis methodology and interpretation of

oral-health-related estimates. Build the trust of health professionals and the pub-

lic in the capacity and value of integrated oral health monitoring and information

systems.

36

Global strategy and action plan on oral health 2023–2030

Proposed actions for international partners

Action 85.

Support the monitoring framework of the Global Oral Health Action Plan:

Improve capacities of effective oral health information systems, surveillance, re-

search and data analysis by providing appropriate tools and training opportuni-

ties for all stakeholders as part of broader health system strengthening.

Action 86.

Advance oral health metrics: Promote the use of oral health indicators aligned

with global health metrics used to assess the burden of disease, such as preva-

lence and disability-adjusted life years, to strengthen usability of information in

the context of the Sustainable Development Goals and other key global health

agendas.

Proposed actions for civil society organizations

Action 87.

Promote oral health data protection and confidentiality: In accordance with

country regulations, seek protection of patient and provider-related information

while allowing anonymized data analysis and reporting for planning, evaluation

and research.

Proposed actions for the private sector

Action 88.

Provide access to insurance data for research and service planning: Enable

access to private oral health insurance data on coverage, health outcomes and

economic information, in full compliance with national data protection policies.

■Proposed actions for member states

■Actions for the WHO secretariat

■Proposed actions for international partners

■Proposed actions for civil society organizations

■Proposed actions for the private sector

Action area for

strategic objective 6:

ORAL HEALTH research agendas

38

Global strategy and action plan on oral health 2023–2030

Action area for strategic objective 6:

oral health research agendas

35. Strategic objective 6 aims to create and periodically update context- and needs-specific research

that is focused on the public health aspects of oral health. This objective strives to create and im-

plement new oral health research agendas that are oriented towards public health programmes

and population-based interventions. Translation of research findings into practice is equally im-

portant and should include the development of country-specific, evidence-informed clinical prac-

tice guidelines. Researchers play an important role in supporting the development and evaluation

of population oral health policies and evaluating and applying the evidence generated by public

health interventions.

Proposed actions for member states

Action 89.

Reorient the oral health research agenda: Define national oral health research

priorities to focus on public health and population-based interventions, taking

into account the wider NCD, primary health care, UHC and health system context.

Review and establish adequate public funding mechanisms for oral health re-

search aligned with national priorities. Facilitate the dissemination of and align-

ment with the national oral health research agenda among all national research

institutions, academia and other stakeholders. Foster collaboration within and

across countries, including multidisciplinary research, based on the principles of

research ethics and equity in health research partnerships.

Action 90.

Prioritize oral health research of public health interest: Support research

areas of high public health interest in addition to basic health research, such

as research on rare oral diseases. Strengthen implementation and operational

research. Close gaps in evidence and translation of research into practice for:

upstream interventions; evaluation of essential oral health care and integration

into primary health care, including workforce models and learning health sys-

tems; barriers to access to oral health care; oral health inequalities; oral health

promotion in key settings, such as schools; digital technologies and their appli-

cation in oral health; environmentally-sound practices and mercury-free dental

materials for dental restoration; and economic analyses to identify cost-effective

interventions. In countries where oral cancer and oro-facial clefts are prevalent,

support population-based epidemiological studies and statistical modelling

tools to strengthen the evidence for estimating, preventing and controlling these

6

GLOBAL TARGETS FOR STRATEGIC OBJECTIVE 6

By 2030, 50% of countries have a national oral

health research agenda focused on public health and

population-based interventions.

Global target 6: Research in the public interest

50%

Action area for strategic objective 6: oral health research agendas

39

diseases and conditions globally and nationally. Consider research on noma’s

aetiology, prevention, therapy and rehabilitation, to contribute to more effective

care and support the review process for including noma in WHO’s list of neglect-

ed tropical diseases.

Action 91.

Translate oral health research findings into practice: Ensure that dedicated

funding is available for implementation and translation research. Evaluate pop-

ulation oral health policies. Apply evidence generated from innovative public

health approaches, such as digital health technologies. Strengthen evidence-in-

formed decision-making with the full participation of target populations. Devel-

op country-specific, evidence-based clinical practice guidelines.

Actions for the WHO secretariat

Action 92.

Guide Member States in oral health research: Provide Member States with

guidance on research priority setting and partnerships. Promote implementa-

tion research focused on an integrative, life-course and public health approach

to improve oral health, in coordination with the WHO Technical Advisory Group

on NCD-related Research and Innovation.

Action 93.

Contribute to noma research: Set up a platform for knowledge-sharing about

noma. Initiate a research agenda on noma, in collaboration with WHO collabo-

rating centres and academia. Support or conduct research to develop guidance

for noma treatment, including a list of essential therapeutic agents and rehabili-

tation best practices.

Proposed actions for international partners

Action 94.

Promote equity in all aspects of global oral health research: Support shared

agenda setting for global oral health research, programme planning, implemen-

tation and evaluation. Foster equitable partnerships in priority-setting, method-

ological choices, research funding, project management, analysing and report-

ing results and authorship in scientific publication. Ensure equitable access to

data, research results and publications, including reducing or eliminating fees to

access information.

Action 95.

Facilitate reorientation of the oral health research agenda: Support the pri-

oritization of research on public health and population-based oral health inter-

ventions. Promote capacity building and training that meet the needs of new

priorities for oral health research. Strengthen evidence on the prevalence and

incidence of diseases and conditions of public health interest that may be un-

der-researched, such as oro-facial clefts and noma.

Proposed actions for civil society organizations

Action 96.

Consider establishing a national oral health research alliance or task force:

Engage academia, research institutions, professional associations, the govern-

ment, community representatives, patients and other stakeholders in such an

40

Global strategy and action plan on oral health 2023–2030

initiative. Support alignment with and prioritization of the national oral health

research agenda. Advocate for transparent reporting of research findings.

Action 97.

Ensure research alignment with national oral health priorities: For academic

and other relevant civil society organizations, review the research and science

training curricula of academic and research institutions to assess whether they

address public health, implementation research and national priorities. Promote

oral health research priorities in relevant conferences and research forums.

Action 98.

Conduct participatory research to identify oral health needs and interven-

tions: When considering interventions for inclusion in essential oral health care

packages and UHC, enlist the participation of diverse community members, in-

cluding patients, people living with oral diseases and marginalized people. Es-

tablish patient public panels for prioritizing studies, design and management of

research, data collection, analysis, reporting and dissemination of findings. Eval-

uate different approaches to social participation and community engagement to

improve oral health, such as citizen forums.

Proposed actions for the private sector

Action 99.

Develop public–private partnerships for oral health research: Strive to avoid

or reduce real or perceived conflicts of interest and researcher bias in public–pri-

vate research partnerships. Foster the public’s interest in reforming oral health

research agendas. Collaborate with the public sector and other stakeholders in

research on digital oral health technologies. Disseminate essential public health

research and results in open access platforms so that they are accessible to the

public. Ensure low publication fees for low- and middle-income countries.

Action 100. Invest in research for safe, environmentally sound, mercury-free dental fill-

ing materials: Accelerate research and development of new mercury-free, safe

and effective dental filling materials. Strengthen the production and trade of en-

vironmentally friendly and sustainable products and supplies.

Global oral health action plan (2023-2030)

41

Monitoring implementation progress of the global oral health action plan

36. The monitoring framework will track the implementation of the Global Oral Health Action Plan by

monitoring and reporting on progress towards the two overarching global targets and nine global

targets related to the strategic objectives. The monitoring framework has 11 core indicators that

will be used for global monitoring and reporting towards the 11 global targets (Appendix 1). The

monitoring framework also has 29 complementary indicators that, according to their relevance,

usefulness for decision-making and resources available, can be selected and used by countries to

monitor specific actions at the national level (Appendix 2). Together, these 40 indicators can be

used to prioritize efforts, monitor trends and assess progress on oral health within broader NCD

and UHC agendas, based on global, regional, national and subnational contexts.

37. The monitoring framework of the Global Oral Health Action Plan is based on a results chain ap-

proach that visualizes the logical relations from inputs and processes to desired outputs, outcomes

and impact, supported by evidence-informed policies. Its conceptual model draws on the re-

sults-chain framework in the WHO Primary Health Care Measurement Framework and Indicators as

well as the monitoring approach of the WHO’s Thirteenth General Programme of Work 2019–2023

to measure progress made towards programmatic milestones and the triple billion targets.

38. WHO will provide technical guidance to support countries with collecting and reporting data for the

monitoring framework indicators. This guidance will detail the indicator specifications, including

indicator definitions, detailed methods of calculation, disaggregation, data sources, data limita-

tions and links for further information.

39. Annually, WHO will report back to the World Health Assembly on progress and results of the Global

Oral Health Action Plan as part of the consolidated report on NCDs, in accordance with paragraph

3(e) of decision WHA72(11). Every three years (starting in 2024), WHO will submit a comprehensive

report on progress on implementing the Global Oral Health Action Plan, including collation of data

on the core indicators and progress achieved towards the global targets.

Appendix 1

Monitoring framework of the

global oral health action plan

44

Global strategy and action plan on oral health 2023–2030

Appendix 1

Monitoring framework of the global oral health action plan

The monitoring framework of the Global Oral Health Action Plan will track implementation by monitor-

ing and reporting on progress towards the two overarching global targets and nine global targets relat-

ed to the strategic objectives. Tracking progress of oral health services as part of UHC by 2030 supports

mobilization of political and resource commitment for stronger and more coordinated global action on

oral health. A key to understanding how the indicators and strategic objectives align with the monitor-

ing framework can be found in Fig. 1 and in Appendix 2.

Empowered people and communities

Social and commercial determinants of (oral) health

Outcomes and impacts

Health and

wellbeing

(SDG 3)

Evidence-informed policy platform

Improved oral

health status

Reduced oral

health inequalities

Reduced morbidity

and premature

mortality from NCDs

Oral disease prevention

and control within

integrated health services

Process

Outputs

Improved

service coverage

and financial

protection

Optimized

fluoride

delivery

Reduced risk

factors common

to NCDs

Availability

and access to oral

health services

Oral health

promotion and

oral disease

prevention across

the life course

Governance

and finance

Health

workforce

Essential

dental

medicines

Oral health policy

environments

Inputs

Health information systems

Research and knowledge translation

Fig. 1 Monitoring framework of the Global Oral Health Action Plan

The monitoring framework of the Global Oral Health Action Plan outlines how inputs within the oral

health policy environment contribute to the processes and outputs of oral disease prevention and con-

trol in integrated health services, which in turn lead to outcomes and impacts related to health and

well-being. Key inputs of the monitoring framework are government and finance, the health workforce

and essential dental medicines. Key processes are oral health promotion and oral disease prevention

across the life course and availability and access to oral health services. Key outputs are improved ser-

vice coverage and financial protection, optimized fluoride delivery and reduced risk factors common to

NCDs. Key outcomes and impacts are improved oral health status, reduced oral health inequalities and

reduced morbidity and premature mortality from NCDs.

The monitoring framework includes an evidence-informed policy platform that incorporates health

information systems and research and knowledge translation to facilitate evidence-informed deci-

sion-making. This evidence-informed policy platform informs and is informed by the oral health poli-

cy environment, oral disease prevention and control within integrated health services, and health and

well-being outcomes and impacts. The entire framework is grounded in empowered people and com-

munities and the social and commercial determinants of oral health.

Appendix 1

45

Overview of indicators

The global monitoring framework identifies 11 core and 29 complementary indicators to track and

monitor progress of implementation of the Global Oral Health Action Plan. As a priority, data on the

core indicators (Table 1) should be collected in all countries using existing and/or new systems and

resources. In addition, countries may use the complementary indicators (Appendix 2) to monitor other

oral health data at the national level, as relevant to their specific contexts. Where possible, the moni-

toring framework indicators align with existing global, regional and national monitoring activities to

minimize the reporting burden and avoid duplication of work.

During planning and implementation of oral health data collection, effort should be made to collect

sociodemographic data across multiple dimensions (e.g., sex, age, socio-economic status, place of res-

idence). This should allow for data disaggregation during analysis, assessment of oral health inequali-

ties and dissemination of such findings to decision-makers to help them develop more equity-oriented

oral health policies.

46

Global strategy and action plan on oral health 2023–2030

A.1. By 2030, 80% of the global population is

entitled to essential oral health care services.

1.1. By 2030, 80% of countries have an

operational national oral health policy,

strategy or action plan and dedicated staff for

oral health at the Ministry of Health or other

national governmental health agency.

2.1. By 2030, 50% of countries implement

policy measures aiming to reduce free sugars

intake.

1.2. By 2030, 90% of countries have

implemented measures to phase down the

use of dental amalgam as stipulated in the

Minamata Convention on Mercury or have

phased it out.

2.2. By 2030, 50% of countries have national

guidance on optimal fluoride delivery for oral

health of the population.

B.1. By 2030, the combined global prevalence

of the main oral diseases and conditions over

the life course shows a relative reduction of

10%.

Global target definition

Global target definition

Global target definition

Core indicator

Core indicator

Core indicator

Global

target 1.1:

National

leadership for

oral health

Global

target 2.1:

Policies to

reduce free

sugars intake

Global

target 1.2:

Environmentally

sound oral

health care

Global

target 2.2:

Optimal fluoride

for population

oral health

A-B

1

2

OVERARCHING GLOBAL TARGETS

STRATEGIC OBJECTIVE 1:

ORAL HEALTH GOVERNANCE

STRATEGIC OBJECTIVE 2:

ORAL HEALTH PROMOTION AND ORAL DISEASE PREVENTION

B.1. Prevalence of the main oral diseases and

conditions.

A.1. Percentage of population entitled to

essential oral health interventions as part

of the health benefit packages of the largest

government health financing schemes.

1.1. Percentage of countries that have an

operational national oral health policy,

strategy or action plan and dedicated staff for

oral health at the Ministry of Health or other

national governmental health agencies.

2.1. Percentage of countries that implement

policy measures aiming to reduce free sugars

intake.

1.2. Percentage of countries that have

implemented measures to phase down the

use of dental amalgam as stipulated in the

Minamata Convention on Mercury or that

have phased it out.

2.2. Percentage of countries that have national

guidance on optimal fluoride delivery for oral

health of the population.

Overarching

global target A:

Oral health

services are part

of UHC

Overarching

global target B:

Reduced oral

disease burden

Table 1. Overview of Global Oral Health Action Plan strategic objectives, global targets and core indicators

Appendix 1

47

4.1. By 2030, 80% of countries have oral health

care services generally available in primary

health care facilities.

4.2. By 2030, 50% of countries include dental

preparations listed in the WHO Model Lists of

Essential Medicines in their national essential

medicines list.

Global target definition

Core indicator

Global

target 4.1:

Integration of

oral health in

primary care

Global

target 4.2:

Availability of

essential dental

medicines

4

STRATEGIC OBJECTIVE 4:

ORAL HEALTH CARE

4.1. Percentage of countries that have oral

health care services generally available in

primary health care facilities.

4.2. Percentage of countries that include

dental preparations listed in the WHO Model

Lists of Essential Medicines in their national

essential medicines list (or equivalent

guidance).

3.1. By 2030, 50% of countries have an

operational national health workforce policy,

plan or strategy that includes workforce

trained to respond to population oral health

needs.

6.1. By 2030, 50% of countries have a national

oral health research agenda focused on public

health and population-based interventions.

5.1. By 2030, 80% of countries have a

monitoring framework for the national oral

health policy, strategy or action plan.

Global target definition

Global target definit