WHPA – Health professional regulation Geneva

May 19, 2014

By kind invitation of the WHPA, via Brenda Myers, Secretary general of the WCPT, World Confederation for Physical Therapy, I was responsible for delivering the closing summary of the Third World Health Professions Regulation Conference in Geneva, Switzerland, on 17 & 18 May.

My role was to draw together key messages from the presentations and discussion sessions.

partners

The World Health Professions Alliance WHPA brings together the global organizations representing the world’s dentists, nurses, pharmacists, physical therapists and physicians and speaks for more than 26 million health care professionals in more than 130 countries. WHPA works to improve global health and the quality of patient care and facilitates collaboration among the health professions and major stakeholders.

01-whprc2014-programme

 

Closing Summary
I’d been involved for about 15 years in national, regional and international regulation. So the theme for this conference was very attractive to me.

This two-day event has demonstrated a certain consensus that Governance, accountability and responsiveness should be an intrinsic part, or the DNA, permeating all regulation systems. It needs to take into account best public interest, justified and proportional in scope and perceived as legitimate.

A theme throughout the sessions has been a distinction on the one hand, between the national regulatory environment, set up to ensure quality and safety of patient care. And, on the other hand, maintaining these values in the face of new pressure exerted on regulation systems from workforce shortages, regional integration and globalization.

These is an increased focus globally on making sure regulators do not create unreasonable barriers to supply of health services under the guise of “protecting the public”. This is especially the case for systems of recognition of competencies and qualifications of foreign practitioners in their access to markets from bilateral, regional or international agreements.

Although numerous models exist, certain principles need to be observed, notably checks and balances between the different stakeholders and, between patients and professionals, an awareness of rights and duties.

1000px-20140517-conferencia-regulacao-genebra-01

More than 200 delegates from all parts of the world attended the conference.

I think we can make sure that the goals of health professions regulation are patient-centred, involving patient care, patient rights and patient safety, taking into account social and economic welfare and professional practice.
Some of issues that stood out during the presentations and discussions of the first session yesterday were:

  • The need for a consensus among health regulators, who defines what?
  • A regulation model that takes into account interprofessional collaborative practice is likely to be more effective than a model purely “silo” one …
  • The need for sustained political commitment by the two principal actors: decision makers and professionals. This implies a leadership role in regulation for the professions themselves as guarantor of compliance.
  • The need for regulatory bodies to produce more information evidence-based examples to justify measures proposed and to create evaluation mechanisms according scientific criteria. For example, there are no studies about private and public health care services.
  • The need for the regulatory body to understand the day-to-day realities of the health professions they are seeking to regulate. These vary from country to country and, if the regulators are unaware of the reality, how can they regulate? The regulatory framework has to be fit for purpose.

Yesterday, we looked at Universal Health Coverage and its associated requirements in terms of access to affordable and quality health care services, robust workforce, and supply shortages, especially in terms of health care professions’ migrations.

We noted that, in certain areas, such as Europe, economic realities such as the single market take precedence over regulation and that regulation is frequently viewed as a brake on economic development. We also saw that regulations were deemed trade restrictive, even protectionist, in bilateral and international trade negotiations.

With these in mind, the EU provides a successful model with regards to

  • The free movement of workers;
  • A focus not on less regulation, but better regulation;
  • Non-trade-restrictive regulation, with an emphasis on EU wide applicability of European Directives;
  • Meeting the needs of citizens.

The European professional card was highlighted as a unique system at European scale in terms of health professionals’ mobility.

In addition, some concern was expressed about the role of standardization within the health care system as a means to circumvent regulation, with possible negative impacts. This type of standards was deemed well adapted to devices but doubts were expressed about how well they applied to medical or surgical procedures.

On an international level, there was concern that the migration of health professions does not always follow population needs and that there appeared to be no cross border planning or management. The danger was that, to manage shortages, there would inevitably some kind of de-skilling and de-professionalization at national level.

The conclusion was that mobility will not solve most of the problems and there is a danger that some regulations are perceived as obstacles to efficiency and expanded access to care. We need to encourage the concept of safe mobility of health professions and we need to prevent unhealthy competition.

We also looked at the challenges specific to health professions’ regulation in Africa. Regulatory issues raised included public interest versus self-interest and the need for the independence of health regulators.

In addition, there is not only the lack of knowledge about regulatory issues among professionals that would benefit from cross border sharing of information. The weakness of professional associations on the African continent was also highlighted as well as cultural and gender issues.

"Any regulation model needs further adapting, delivering sustainable performance. It is also important to demonstrate the capability to be flexible to adapt and perform well in a variety of market conditions. In that sense it is very important to identify trends at an early stage."

“Any regulation model needs further adapting, delivering sustainable performance. It is also important to demonstrate the capability to be flexible to adapt and perform well in a variety of market conditions. In that sense it is very important to identify trends at an early stage.”

This morning’s session investigated whether non-technical skills, called NTS, recognized within the context of high risk industries such as aviation, nuclear energy and offshore oil production, could be adapted to health sector in the interest of positive outcomes, team work and patient safety.

If skills such as communication, decision making, team coordination, leadership, situation awareness, as well as managing stress and fatigue were recognized, at what stage should they be introduced into the health care profession curriculum: at secondary level, at university level or during later training? And testing or examination method would increase their perceived importance by students and professionals?

We then saw three national models described. The looked at the regulatory structure in Jamaica, and what is was trying to achieve nationally and within the context of the single Caribbean market, CARICOM in terms of recognition, accreditation and common competencies.

The next focus was South Africa, and the concept of developing shared or “core” competencies among health professions, advancing the cause of interprofessional collaborative practice and enhancing health management and leadership. The five competency clusters identified were identified in professional practice, health system, public health, management, leadership and personal interpersonal skills.

We then heard details of the competence the ‘balancing act’ of the competence based approaches for professional regulation from Quebec. Inevitably, governments become more involved in the public interest debate and ask questions, for example, should we move beyond the current diploma-based approach? Are there new ways to demonstrate competence? Is current regulation too precise and comprehensive? And, in general, how to ensure that regulation remains true to its purpose.

This afternoon, we looked at research evidence and some of the overriding issues. We saw that there was no organized framework at transnational level and good information is part of good regulation. Maybe we need to work on an agreed set of definitions and terms for regulation. We need to ask ourselves “which models provide the best performance” and start research to collect evidence to invest in regulation models that deliver results.
You’ve just heard the final panel, so I don’t need to remind you in detail of its content.

A description of 3 years as a new model of health practitioner regulation in Australia. We’ve heard about core functional areas, notifications management and accreditation of education there.

We noticed how regulation has changed in the UK since 1858 to now.

From self regulation to the designated “independent professional Regulation” since 2003… Could this be a revolution ?

No value judgement…

Finally, the Israeli experience, with a Law regulating health professionals since 2008 and its impact on the physiotherapists role function.

A final note:

Any regulation model needs further adapting, delivering sustainable performance. It is also important to demonstrate the capability to be flexible to adapt and perform well in a variety of market conditions. In that sense it is very important to identify trends at an early stage.

We hope you all found this enlightening and, most of all, engaging. We have all been given much to think about in terms of the challenges of health profession regulation and factors we may wish to consider in addressing these challenges.

We all trust that WHPA will maintain and reinforce its role as “think-tank” in terms of health professions regulation on a global level and looking forward to the next WHPA regulation conference.

Ladies and gentlemen, I would like to leave you with the message that regulation whatever the model is a responsibility and a public duty and not an option.

1000px-20140517-conferencia-regulacao-genebra-02-v2

“I would like to leave you with the message that regulation whatever the model is a responsibility and a public duty and not an option.”

The discussions we have had over the last two days have enriched an ongoing process. No-one has the magic answer but we’ll get closer to finding it by getting together and exchanging views and experience.

Thank you to the keynote speakers and panellists for their relevant and constructive presentations. Thanks to WHPA and Brenda Myers for their work in organizing this exceptional event.

And most of all, thank you all for joining us here in Geneva and making the WHPA conference such an outstanding success.

 

Speakers and Session Chairs
David Benton (Switzerland)
Hazel Bradley (South Africa)
Jonh Chave (Belgium)
Niall Dickson (United Kingdom)
Gilles Dussault (Portugal)
Rhona Flin (United Kingdom)
Katrín Fjeldsted (Belgium)
André Gariépy (Canada)
Mukesh Haikerwal (Australia)
Orlando Monteiro da Silva (Portugal)
Margaret Mungherera (Uganda)
Ayala Parag (Israel)
Annabel Seebohm (Belgium)
Marlene Smadu (Canada)
Una Reid (Jamaica)
Chris Robertson (Australia)


World Healthcare Students University of Lausanne – Switzerland

September 20, 2013

As past-president of the FDI, I attended the 5th World Healthcare Students’ Symposium, 8-13th September.

WHSS is the biggest international event for healthcare students. It involves about 300 students of medicine, dental medicine, pharmacy, nursing, chiropractic and other healthcare professions spending five days together in a world wide student congress, which is held every two years.

whss-01

This 5th symposium helped students identify the future challenges of the healthcare system in order to promote a better interprofessional collaboration. The program included many workshops and lectures on interprofessional studies, the role of different professions, perspectives and strategies, the evolution and outcomes of the healthcare system and its actors, global health and primary care.

whss-02

Adressing the audience on the topic Interprofessional Collaboration Practice.The role of Dentists and Oral Health…

The symposium was be conducted by many prestigious speakers and representatives of international organizations such as the World Heath Organization (WHO), the World Heath Professions Alliance (WHPA), the World Medical Association (WMA), International Pharmaceutical Federation (FIP) and the World Dental Federation (FDI), Doctors without Borders (DWBand) and several professionals and experts from Australia, Belgium, Czech Republic and Switzerland.

whss-03

The WHSS is the largest international and interprofessional healthcare student congress. This year’s 5th edition focus on «Demystifying interprofessional collaboration». An audience of about 300 very interested students from different health areas (including dental medicine) from all around the world…

whss-05

Thank you to the organisers:
– ASEP: Swiss pharmacy students association
– SWIMSA: Swiss medical students association
– ASSIDE University applied sciences (health) students association from the canton of Vaud. (Nursing, Physio, ergotherapy…)
– ADES: Students association of HEdS La source – Lausanne (Nursing)
– AEML: Medical students association of Lausanne.

The WHSS committee benefited from the help of the Federal Office of Public Health (FOPH), many professional associations such as the Swiss Medical Association (FMH), PharmaSuisse and important institutions such as The University Hospital of Lausanne (CHUV), the Faculty of Biology and Medicine of UNIL, the Geneva-Lausanne School of Pharmacy (EPGL), the University of Applied Sciences and Arts – Western Switzerland (HES-SO) and the Lausanne Medical University Polyclinic (PMU).

For me, it was a unique experience!


Vision 2020 “phase 2” – meeting in Geneva

June 22, 2013

Within its commitment of “Leading the World to Optimal Oral Health”, FDI’s Vision 2020 has set objectives for the dental profession. In order to achieve these objectives and transform this Vision into concrete actions, the FDI Council has established two priorities for 2013-2014: 1) to organize a systematic and updatable collection of oral health data at the international level (oral health indicators meeting), and 2) to identify successful models of collaborative practice in oral health (collaborative practice meeting).

From Left to right: David Williams, Michael Glick, Jean-Luc Eiselé and me.

From left to right: David Williams, FDI Vision 2020 Task Team Member; Michael Glick, FDI Vision 2020 Task Team Chairman; Jean-Luc Eiselé, FDI Executive Director; and me.

Group photo of the Oral Health Indicators Meeting Provisional Agenda.

Group photo of the Oral Health Indicators Meeting Provisional Agenda. From Left to right: David Williams, FDI Vision 2020 Task Team Member; Jean-Luc Eiselé, FDI Executive Director; Rosalyn Davies, ABM ULHB – Community Dental Service; Orlando Monteiro da Silva, FDI President; Lisa Howells, Senior Dental Officer – Welsh Government and Public Health Wales; Alexander Tolmeijer, from Dutch Dental Association; Daniel M. Meyer, ADA Senior Vice President – Science and Professional Affairs; Nermin Yamalik, FDI Councilor; Michael Glick, FDI Vision 2020 Task Team Chairman; Erica Lynette Wheeler, Technical Officer Human Resources for Health Department of Health Systems Policies and Workforce WHO; Prathip Phantumvanit, FDI Public Health Committee Vice Chairman; Carlos Madrid, University Hospital Lausanne Service de stomatologie et médecine dentaire; Corrie Jongbloed- Zoet, Dutch Dental Hygienists Association; John S. Greenspan, Associate Dean, Global Oral Health University of California San Francisco .

Group photo of the Collaborative Practice Meeting Provisional Agenda.

Group photo of the Collaborative Practice Meeting Provisional Agenda. From Left to right: Jean-Luc Eiselé, FDI Executive Director; Poul Erik Petersen, WHO Chief, Oral Health Programme; Sylvia Casagranda, Ivoclar Vivadent AG Head of Marketing Research & Controlling; Habib Benzian, International Public Health Professional – Health Bureau; Orlando Monteiro da Silva, FDI President; Kevin Hardwick, FDI Public Health Committee Member; Prathip Phantumvanit, FDI Public Health Committee Vice Chairman; Michael Glick, FDI Vision 2020 Task Team Chairman; Daniel M. Meyer, ADA Senior Vice President – Science and Professional Affairs; Christopher Fox, IADR Executive Director; Charlotte Ndiaye Faty, WHO Representative to Cameroon; Juan Carlos Llodra Calvo, FDI Public Health Committee Chairman and Oral Health Indicators Project Leader; Denis Bourgeois, Dean of Odontology Faculty-Claude Bernard University Lyon 1, France and FDI Oral Health Indicators Project Leader; Virginie Horn, FDI Education and Development Manager; David Williams, FDI Vision 2020 Task Team Member.

We did not expect the three day Geneva FDI Vision 2020 Implementation Workshop to provide immediate solutions to these challenges. However, with those distinguished international team on hand to debate the issues, it set us in the right direction and constitutes the next step in this initiative. See more at: www.fdiworldental.org/home.aspx#president.


FDI and Sunstar in Etoy, Geneva

December 10, 2012

During my last stay in FDI Geneva, I had the pleasure to visit Sunstar head office in Etoy, Switzerland.

Sunstar is a leading global company in the Mouth & Body Care field,eg GUM, Butler and Ora2.

We had the opportunity to share FDI’s projects, namely Vision 2020 and take notice of Sunstar global approach and Sunstar Foundation.

Curious, the designation of the company started from the concept of brushing teeth twice daily, in the morning, Sun and in the evening, Star…

Thanks to Mayumi, Mayur and Shigeki for a wonderful reception to the FDI!

From left to right, Jean Luc Eiselé, FDI executive director, Mayumi Kaneda, diretor of Sunstar Foundation and Global Public Relations, me, Emmanuel Chevron, Associate Director, Business Development & Corporate Relations of the FDI, and Mayur V. Dixit, Global Professional Relations and Scientific Affairs.From left to right, Jean Luc Eiselé, FDI executive director, Mayumi Kaneda, diretor of Sunstar Foundation and Global Public Relations, me, Emmanuel Chevron, Associate Director, Business Development & Corporate Relations of the FDI, and Mayur V. Dixit, Global Professional Relations and Scientific Affairs.

From left to right, Jean Luc Eiselé, FDI executive director, Mayumi Kaneda, diretor of Sunstar Foundation and Global Public Relations, me, Emmanuel Chevron, Associate Director, Business Development & Corporate Relations of the FDI, and Mayur V. Dixit, Global Professional Relations and Scientific Affairs.From left to right, Jean Luc Eiselé, FDI executive director, Mayumi Kaneda, diretor of Sunstar Foundation and Global Public Relations, me, Emmanuel Chevron, Associate Director, Business Development & Corporate Relations of the FDI, and Mayur V. Dixit, Global Professional Relations and Scientific Affairs.

With Mayumi Kaneda.

With Mayumi Kaneda.


A personal message from the FDI President

December 29, 2011

Dear colleagues and members of FDI,

It is now three months since our meeting in Mexico and the occasion when I took over the FDI presidency. During the intervening period, I have, along with members of the Council and Executive Committee as well as the Executive Director, put my best efforts into ensuring FDI is perceived as a reliable, trustworthy and venerable institution by our members, stakeholders and corporate partners.

I have had the good fortune to visit a number of countries as the federation’s representative, among them India, Uruguay, Brazil, Argentina and the United States (Las Vegas and New York), an also a few FDI institutional high level stakeholders, such as WHO and IFPMA. Everywhere, I was impressed by the tremendous prestige that FDI enjoys, the goodwill it inspires and the high honour in which it is held.

I also had opportunity to share our vision with ministers, officials and the leadership and members of our national dental associations; and heighten their awareness of the latest international trends and best practice with regard to access to oral health, which today increasingly involves all medical professions within a context of holistic care.

It is heartening to see that, in the field of dental medicine, FDI is able to maintain its high profile among government officials, external stakeholders, corporations, foundations and other NGO’s. It is this high profile that contributes to the federation’s added value during this period of global economic crisis.

As an institution with worldwide outreach, FDI is in a unique position to make things happen. Its initial impact may appear slight but, just like a stone falling on the surface of a lake, the long-term effect of FDI actions ripple out to all parts of the globe

Whether in the field of Noncommunicable Diseases, the Global Caries Initiative, international policy on amalgam/mercury within UNEP, Continuing Education, the Annual Congress and Vision 2020, a recent project mapping oral health for the next nine years, we can be sure that FDI will, with the support of its members and partners, continue to have an impact and continue to make a difference.

With FDI staff

With FDI staff

Next year, 2012, will be crucial, not only because we will be holding our 100th Annual World Dental Congress in Hong Kong, SAR China, but also because we will be taking major steps towards achieving our aims within the context of the overarching FDI vision of ‘Leading the World to Optimal Oral Health’.

During this special festive season, let me, on behalf of the Council, Committees and Staff, take this opportunity to wish you good luck and happiness and reiterate our firm commitment to fulfilling the high expectations of our members, our partners and, most of all, people around the world for whom we are determined to make FDI’s vision of “optimal oral health” a reality.

Orlando Monteiro da Silva

FDI President


FDI at the Pharmaceutical Manufacturers (IFPMA) reception

December 15, 2011

The next stage, which IFPMA has agreed to support, is to test and assess the NCD Toolkit in the field, that is, to answer the question: can health practitioners around the world use it in their daily work to educate patients on the risks of behaviours and to assess their current exposure to NCDs. 

My speech at the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA) reception, held in Geneva last 1st December:

Thank you for your kind invitation: it is indeed a great pleasure to be here today to address and touch base with IFPMA, one of FDI’s most valued partners and friends.

Last time I spoke to you was on 7 July, at the very well attended IFPMA reception during ECOSOC at the United Nations. That, of course, was also an early stage of what turned out to be a highly successful and visible campaign on noncommunicable diseases.

From left, Eduardo Pisani, IFPMA director general, and David Brennan, IFPMA president and CEO of AstraZeneca.

From left, Eduardo Pisani, IFPMA director general, and David Brennan, IFPMA president and CEO of AstraZeneca.

It was particularly important for FDI to lead the NCD campaign: it meant we could help our partners in the World Health Professions Alliance in their efforts to accomplish goals in the field of public health.

For FDI, it meant that we could achieve a long-standing need—and personal goal of mine—to better integrate dental medicine into the general practice of medicine. This is particularly important in NCDs where dentists will be called upon to play a key role identifying tell-tale signs of high risk behaviour, such as tobacco use, as well as early signs of chronic illness.

In effect, practitioners in oral health are one of the few medical professions that patients visit routinely for a check-up and whose work involves visual inspection of the mouth and gums

In addition, as IFPMA and its members well know, saliva testing is becoming increasingly used as a means of disease diagnosis and monitoring, due to its convenience, accuracy and non-invasive nature – and, once again, dental practitioners are in privileged position.

Just to recapitulate, the campaign itself involved two major processes: the first was educational and included the development of a health improvement scorecard and scorecard user manuals targeting health professionals, on the one hand, and patients and public, on the other.

I think we all agree that the resulting product was pleasing to the eye, conveniently packaged, and well-conceived in terms of content and usability.

We will know the answers to those questions during the next few months of field testing.

The other part of the campaign was to launch the toolkit prior to and during the United Nations Summit on NCDs in New York. We did the launch in three places and in my presence, although my presence at the Geneva event was via a recorded message!

Both I and former FDI President addressed some 40 participants at a media launch in Mexico City. The location was aptly chosen because WHO had already held a high-level regional consultation of the Americas on NCDs in February of this year, which meant the media were already sensitized to the issue.

Finally, the toolkit was presented at number of side events held during the UN Summit itself, including the event ‘Putting the teeth into NCDs’ sponsored by the Republic of Tanzania, Australia and Sweden – and, of course, the IFPMA reception, held at the United Kingdom Mission to the UN in New York.

Further, I was able to introduce WHPA and the Toolkit as a prime example of inter-professional collaboration on NCDs during two of the parallel sessions at the World Conference on Social Determinants of Health last October in Rio.

One of the sessions was moderated by Jorge Venegas, Ministry of Health of Uruguay; the other, in the presence of Dr. José Luiz Amaral, President-Elect of the World Medical Association, was entitled ‘the Changing the role of public health’.

These have been exciting times and, from the point of view of FDI, an excellent opportunity to promote our product and consolidate our working relationship with IFPMA.

For our part, we very much look forward to the field testing, to be carried out jointly with our WHPA partners – and of course, to our continued excellent relations with our friends at IFPMA.

Thank you for your attention!


WHPA: Non Communicable Diseases

July 11, 2011
With Eduardo Pisani, Director General of IFPMA, International Federation of Pharmaceutical Manufacturers & Associations

Me with Eduardo Pisani, Director General of IFPMA (International Federation of Pharmaceutical Manufacturers & Associations)

By invitation of the IFPMA – International Federation of Pharmaceutical manufacturers and Associations, I had the pleasure of participating as speaker representing the World Health Professional Alliance (WHPA) at the United Nations – Economic and Social Council, ECOSOC “Innovation Fair”, on 7 July in Geneva. The Fair run parallel to the ECOSOC High-level Segment.

ifpma-logoThe theme was Education for Non Communicable Diseases. I’m sharing a part of my communication, provided by FDI – World Dental Federation Head office Geneva, to a selected audience, acknowledging in particular Eduardo Pisani, moderator and Director General of IFPMA.

FDI President-Elect – brief address to ECOSOC – 7 July 2011

Your excellencies
Ladies and gentlemen

Thank you for inviting me to say a few words on behalf of the World Health Professions Alliance, representing the views of more than 26 million health professionals. These professionals play a significant role in reducing the global NCD burden through health promotion, disease prevention, patient care and rehabilitation.

One theme of this ECOSOC event is ‘Education for All’: we might equally say ‘health for all’. Health education or health literacy, as we call it, is so tightly related to education: whether it’s basic literacy, to read instructions on medications, or the ability to understand and use the information provided by the medical professional.

Health education will play an extremely important role as policy makers and professionals try to grapple with one of today’s major challenges: the global epidemic of noncommunicable diseases, or NCDs, as they are known. What we need is education, education for the professional, to communicate better, listen better, and education for the patient: how to interpret the advice of the health professional.

WHPA is currently involved in a project to develop and deliver some educational and communication tools to convey important messages to members of the general public on the subject.

Although social and environment factors play an important role in NCDs, our own behaviour can have a significant. The educational messages WHPA is developing are based on prevention: don’t smoke, or if you do, give up; limit your consumption of alcohol, eat healthy food, exercise and check your health from time to time with a health professional for danger signal.

These are easy messages, you may think, yet messages that encounter resistance not just from individuals but from the industries that promote and encourage, for example, smoking or unhealthy food. The important point we want to convey is personal responsibility for health through the choices we make and through our own behaviour. This will be a crucial factor in the fight against NCDs.

The other part of the WHPA campaign is to ensure that our views on preventing and managing noncommunicable diseases are heard by the major international institutions and reflected in the various declarations from international gatherings convened to discuss NCDs.

Our next target is the UN Summit convened in New York on 19 September. We have already provided input and we very much hope that our views translate into specific terminology that addresses our concerns in the Summit Declaration. What we recommended was:

  • Adopting an holistic approach based on common risk factors;
  • That due attention be paid to the social determinants of health;
  • To widen the scope of NCDs and associated recommendations to include oral health and mental health
  • Investment in the development and education of the healthcare workforce.

We also believe very much in the need to strengthen health care systems through a holistic health care system, with a focus on primary health care and strong link to prevention, specialized treatment and rehabilitation

I would like to close my remarks by quoting a colleague of mine who highlighted education in school as an effective vehicle to address noncommunicable diseases. Education on health in school reaches children at an age when they are still receptive about behaviour change and to acquire lifelong skills to enable them to lead healthy lives.

As a dentist, I would like also the role of oral health in the context of NCDs: the most common disease worldwide is tooth decay. It has large impact on societies, on children, on each an every one of us. Oral health also has significant co-factors with the other major NCDs. So, in educational programmes dedicated to the control and prevention of NCDs, let’s make sure we include oral diseases.