'Never underestimate the power of a bold golden frame' is a famous quote from the contemporary artist Banksy. Tongue-in-cheek, he alluded to one of his simple cartoon-like artworks that uses such a surround. A similar principle applies in communication and advocacy. The messaging context, the messenger and the message framing - all have the power to significantly impact the message's perceived value, relevance, and power.1
This could be witnessed in the context of the WHO's first ever Global Oral Health Status Report, published in November 2022.2 The key messages of the presented data and information are robust and bold: 'The report's clear conclusion is that the status of global oral health is alarming and requires urgent action by all stakeholders on global, regional, national and local levels'. Frequently reported by global media, the publication has already reached one of its key objectives - the raising of awareness.
For years, experts and advocates have highlighted the troubling burden of oral illness globally. From publications to calls to action and advocacy events, the list of activities aimed at ending oral health neglect is long; even if their impact may be limited due to lack of follow-up or accountability. Nevertheless, these efforts have undoubtedly fuelled our understanding that it is 'time for radical action', as declared in The Lancet's first papers discussing global oral health in 2019.3
Most of the information in the report is not new: 3.5 billion people affected by oral disease, two-thirds living in low- and middle-income countries, massive inequalities across all countries of disease burden and access to prevention and care, and more than a billion additional cases over the last 30 years. Yet, by collating vast amounts of information from diverse sources and presenting the analysis in a concise way, the report is a unique resource for decision makers and civil society. Country profiles with key oral health indicators complement the report and will serve as a baseline to assess future progress.
Seeing oral health take the centre stage was a watershed moment.
It is undeniable that when the WHO speaks, it has more authority and influence than other voices, and the world listens in a different way. This communicative power unlocks new opportunities, captures the attention of new audiences and gives a much-needed boost to the cause of oral health. Acknowledging this, the WHO organised a public launch for the report in Geneva, Switzerland which was attended by oral health leaders and over 600 others from around the world. Seeing oral health take the centre stage was a watershed moment. WHO's Director-General, Dr Tedros Ghebreyesus, opened the event by noting that 'oral health has long been neglected in the global health agenda.' He called for action on the major challenge of providing access to essential prevention and oral healthcare for all, at affordable cost or even free of charge. This will require health systems with an appropriately trained workforce and capacities to provide essential oral health services.
Similarly, the Assistant Director-General, Dr Ren Mingui, pleaded that 'the report's findings should be seen as a wake-up call for us to collectively take strong action on the oral disease burden and more boldly address the glaring and persisting inequalities in oral health care … We must act now without further delay!' Sir Richard Horton, editor-in-chief of The Lancet, closed the event by confirming that 'oral health is an indispensable part of health and global health', and admitting that 'this simple message has been largely ignored and is still being ignored by mainstream public and global health'. He called for oral health 'to be an integral part of our collective vision of universal health coverage and primary health care […] Oral health has for far too long been seen as a luxury commodity only for a few, not as a central element in the idea of health as a human right. That has to change'.
In May 2022, the WHO adopted a Global Strategy on Oral Health, which will soon be complemented by an equally ambitious Global Oral Health Action Plan and a monitoring framework with global targets to measure country progress.4,5 The report shows the dire state of oral health in a 'golden frame'. It is up to the oral health, public health and wider health policy communities, organisations, civil society, the corporate sector and all stakeholders to use this powerful framework and to bring about meaningful change.
Wright S, Neimand A, Steinman M. Finding the right messenger for your message. 2021. Available at: https://bit.ly/finding_the_right_messenger (accessed January 2023).
WHO. Global Oral Health Status Report - Towards Universal Health Coverage for Oral Health 2030. 2022. Available at: https://www.who.int/team/noncommunicable-diseases/global-status-report-on-oral-health-2022 (accessed January 2023).
Watt R G, Daly B, Allison P et al. Ending the neglect of global oral health - time for radical action. Lancet 2019; 394: 261-272.
WHO. Global Strategy on Oral Health. 2022. Available at: https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_10Add1-en.pdf (accessed January 2023).
WHO. Draft Global Oral Health Action Plan 2023 -2030. 2023. Available at https://www.who.int/publications/m/item/draft-global-oral-health-action-plan-(2023-2030) (accessed January 2023).
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Benzian, H. Oral health in a bold golden frame. Br Dent J 234, 71 (2023). https://doi.org/10.1038/s41415-023-5467-8
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