Global Health Centre

Today, for the first time in history, most people can expect to live into their 60s and beyond ( United Nations Department of Economic and Social Affairs [UNDESA], 2007 ). And those who reach 60 years of age can expect to live longer than ever before. When combined with marked falls in fertility rates, these increases in life expectancy are leading to the rapid ageing of populations around the world. These changes are dramatic, and they have profound implications for each of us as individuals, as well as for society more broadly. Longer lives present many opportunities, and the article by Fried (2016) in this supplement makes a strong case that appropriate social investment can create a “third demographic dividend” for society. Yet, the extent of the opportunities that arise from increased longevity will depend heavily on one key factor: health. If people are experiencing these extra years of life with good physical and mental capacity, and if they live in enabling environments, their ability to do the things they value may have few limits. If these added years are instead dominated by declines in capacity and disabling environments, the implications for older people and for society are much more negative. Staudinger, Finkelstein, Calvo, and Sivaramakrishnan (2016) take up this issue and look specifically at the effects of work on health in later life. Unfortunately, there is only limited information to suggest that older people today are experiencing these extra years in better health than previous generations ( Chatterji, Byles, Cutler, Seeman, & Verdes, 2015 ). Moreover, in many places, neither the policies nor the infrastructure is in place to ensure that the opportunities that arise from population aging can be realized. Public health action on ageing is therefore urgently needed. Yet debate on what this might comprise has been remarkably limited ( Lloyd-Sherlock et al., 2012 ) To progress action in this area, the World Health Organization (WHO) recently released the first World report on ageing and health ( WHO, 2015 ). Nearly 200 people contributed directly to the report, including authors of a series of background articles, many of which have been refined for academic publication in this supplement. Given the great diversity of issues that are relevant to ageing and health, it is not surprising that the scope of these articles is broad. The report outlines a public health framework for action on Healthy Ageing that is built around the concept of functional ability. This is defined by the report as “the health related attributes that enable people to be and to do what they have reason to value”. The report emphasizes that this ability is determined by both the intrinsic capacity of the individual and the influence of the environments they inhabit. This builds on capabilities-based approaches used in other fields ( Anand, 2005 ). The report approaches the changes associated with ageing in the context of the entire life course, yet focuses on the second half of life. It describes some of the important underlying physiologic changes that can occur with age (for example, those outlined in the article by Blume-Peytavi et al. (2016) on skin) but also considers the disorders that become more frequent in older age and that can impact on functioning. These are largely chronic conditions, particularly noncommunicable diseases, hearing loss, and musculoskeletal disorders as discussed by Davis and colleagues (2016) and Briggs and colleagues (2016) , respectively. Many of these can be prevented or delayed by engaging in healthy behaviors across the life course, and the benefits of these behaviors continue into later life ( Hrobonova, Breeze, & Fletcher, 2011 ). The article by Bauman, Merom, Bull, Buchner, and Singh (2016) highlights the importance of these ongoing influences, making a robust case for promoting physical activity among older adults. However, Bauman and colleagues also show how ageing influences the relationship of these behaviors to health and the importance of considering this when developing interventions to foster capacity and ability. Their article highlights how, for physical activity, this may lead to a shift in focus that gives priority to interventions that can help the retention of muscle mass and balance. Subtle shifts in messaging across the life course may also be required if these interventions are to succeed ( Notthoff & Carstensen, 2014 ). Yet, even with effective health promotion strategies, many older people will still experience chronic disease and most likely more than one of them at the same time. Integrated person-centered care can ensure these are effectively managed, particularly if they are detected early enough. And even for people where these result in significant declines in capacity, access to medical and assistive technologies (see article by Garçon et al. (2016) ) and supportive environments can ensure that they can continue to live lives of dignity and continued personal growth. These responses would fulfill the right to health and other related rights and fundamental freedoms of older people that are enshrined in international law, an issue expanded on by Baer, Bhushan, Abou Taleb, Vasquez, and Thomas (2016) . Yet, globally, breaching of these rights is almost the norm, as highlighted by the high prevalence of elder abuse. The article by Pillemer, Burnes, Riffin, and Lachs (2016) considers this issue—a problem that has devastating individual consequences and societal costs for which we are yet to identify evidence-based interventions that work. But few places in the world offer the policies and infrastructure necessary to ensure older people can experience a long and healthy life. One challenge for decision makers is that when it comes to health, every older person is different. The report highlights how physical and mental capacity are only poorly associated with chronological age. Even in low- and middle-income countries, some 80-year-olds have physical and mental capacities similar to many 20-year-olds, whereas others experience significant declines in physical and mental capacities at much younger ages. Furthermore, this diversity of health state in older age is not random. As the article from Foebel and Pedersen (2016) states, genetic inheritance plays some role. But most of the variation is likely to result from personal factors such as our sex, ethnicity, and occupation, as well as the physical and social environments in which we live our lives. Together these influence opportunities and health behavior, and these impacts start from childhood and continue across life( Commission on Social Determinants of Health, 2008 ; Dannefer, 2003 ). The article by Sadana, Blas, Budhwani, Koller, and Paraje (2016) elaborates in detail the causes of health inequities across contexts and policy and research options for stimulating change. Together the articles in this supplement highlight the complexity in the health and functional states experienced by older adults. They help raise fundamental questions such as what do we mean by health in older age, how do we measure it, and how might we foster it. The reconceptualization of Healthy Ageing provided by the report draws on many years of gerontological and geriatric research and debate to start to answer these challenging queries. In building this public health framework for action, WHO looked to challenge many pervasive misconceptions. In particular, the report seeks to emphasize that action is urgent; to acknowledge the great diversity of health and experience in older age and the need for policy responses to reflect this rather than being built on ageist stereotypes of a “typical” older person; to shift conceptualizations of health in older age from a focus on the absence of disease in an individual to a focus on functioning and an acceptance that both the individual and their environments have a role in determining this; to frame Healthy Ageing as a process that takes place across the life course rather than as a state at a particular point in time, and that both policy makers and researchers should be interested in how we maintain optimum trajectories of functional ability and capacity across life and older age. to understand the cumulative impact of environmental determinants across life and to shape policy that looks to address disadvantage rather than reinforcing it. The policy priorities it proposes are relevant for all older people, regardless of where they sit on their personal trajectory of Healthy Ageing . They emphasize the need to build supportive and enabling environments. These can help people build and maintain capacity (for example, a walkable environment may foster physical activity). But they can also provide a range of resources or barriers that determine whether people with a given level of capacity can do the things they feel are important. Thus, although older people may have limited capacity, they may still be able to get where they want and need to go if they have access to an assistive device (such as a walking stick, wheelchair, or scooter) and live close to affordable and accessible transport. This will require a coordinated response from many sectors and multiple levels of government to create age-friendly environments (housing, employment, transport, and social protection) to facilitate the ability of older people to age in a place that is best for them and to do what they value. The report also recommends a better alignment of health systems to the older populations they increasingly serve. This requires a greater integration of services and shifts from disease-based reactive services to models of health care that prioritize the functioning of the older person as a whole, take account of the physiological trends and health conditions that may influence it, and consider the individual’s circumstances and ambitions. And this integration of services must extend to the support and care needed by those older people with significant loss of capacity. Crucially, the report is very clear that “In the 21st Century, no country can afford not to have an integrated system of long term care.” Population and social trends mean it is no longer feasible, sustainable, or equitable for governments to leave this to families alone. This does not mean that this role should instead fall solely to governments, but if families are to provide adequate care and not be unreasonably burdened, at a minimum they need information that can allow them to fill this role, and have access to support such as respite care. Governments also need to put in place mechanisms to ensure the quality of the care that might be contracted by private care givers or in institutions. Positive responses from WHO’s “Member States” to the Report suggest that this new emphasis on the need to build systems of long-term care, even in the poorest countries, may result in much greater global attention to this neglected issue. Finally, the report emphasizes the extensive knowledge gaps that form a major barrier to evidence-based policy development. There is little global consensus on even widely used terms in the field, and although longitudinal research and population surveys are increasingly common, the instruments they use are often not comparable and may not provide the information needed by decision makers. Most of the treatments offered to older people are derived from clinical research that excludes them and that fails to take account of the influence of the comorbidities most of them will have. These recommendations will not be surprising to gerontologists and geriatricians. However, to date, policy related to older age in many countries has often prioritized cost containment over the investment needed to enable the human and social resource that is inherent in older populations. Moreover, policy can appear disjointed, reflecting a political polarization that portrays older people as either vulnerable and needing support, or robust and needing to contribute. Although each characterization may have legitimacy, they are simply the ends of a continuum of diversity, and broader policy responses are needed to encompass this heterogeneity in a coherent way. We hope that the World Report and the articles in this special issue help progress work to achieve this. Certainly, the framework for action outlined in the report is designed to speak to all people at all stages in life and to look to how society can help them experience more positive Healthy Ageing trajectories. Moreover, rather than tell them what they should do, it looks to build their abilities to navigate the challenges and seize the opportunities of later life. As the report says, enabling these abilities is likely to be a sound investment in a future where older people have the freedom to live lives that previous generations might never have imagined. The World report on ageing and health can be found at http://apps.who.int/iris/bitstream/10665/186463/1/978 9240694811_eng.pdf?ua=1 . To navigate the report—which features content from the articles in this supplement— Chapters 1 and 2 cover all the main ideas. The analysis of context and rationale for action in Chapter 1 is followed by the development and explanation of a Public Health Framework for Action in Chapter 2. Chapter 3 provides a comprehensive, stand-alone update of current knowledge on health in older age. It includes a review of demographic and epidemiological change; the characteristics of health in older age, including underlying changes as well as the health conditions of older people; changes in intrinsic capacity and functional ability; behaviors that influence Healthy Ageing ; and key environmental risks. Chapters 4, 5, and 6 can be read together. They take the Public Health Framework for Action (Chapter 2) as their starting point and examine in detail the implications for health care systems, long-term care, and age-friendly environments, respectively. Chapter 7—Next steps—sets out a menu of options for action applicable to countries at all levels of development. It is organized in four sections: aligning health systems to the needs of the older populations they now serve; developing long-term care systems; creating age-friendly environments; and measuring monitoring and understanding.

___Key messages___ The Commission recommends five priority investments to achieve a tuberculosis-free world within a generation. These investments are designed to fulfil the mandate of the UN High Level Meeting on tuberculosis. In addition, they answer the question of how countries with high-burden tuberculosis and their development partners should target their future investments to ensure that ending tuberculosis is achievable. __Invest first to ensure that high quality rapid diagnostics and treatment are provided to all individuals receiving care for tuberculosis, wherever they seek care__ This priority includes rapid drug susceptibility testing and second-line treatment for resistant forms of tuberculosis. Achieving universal, high-quality person-centred and family-centred care—including sustained improvement in the performance of private sector providers—usually should be the top policy and budget priority. __Reach people and populations at high risk for tuberculosis (such as household and other close contacts of people with tuberculosis, and people with HIV) and bring them into care__ Active case-finding and treatment in high-risk populations demands adequate resources to reach and care for these populations. At the same time, reaching certain high-risk populations, such as people co-infected with tuberculosis and HIV, for tuberculosis preventive therapy is essential to achieve epidemiologic control. Once high-risk populations have access to affordable, high-quality diagnostic, treatment and preventive services, invest in identifying tuberculosis cases in the general population, primarily by strengthening the capacity to deliver health services and move toward universal health coverage. __Increase investment to accelerate tuberculosis research and development and bring new diagnostics, therapeutic strategies, and vaccines to clinical practice to quickly end the pandemic__ Strong advocacy with science ministries and research-oriented pharmaceutical companies is crucial, including ministries and companies in middle-income countries, to highlight the importance of investing in new tools. Financing the early uptake of new products will provide important confidence signals to product developers. __Make investment in tuberculosis programmes a shared responsibility, increasing development assistance for tuberculosis according to the financial needs of individual low-income and middle-income countries__ As countries successfully mobilise more domestic resources towards tuberculosis programmes, external assistance to middle-income countries should address the following priorities: reduce the spread of drug-resistant tuberculosis in all affected low-income and middle-income countries; facilitate market-shaping activities to enable access to high quality drugs and diagnostics for high-burden countries; and finance tuberculosis research and development, including product development as well as population, policy, and implementation research that will provide lessons and international sharing of best practices. __Hold countries and key stakeholders accountable for progress made towards ending tuberculosis__ Accountability entails establishing independent, multisectoral processes, such as national tuberculosis report cards, to ensure that all stakeholders carry out their responsibilities to contribute to ending the pandemic. Accountability mechanisms should not only assess progress, but also guarantee that Heads of Governments, national tuberculosis programmes, and even regional and site-level clinics, as well as key non-governmental organisations, take the necessary corrective actions to remove obstacles to ending tuberculosis.

•Civic literacy refers to the ability to engage meaningfully with one's community.•Digital, health, and civic literacy are key predictors for digital health literacy.•The extent to which these three affect digital health literacy remains unclear.•Building digital health literacy is vital to limit inequalities from expanding.

Health risks in the 21st century are beyond the control of any government in any country. In an era of globalisation, promoting public health and equity requires cooperation and coordination both within and among states. Law can be a powerful tool for advancing global health, yet it remains substantially underutilised and poorly understood. Working in partnership, public health lawyers and health professionals can become champions for evidence-based laws to ensure the public's health and safety.

Abstract Particle tracking is a ubiquitous task in the study of dynamic molecular and cellular processes by live microscopy. Light-sheet microscopy has recently opened a path to acquiring complete cell volumes for investigation in 3-dimensions (3D). However, hypothesis formulation and quantitative analysis have remained difficult due to fundamental challenges in the visualization and the verification of large sets of 3D particle trajectories. Here we describe u-track 3D, a software package that addresses these two challenges with three algorithmic innovations. Building on the established framework of globally optimal particle association in space and time implemented in the u-track package and recent advances in gaining association robustness in the case of erratic motion, we first report a complete and versatile pipeline for particle tracking. We then present the concept of dynamic region of interest (dynROI), which allows an experimenter to interact with dynamic 3D processes in 2D views amenable to visual inspection. Third, we present an estimator of trackability, which provides for every trajectory a confidence score, thereby overcoming the challenges of visual validation of trajectories in dense particle fields. With these combined strategies, u-track 3D provides a framework for the unbiased study of molecular processes in complex volumetric sequences.

The trade-off between different objectives is at the heart of political decision making. Public health, economic growth, democratic solidarity, and civil liberties are important factors when evaluating pandemic responses. There is mounting evidence that these objectives do not need to be in conflict in the COVID-19 response. Countries that consistently aim for elimination—ie, maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible—have generally fared better than countries that opt for mitigation—ie, action increased in a stepwise, targeted way to reduce cases so as not to overwhelm health-care systems.

We may emerge from this with a healthier respect for our common humanity

The COVID-19 pandemic has highlighted the importance of digital health technologies and the role of effective surveillance systems. While recent events have accelerated progress towards the expansion of digital public health (DPH), there remains significant untapped potential in harnessing, leveraging, and repurposing digital technologies for public health. There is a particularly growing need for comprehensive action to prepare citizens for DPH, to regulate and effectively evaluate DPH, and adopt DPH strategies as part of health policy and services to optimise health systems improvement. As representatives of the European Public Health Association's (EUPHA) Digital Health Section, we reflect on the current state of DPH, share our understanding at the European level, and determine how the application of DPH has developed during the COVID-19 pandemic. We also discuss the opportunities, challenges, and implications of the increasing digitalisation of public health in Europe.

OBJECTIVE: Use of preexposure prophylaxis (PrEP) for HIV raises concerns about sexually transmitted infection (STI) incidence because of decreased condom use among MSM. This study examines whether PrEP is associated with STIs in the 12 months following PrEP prescription relative to the 12 months prior to PrEP and if STI rates are higher among PrEP users relative to individuals receiving postexposure prophylaxis (PEP). DESIGN: Retrospective cohort study including PrEP users with more than 12 months of follow-up before PrEP prescription and individuals receiving PEP from 2010 to 2015 at Clinique l'Actuel (Montréal, Canada). METHODS: Incidence of chlamydia, gonorrhoea, syphilis and hepatitis C virus over 12 months was compared before and after PrEP; and for PrEP versus PEP users using Poisson models to generate incidence rate ratios (IRRs) with 95% confidence intervals (CIs) and adjusted IRRs (aIRRs) controlling for frequency of STI-screening visits. Models comparing PrEP and PEP users were further adjusted for age and education. RESULTS: One hundred and nine PrEP and 86 PEP users were included. Increased rates of STIs were observed in the 12 months after PrEP relative to the 12 months prior (IRR: 1.72, CI: 1.22-2.41; aIRR: 1.39, CI 0.98-1.96). PrEP users were also at higher STI risk relative to PEP users (IRR: 2.18, CI: 1.46-3.24; aIRR: 1.76, CI: 1.14-2.71). CONCLUSION: Increased rates of STIs among individuals after initiation of PrEP may suggest greater risk behaviours during the first year on PrEP. Further studies are needed to measure long-term trends in STI acquisition following PrEP initiation.

Ensuring future generations have access to antimicrobials is high on the agenda for many heads of state, and almost all Ministers of Health. Following the UN General Assembly's 2016 High-Level Meeting on antimicrobial resistance (AMR), an ad-hoc Interagency Coordination Group (IACG), co-chaired by the UN Deputy Secretary-General and the Director-General of WHO, was tasked with providing guidance to political leaders on approaches needed to promote sustainable action on AMR. 1 Interagency Coordination Group (IACG) on Antimicrobial ResistanceWork plan of the Ad-hoc Interagency Coordination Group on Antimicrobial Resistance May 2017–September 2019. IACG, 2017http://www.who.int/antimicrobial-resistance/interagency-coordination-group/FINAL_IACG_DRAFT_WORKPLAN.pdfDate accessed: May 1, 2018 Google Scholar Department of ErrorRochford C, Sridhar D, Woods N, et al. Global governance of antimicrobial resistance. Lancet 2018; 391: 1976–78—In this Comment, the second sentence of the fifth paragraph should read: “First, ensure appropriate use of antibiotics in both human and animal health, over time eliminating the unnecessary use of antibiotics in agriculture.” This change has been made to the online version as of May 18, 2018. Full-Text PDF

Worldwide political commitment to pandemic preparedness is essential

Manufacturers using their market power to maximise profits results in prices that are unjustifiable and unaffordable, argue Steven Morgan and colleagues

The COVID-19 pandemic accelerated the uptake of digital health worldwide and highlighted many benefits of these innovations. However, it also stressed the magnitude of inequalities regarding accessing digital health. Using a scoping review, this article explores the potential benefits of digital technologies for the global population, with particular reference to people living with disabilities, using the autism community as a case study. We ultimately explore policies in Sweden, Australia, Canada, Estonia, the United Kingdom, and the United States to learn how policies can lay an inclusive foundation for digital health systems. We conclude that digital health ecosystems should be designed with health equity at the forefront to avoid deepening existing health inequalities. We call for a more sophisticated understanding of digital health literacy to better assess the readiness to adopt digital health innovations. Finally, people living with disabilities should be positioned at the center of digital health policy and innovations to ensure they are not left behind.

Objective: Medical students, as clinicians and healthcare leaders of the future, are key stakeholders in the clinical roll-out of artificial intelligence-driven technologies. The authors aim to provide the first report on the state of artificial intelligence in medical education globally by exploring the perspectives of medical students. Methods: The authors carried out a mixed-methods study of focus groups and surveys with 128 medical students from 48 countries. The study explored knowledge around artificial intelligence as well as what students wished to learn about artificial intelligence and how they wished to learn this. A combined qualitative and quantitative analysis was used. Results: Support for incorporating teaching on artificial intelligence into core curricula was ubiquitous across the globe, but few students had received teaching on artificial intelligence. Students showed knowledge on the applications of artificial intelligence in clinical medicine as well as on artificial intelligence ethics. They were interested in learning about clinical applications, algorithm development, coding and algorithm appraisal. Hackathon-style projects and multidisciplinary education involving computer science students were suggested for incorporation into the curriculum. Conclusions: Medical students from all countries should be provided teaching on artificial intelligence as part of their curriculum to develop skills and knowledge around artificial intelligence to ensure a patient-centred digital future in medicine. This teaching should focus on the applications of artificial intelligence in clinical medicine. Students should also be given the opportunity to be involved in algorithm development. Students in low- and middle-income countries require the foundational technology as well as robust teaching on artificial intelligence to ensure that they can drive innovation in their healthcare settings.

had been increasing at some 10% per year from 2011-2016 [2].Among Russian men aged 30-39 years of age, a group that has the highest male infection burden, some 2.8% were living with HIV infection in 2016 [2].AIDS deaths, too, are rising and now negatively impact life expectancy [3].From January to June 2017, some 14,631 AIDS deaths were recorded, a 13.5% increase over the previous 6-month period [3].HIV/AIDS has risen to feature in the top 10 causes of premature death in the RF-a 35% increase from 2005 [4].These realities should concern all who seek global control of the HIV pandemic.Despite the severity of this epidemic, including its scale, scope, and trajectory, remarkably little attention has been paid to the associated public health crisis in the international scientific literature.This may in part be due to the limited availability of data on HIV-1 in the RF that are presented and published outside Russia, and to the few international collaborations on HIV in the RF under the current administration.Therefore, we reviewed publicly available data in the Russian language on HIV-1 in the RF through mid-2017 and analyzed Russian federal and oblast (province)-level HIV policies and programs to assess the current burden of HIV-1 prevalence and incidence, the state of prevention programs as they relate to the epidemiology of HIV in the country, and policy impacts of current Russian laws, policies, and practices on the future trajectory of the epidemic.Cumulative Russian federal data through mid-2017 are available on Russian language websites from several oblasts, a Federal AIDS Center report, and from Rosstat, the Russian Federal Statistics Bureau [2,[5][6][7].Russian federal data are reported as cumulative diagnoses and as new diagnoses per 100,000 population.We used these data to generate burden maps of reported prevalence and of new diagnoses, by oblast, across the RF (Fig 1 and Fig 2).Neither measure can be said to yield true HIV prevalence or incidence infection estimates, since they do not account for deaths (in the case of cumulative infections) or estimate the rate of new infections,

The exercise of power permeates global governance processes, making power a critical concept for understanding, explaining, and influencing the intersection of global governance and health. This article briefly presents and discusses three well-established conceptualizations of power-Dahl's, Bourdieu's, and Barnett and Duvall's-from different disciplines, finding that each is important for understanding global governance but none is sufficient. The conceptualization of power itself needs to be expanded to include the multiple ways in which one actor can influence the thinking or actions of others. I further argue that global governance processes exhibit features of complex adaptive systems, the analysis of which requires taking into account multiple types of power. Building on established frameworks, the article then offers an expanded typology of eight kinds of power: physical, economic, structural, institutional, moral, discursive, expert, and network. The typology is derived from and illustrated by examples from global health, but may be applicable to global governance more broadly. Finally, one seemingly contradictory - and cautiously optimistic - conclusion emerges from this typology: multiple types of power can mutually reinforce tremendous power disparities in global health; but at the same time, such disparities are not necessarily absolute or immutable. Further research on the complex interaction of multiple types of power is needed for a better understanding of global governance and health.

The balance between respecting choice, autonomy, and individual responsibility and ensuring that no one in need of health care suffers for lack of financial resources has worked well for Switzerland. But this health care system is not without its challenges.

The field of global health has reached a critical juncture, where both its visibility and the complexity of its challenges are unprecedented. The World Health Organization, as the only global health actor possessing both democratic and formal legal legitimacy, is best positioned to capitalize on this new, precarious situation in public health and respond with the governance innovation that is needed to bring the increasingly chaotic network of activities and entities affecting health outcomes under the fold of a centralized, standard-setting agency. One such proposed innovation to guide normative and strategic coordination in global health is the creation of a Committee C of the World Health Assembly that would promote consensus building and multi-stakeholder decision-making within the unique convening power of the World Health Organization.

The Policy Forum allows health policy makers around the world to discuss challenges

The coronavirus disease 2019 (COVID-19) pandemic revealed a lack of consensus on the concept of essential oral health care. We propose a definition of essential oral health care that includes urgent and basic oral health care to initiate a broader debate and stakeholder alignment. We argue that oral health care must be part of essential health care provided by any health system. Essential oral health care covers the most prevalent oral health problems through an agreed-on set of safe, quality, and cost-effective interventions at the individual and community level to promote and protect oral health, as well as prevent and treat common oral diseases, including appropriate rehabilitative services, thereby maintaining health, productivity, and quality of life. By default, essential oral health care does not include the full spectrum of possible interventions that contemporary dentistry can provide. On the basis of this definition, we conceptualize a layered model of essential oral health care that integrates urgent and basic oral health care, as well as advanced/specialist oral health care. Finally, we present 3 key reflections on the essentiality of oral health care. First, oral health care must be an integral component of a health care system's essential services, and by implication, oral health care personnel are part of the essential health care workforce. Second, not all dental care is essential oral health care, and not all essential care is also urgent, particularly under the specific risk conditions of the pandemic. Third, there is a need for criteria, evidence, and consensus-building processes to define which dental interventions are to be included in which category of essential oral health care. All stakeholders, including the research, academic, and clinical communities, as well as professional organizations and civil society, need to tackle this aspect in a concerted effort. Such consensus will be crucial for dentistry in view of the Sustainable Development Goal's push for universal health coverage, which must cover essential oral health care.