On 6 May 2022, WHO headquarters and the WHO Regional Office for Africa jointly hosted the first ever stakeholders meeting on noma.
Noma, a necrotizing noncommunicable disease starting in the mouth, is estimated to be fatal for 90% of affected children in poor communities, mostly in Africa, but has also been reported in other regions such as South-East Asia.
Children who survive the disease are often left with serious aesthetic and functional consequences that can include disfigurement, impairments in breathing, swallowing, speaking and vision, and definitive mouth closure, which further contribute to their social isolation, stigmatization, discrimination and to violations of their human rights.
The landmark resolution on oral health, adopted at the World Health Assembly (WHA74.5) in 2021, requests the Director-General, inter alia, “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” since noma shares important characteristics with neglected tropical diseases (NTDs).
The purpose of the stakeholders meeting was to inform key stakeholders including the Member States and non-State actors about the preparation and submission process of the dossier for consideration by the Strategic and Technical Advisory Group for Neglected Tropical Diseases (STAG-NTD) to formally include noma on the WHO list of NTDs.
Dr Gautam Biswas, NTD Director a.i. at WHO headquarters, presented the current criteria for classifying a condition as an NTD used by the NTD-STAG. This includes diseases which (i) disproportionately affect populations living in poverty and cause important morbidity and mortality; (ii) primarily affect populations living in tropical and sub-tropical areas; (iii) are amenable to broad control, elimination or eradication by applying one or more of the five public health strategies adopted by the Department for Control of NTDs, and/or (iv) are neglected by research.
Additionally, speakers and panellists from the Member States, WHO, academia, implementation partners, and noma survivors joined the meeting. The latest scientific evidence on epidemiology of noma, human rights concerns, as well as the activities implemented in the WHO African Region and countries for the prevention and management of noma were presented. The panellists discussed the current gaps to meet the requirements to progress the dossier for the potential inclusion of noma into the WHO NTD list.
The meeting heard sentiments from countries affected by noma and non-State actors working in the field of noma who are keen to see the disease added to the WHO NTDs list, as they believe it will raise its profile and bring needed attention by national health authorities, specialized research institutions and international development and health agencies.
It is also anticipated that based on the information presented during this meeting, key stakeholders will be able to use this meeting as a springboard to connect with each other and progress development of the dossier in line with the STAG-NTD guidance. WHO will continue following up and facilitating this work, within the mandate of its role.
Dr Bente Mikkelsen, NCD Director at WHO headquarters, reaffirmed the Organization’s commitment to support all efforts to promote noma research, awareness and funding. She declared that “the success in the fight against noma is linked to the capacity of stakeholders to work together. It is now time to unite with other sectors, not just oral health as part of NCDs, in a true collaborative effort.”