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The Fourth High-level Meeting of the United Nations General Assembly (UNGA) on the Prevention and Control of Noncommunicable Diseases (NCDs) and the Promotion of Mental Health and Well-being (HLM4) took place on Thursday, 25 September 2025, in New York, USA. Following more than a year of preparation, planning, and advocacy, ������٠participated in this pivotal meeting to strengthen political commitment to the global oral health agenda.

In the lead-up to HLM4, UN Member States engaged in extensive negotiations to develop a new Political Declaration on the prevention and control of NCDs and the promotion of mental health and well-being. This Declaration sets out a renewed framework to accelerate global action on NCD prevention and control, as well as on the promotion of mental health and well-being from 2025 onwards.

HLM4 Political Declaration addresses oral health extensively: a historic milestone

Building on the momentum of the successful first-ever WHO-led global oral health meeting, oral health advocates, including the ������Ů and the International Association for Dental, Oral and Craniofacial Research (IADR) leveraged HLM4 to call for prioritizing oral health within the global oral health agenda. 

������٠is proud to report that its unrelenting advocacy efforts spanning over a decade paid off. For the first time in a UN meeting on NCDs, oral diseases were explicitly referenced in the Political Declaration of HLM4, appearing in both the preambular (pages 2 and 6) and operative (pages 10 and 11) sections. This marks a historic milestone for the global oral health community and a major step forward in securing recognition of oral health as an integral part of the NCD agenda.

This achievement did not come easily. The initial Zero Draft of the Declaration made no mention of oral health. Through concerted action, ������٠mobilized its leadership, National Dental Associations, and a wide network of allies across health organizations, missions, and governments to advocate for inclusion. Thanks to these coordinated efforts, oral health was ultimately recognized in the final text, a testament to the power of sustained, unified advocacy.

Other important highlights of the Political Declaration

The Declaration also introduced a set of fast-track targets to be achieved by 2030:

• 150 million fewer tobacco users,
• 150 million more people with controlled hypertension, and
• 150 million more people with access to mental health care.

Additionally, the Political Declaration called for stronger regulatory measures on e-cigarettes and novel tobacco products, restrictions on the marketing of unhealthy foods to children, the implementation of front-of-pack nutrition labelling, and the elimination of industrially produced trans fats. Mental health was addressed extensively throughout the Declaration, along with reinforced commitments to ensuring access to affordable medicines and technologies, as well as improving financial protection.

However, the final version of the Political Declaration fell short of expectations in several areas. Compared with the Zero Draft, certain key prevention measures were diluted, commitments to implementing health taxes were removed, and references recognizing the essential role of civil society were weakened. These shortcomings likely reflect the continued influence of lobbying by unhealthy commodity industries.

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Understanding the UN process for Political Declaration negotiation, approval and adoption

Negotiations on Political Declarations typically span several months. Once Member States reach consensus on the text, a “silence procedure” is initiated, during which countries are given a specified period to raise any final objections. If no objections are made and consensus is maintained, the Declaration is approvedby acclamation at the High-level Meeting. The document is then transmitted to the UN General Assembly (UNGA) for formal adoption through a resolution.

During the silence procedure and again at HLM4, the United States of America expressed its dissatisfaction with the Political Declaration negotiated by Member States. As a result, the UNGA President was unable to facilitate the Declaration’s approval by acclamation at HLM4. Nevertheless, she reaffirmed that the vast majority of Member States expressed strong support for the text and subsequently transmitted the Declaration to the UNGA for adoption via resolution. It is highly likely that Member States’ broad support will be sustained and that the Declaration will be formally adopted.

������٠goes all out for oral health at HLM4

������Ů`s delegation for HLM4 included the newly elected President, Asst. Prof. Dr Nikolai Sharkov, the Executive Director, and the Public Health, Advocacy, and Communications Director. Throughout the week, the team engaged closely with the government representatives, NCD Alliance, partners and other key stakeholders to ensure that oral health remained high on the global health agenda, further strengthening ������Ů’s visibility and advocacy efforts on the global stage.

Joint ������Ů – IADR statement during multistakeholder Panel 1

At HLM4 and during the multistakeholder Panel 1 on tackling the determinants of NCDs and mental health through multisectoral action, ������Ů co-delivered with the IADR a joint statement 
highlighting the critical links between oral health and NCDs, the importance of the common risk factor approach and the importance of ensuring oral diseases, the world’s most prevalent NCDs, are addressed in global and national health agendas.

Participation in side events

������Ů co-sponsored a side-event titled “Time to Act on Sugars: Advancing Health Equity and Tackling NCDs with a Focus on Oral Diseases”, with the governments of Malaysia, Ireland, France, Egypt, the Philippines and Thailand. In his intervention, the President described ������Ů`s advocacy for sugar reduction spanning nearly two decades and highlighted the impact of the most recent efforts. 

������Ů also participated in the Fourth Multistakeholder Gathering on NCDs convened to rally high-level political support and accelerate the achievement of the global NCDs targets. 

During this session, political leaders, technical experts and leading civil society actors shared practical insights on mobilizing multisectoral and multistakeholder strategies for NCDs and mental health. ������Ů’s Executive Director, Enzo Bondioni, who was a panelist in this event emphasized that national oral health policies are more likely to succeed when ministries beyond health are engaged.  The event also marked the launch of the World Health Organization Global Coordination Mechanism (. 

Furthermore, the ������Ů President joined a roundtable on role of self-care in the prevention and control of NCDs. Asst. Prof. Dr Sharkov took the opportunity to highlight how oral health education and oral self-care remain key elements of the World Oral Health Day (WOHD) campaign which reaches billions of people annually. He also called for distinguishing between safe self-care and resorting to unsafe practices, such as DIY dentistry, which can cause serious complications.  

In addition, Dr Wendy Thompson, Chair of the ������Ů Preventing Antimicrobial Resistance (AMR) and infections task team, participated in a side event on AMR hosted by the Union for International Cancer Control (UICC), the Norwegian Cancer Society & Norway’s Mission to the UN. She emphasized how effective oral disease prevention measures and improved access to oral healthcare can reduce unnecessary antibiotic use in dentistry and urged governments to partner with National Dental Associations for the development and implementation of their national AMR action plans. 

Building on this milestone, ������Ů will continue to work closely with its members and partners to ensure that the Political Declaration’s recognition of oral health translates into concrete national actions and measurable impact. Through sustained advocacy and collaboration, ������Ů remains dedicated to advancing integrated, equitable, and sustainable solutions that make optimal oral health a reality for all.