In a first for the international global health community, a diverse, globally representative group of dermatology experts are calling for comprehensive action to elevate skin diseases on the health policy agenda. Their manifesto makes a bold claim: that skin diseases “represent one of the most significant opportunities to improve health around the world—and one of the most widely overlooked.” The call-to-action was launched globally on the occasion of Universal Health Coverage Day, celebrated every year on December 12th.
The open letter details the devastating consequences of this health issue. Skin diseases are the third most prevalent cause of illness worldwide, one of the top ten causes of disability, and drain billions of dollars each year in direct and indirect costs. They range from disfiguring tropical diseases to lifelong chronic conditions to rare, highly fatal diseases, affecting people of all ages and demographics, in every country in the world.
“We often underestimate the burden of diseases with visible skin symptoms. The psoriatic disease community welcomes this initiative. By writing this letter we insist on action to improve millions of lives worldwide.” – commented one of the co-authors, Frida Dunger Johnsson who heads IFPA, a global organization representing psoriasis patients globally.
Yet health policy does not reflect the scale or severity of these impacts. In fact, skin diseases have been largely marginalized or ignored in health policy. Health systems still often struggle to respond in a way that is effective, efficient, and timely—leaving many of those affected to battle with severe physical and psychosocial effects.
Speaking with a more unified voice than ever before, dermatology experts argue that now is the time for a change. Their effort stands apart because of the globally diverse set of signatories, with voices from more than 20 countries across all continents. They say this reach reflects the wide-reaching need for new solutions, while also dispelling the notion that skin diseases are a secondary concern for global health or national health policy.
The group has chosen Universal Health Coverage Day as the launch date to provide the powerful message that prioritizing skin diseases in national and global planning is important for achieving broader health policy priorities, such as overall system efficiency.
The call-to-action builds on growing momentum and important recent milestones for skin diseases, like the World Health Organization’s resolution on psoriasis and its efforts on neglected tropical diseases with skin manifestations. At the same time, new research has helped to document the global burden of skin diseases and uncover new diagnostic and treatment tools.
“The skin is the largest organ in the body with critical roles in immunological surveillance and sensation as well as temperature regulation and water conservation. So it is not surprising that nearly 1 in 3 people around the world are affected by illnesses that directly impact the skin. However, successive global governments continually ignore and neglect these millions of sufferers with poor funding and access to equitable healthcare for their skin diseases”, commented Clinical Professor Saxon D Smith, from The Australian National University, Canberra, Australia.
However, experts say more must be done to meet the scale of the challenge. They lay out four clear goals to drive this progress. First, policymakers and other stakeholders must assess health systems’ capacity to effectively and efficiently address skin diseases. This includes better data on the most common skin diseases and indicators of effective responses to those diseases, providing a baseline for progress over time.
Second, experts call on health systems to step-up dermatology training for primary care providers, including nurse practitioners, physician’s assistants, and other medical professionals. This can help to increase health system capacity on the frontlines, especially if used in conjunction with new telehealth tools and technologies.
Third, stronger cross-specialty connections can bring the benefits of a multi-disciplinary approach to skin diseases. This goal reflects growing recognition of the complex links between skin diseases and other conditions, requiring deep collaboration between experts in dermatology, allergy, rheumatology, gastroenterology, psychiatry, and other disciplines.
Fourth, the open letter urges leaders to elevate skin diseases on global and national health policy agendas, including at the WHO. It also suggests a universal set of guidelines for the most relevant skin diseases, incorporating the latest research and supported by health policy experts.
“The burden of skin diseases is one that requires everyone’s voice to speak up and advocate for. It is great to see the overwhelming response of these signatories coming together and calling for action, but this is only the start. To elevate skin diseases on the policy agenda, we need to engage with the decision-makers who can make a true difference for people living with skin diseases and their caregivers, across the globe”, said Manan Shah, who leads global public affairs at Danish biopharmaceutical company Leo Pharma.
The experts invite all stakeholders, including policy leaders, health organizations, healthcare providers, and patient advocates, to join their movement to achieve these goals. They say that responding to skin diseases should be a top priority in every country: an overlooked, but powerful opportunity to increase health system efficiency, bolster economic productivity, improve millions of lives
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Mario Ottiglio High Lantern Group
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