ILDS and WHO Collaboration Report 2020
5 April 2021
2020 has offered unique challenges to the ILDS and our shared initiatives with the World Health Organization (WHO). Despite the global pandemic, progress has been made in all four areas of our official collaboration plan along with the three additional areas of mutual interest and a renewed commitment to the vision of attaining the best possible skin health for all people around the world.
We also had the privilege to attend the WHO World Health Assembly and submitted a Statement to the Assembly on dermatology and COVID-19. The statement can be viewed here. Further action was taken to address the COVID-19 pandemic by the establishment of a COVID Taskforce, the publication of three guidance notes for members, the creation of a COVID resource hub on the ILDS website and the support of four dermatology COVID-19 registries.
Work has continued to update the International Classification of Diseases (ICD-11). Key meetings were held with the WHO to discuss important changes, including establishing a new Dermatology Specialty Advisor for the Medical and Scientific Advisory Committee (MSAC) as Robert Chalmers stepped down after many dedicated years. Jonathan White takes his place and will continue to work with Robert. All major refinement has been completed for ICD-11’s Mortality and Morbidity Statistics (MMS) with any future work now restricted to a once yearly update and any major structural changes every five years thereafter. In 2021, experts will be invited to undertake a post-publication review of the dermatology content of MMS and ICDD.
Great strides have been made in the area of Skin Neglected Tropical Diseases this year. With the restructuring of the WHO’s NTD division, new focus has been given to skin NTDs with Dr Mwelecele Malecela, head of the NTD Department, who presented during the GLODERM Virtual EADV Pre-Meeting in October 2020. Additionally, other WHO staff were frequently engaged in relevant ILDS initiatives, continuing to show the WHO’s support. A WHO led webinar series on developing training programmes on specific diseases was launched with a webinar in October specifically on skin. Claire Fuller and Rod Hay, members of the editorial group, are contributing towards the development of “A Strategic Framework for Integrated Control Of Skin-Neglected Tropical Diseases 2030” to support the WHO NTD Roadmap to encourage countries to adopt programmes as part of their skin NTD efforts. After several versions and updates, the WHO’s Skin NTD training app is now available and can be downloaded here. In January, after ratification in 2020 and input by the ILDS team, the NTD roadmap was launched.
Several successful meetings were held to raise skin NTD profiles, including the NTD NGO Network (NNN) Skin Cross Cutting Group (NNN SCCG) Stakeholder meeting and the Migrant Health Dermatology Conference which were both held online in April with good attendance from WHO.
The ILDS put forward two applications to update the Essential Medicines List (EML) this year, these included calcipotriol (calcipotriene) for psoriasis and hydroxycholoroquine for dermatological conditions. The updated EML will be published in June 2021. A position statement was also drafted on the Safe and Appropriate Use of Topical Corticosteroids to address the misuse of medicines with member states. The ILDS’ Statement was developed in order to assist societies who can use it in their advocacy efforts at a national level.
Despite the impact of COVID-19 on activities related to occupational health, several important steps were taken in 2020. A systematic review and meta-analysis were completed which looked at UV associated occupational skin cancer. The publication can be read online here. Additionally, a letter was sent to the WHO to propose the integration of irritant and/or allergic contact dermatitis as an important occupational health threat to the WHO/ILO global disease burden project. ILDS also contributed to the yearly WHO InterSun Advisory Committee meeting on non-ionizing radiation. In terms of achieving a better protection of outdoor workers against solar UV radiation, a joint position statement, including the social partners (LINK: https://onlinelibrary.wiley.com/doi/pdf/10.1111/jdv.17011) was published in late 2020. This contains a Global Call to Action, involving all stake holders, and will significantly contribute to the public dissemination of current scientific knowledge on this most frequent occupational cancer and its prevention.
The Global Psoriasis Atlas has completed its first three year plan, achieving its milestones and launching the next phase which, will span years four to six. A few of its successes include : a systematic review of psoriasis and cancer risk, the development of a global network of enthusiastic regional and national coordinators, development of new diagnostic criteria for psoriasis, an updated systematic review of the worldwide prevalence of psoriasis revealing data for 19% of the countries of the world, and eight scientific publications plus many more presentations. Due to its successes and recognised importance, the majority of the funding has already been secured. In addition, the ILDS continues to lead strategic thinking on vitiligo and atopic dermatitis at a global level and with the WHO, with plans being developed on best approaches to ensure their inclusion in future initiatives.
In early February of 2020, the WHO encouraged the ILDS to develop a scoping review to provide background information and demonstrate the importance of including skin health in the WHO Guidelines on Integrated Care for Older People (ICOPE) pathways for the WHO Clinical Consortium on Healthy Ageing (CCHA). Work continues with the hope that skin health will be included in 2022/2023 revisions.
And finally, the ILDS submitted a response to the WHO’s Global Competency Framework for Universal Health Coverage call for consultation. This response pulled together input from ILDS WHO Committee, the IFD Committee and additional nursing colleagues and was very well received by the WHO. In addition to the WHO’s thanks for the incredibly helpful and thoughtful feedback, contributors will also be acknowledged in the report. Building on these successes, the ILDS will continue its positive relationship with the WHO and move forward with its mission to increase awareness, cooperation and communication within the global dermatology community to promote high quality education, clinical care, research and innovation that will improve skin health globally.