WHO resolution helps reframe skin diseases as a ‘global public health priority,’ not a ‘cosmetic issue’

When Patrick Davies receives a call from the health center in his community, in a rural area of Ghana, he knows what to expect: a patient with a dermatological condition that the medical staff cannot identify. He is neither a doctor nor a nurse, but he leads a small local organization, the Gate Foundation, based in Ankaful (Cape Coast, Ghana), which works to improve the lives of people suffering from neglected tropical skin diseases, such as leprosy or Buruli ulcer, which, if left untreated, can cause severe disability. “They call me because there is no one else — no trained doctors or diagnostic resources — so they rely solely on my years of experience on the ground,” he explains to EL PAÍS via video call.

Cases like the one described by Davies highlight the lack of attention that the largest organ of the human body has received worldwide until now, despite the fact that skin diseases affect, according to the World Health Organization (WHO), one-third of humanity at some point in their lives and constitute “the seventh leading cause of disability.”

However, last week Ivory Coast, with the of other Global South countries and institutions such as the International Alliance of Dermatology Patient Organizations and Spain’s Anesvad Foundation, succeeded — after years of effort — in getting the World Health Assembly to approve a resolution that recognizes skin diseases as a global health problem for the first time.

The text, approved unanimously, urges countries to integrate skin health into their universal health coverage strategies, to train their primary care teams, and to improve access to treatments and diagnostics, especially in rural and low-resource areas. Although this is a first step and national health systems still need to develop policies to implement the resolution, experts agree that the measure opens a new path for skin conditions to be seen not merely as an aesthetic issue but as a “global public health priority.”

“The resolution is very important because skin diseases place an enormous burden on healthcare systems, yet they go relatively undetected because the numbers are underestimated,” explains Jennifer Austin, director of GlobalSkin, via video call.

The numbers, according to Austin, are devastating: “There are 4.69 billion new cases of skin diseases each year, and it’s one of the top 10 reasons people seek healthcare,” she says, referring to data from the University of Washington’s Global Burden of Disease Study, published in 2024 in The Lancet. Despite this, in sub-Saharan Africa, for example, “there is less than one dermatologist per million people.”

For Antoine Gliksohn, an albino person and executive director of the Global Albinism Alliance, “the resolution sends the message that dermatological conditions must be taken seriously, that they are not a cosmetic issue, but rather affect physical and mental health,” he tells EL PAÍS in a phone interview.

As the activist recalls, “skin diseases are among the leading causes of disability.” “When you have a skin disease, the burden can be enormous and affect your daily life, your family, your work, your studies... But patients have often been told until now that it’s just skin and not a big deal,” he adds.

Inequality and discrimination

Skin diseases not only cause disability, but in the most severe cases, “they can even kill you if left untreated,” says Davies. The activist recalls the case of a 52-year-old woman from a rural community in Ghana who had advanced skin symptoms, yet no one was able to provide a definitive diagnosis.

“I sent the woman to a hospital, which was an eight-hour drive away. The hospital director told us what medications we should give her and discharged her again, but we didn’t have enough money to treat her in her village, and she eventually died,” he laments.

This argument is echoed by Toni Roberts, founder and director of DEBRA South Africa, an organization focused on research into epidermolysis bullosa, a rare skin condition that makes both external and internal tissues extremely fragile. “In South Africa, most babies with this condition don’t survive; there’s no training or capacity to care for them from birth. And in the rest of the continent, the situation is even worse, because we don’t even know how many cases there are,” says the activist, who also suffers from the disease.

One of the key issues addressed by the WHO resolution is the need to tackle inequities in access to treatments. There are particularly severe cases, such as in “Malawi, where there are only three dermatologists” for a population of over 20 million,” says Gliksohn.

Davies adds: “In my community, when someone has a skin problem, they don’t go to the hospital because they know they won’t be properly treated. They call me instead, and that says it all.”

The resolution goes beyond medical treatment and also recognizes the social, psychological, and economic impact of dermatological diseases. For example, in some countries, having vitiligo can ruin a woman’s marriage prospects. In other countries, especially in sub-Saharan Africa, leprosy or albinism continue to be grounds for discrimination.

“With stigma, you can’t have a social role or find work. Your life can be hell,” says Iñigo Lasa, general director of the Anesvad Foundation, in a telephone interview.

Davies adds: “There are healthcare workers who don’t dare touch a patient with a skin condition because they believe it’s contagious. That hurts more than the disease itself.”

However, the resolution, experts agree, now needs to be implemented. “The resolution is good, but if patients don’t ultimately benefit, what’s the point?” warns Kingsley Asiedu, lead of skin neglected tropical diseases team at the WHO, during a video call. “It is our collective responsibility to work with states to ensure that what has been approved is reflected in national policies and concrete plans.”

Some measures are relatively simple. “An important statistic is that 80% of skin disease cases correspond to 10 common diagnoses, so if we train healthcare professionals in these diseases, we can treat a large proportion of cases,” explains Claire Fuller, president of the International League of Dermatological Societies.

Gliksohn calls for more concrete measures, such as including sunscreen on the essential medicines list for patients with albinism, a decision that depends on the WHO.

“The real impact of the resolution on people’s lives will come in the long term,” warns the activist, emphasizing that it will take time to develop “national public policies and train healthcare personnel.” However, he notes that “for the first time, millions of patients worldwide have heard that skin diseases are a matter of physical and mental health that can profoundly affect their daily lives.” And he stresses that this is a recognition “that had not been made until now.”

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