Building Sustainable Solutions to Meet the Needs of Global Dermatology Deserts

In a historic act, global dermatologic societies united at this summer’s 78th World Health Assembly (WHA) to pass a resolution declaring skin disease a global public health priority.¹ The resolution, first proposed by Côte d’Ivoire, was adopted by WHA member states that now call for stakeholders to unite and focus not just on policy but also on addressing the vast “dermatology deserts” that leave millions without access to proper skin care.

These deserts, or regions with few or no dermatology providers, exist in both low- and middle-income countries and in rural areas of wealthier nations. In the United States alone, dermatologists are concentrated in urban areas at a rate 40 times higher per 100,000 citizens compared with rural areas.² Limited access to clinical care leads to an exacerbation of existing inequities, with researchers noting a greater lack of access for patients with skin of color vs white individuals.³

From sub-Saharan Africa to parts of Southeast Asia and Latin America, the consequences are severe, including untreated chronic conditions, delayed diagnoses of life-threatening skin diseases, and widespread stigma.^4,5 Other factors, such as location and the distribution of resources, play significant roles in accessibility to care.⁶

Lars French, MD, a clinician scientist and professor and chair of dermatology at Ludwig Maximilian University in Munich, highlighted the significant scale of the problem.

“It’s really a true turning point for global dermatology,” French said. “For a long time, skin diseases have been overlooked by the broader public health agenda, despite the profound impact that they have on individuals and communities.”

The WHA resolution also calls on countries to integrate skin care into primary care systems, particularly in underresourced regions.

“The World Health Assembly really does formally acknowledge skin diseases as not just being cosmetic concerns, but as conditions that carry a really significant physical, psychological, social, and economic consequence,” French added.

A Mandate to Fill Global Gaps

The resolution is not just symbolic. It lays out actionable steps for countries to follow, including developing national dermatology policies, expanding training and education for frontline providers, and ensuring access to essential medicines.

Claire Fuller, MD, chair of the International Foundation for Dermatology, explained the resolution’s deeper significance.

“We’re the only nonstate actor in official relations with the WHO [World Health Organization] that has a focus on skin disease,” Fuller said. “This is an absolute game changer.... It gives us, if you like, a visa to be able to go and talk to our member states’ ministers of health to say, ‘Look, you’ve signed up to this. How can we help you deliver it?’”

The resolution calls for integrating skin health into primary care, aiming to reach people who are otherwise disconnected from formal dermatologic services. This shift is especially vital in areas where dermatologists are virtually nonexistent.

“The solution to this is really much more training for field workers,” French said. “It can be people who are present at the site, in the population, educators, then obviously nurses, nurse practitioners, then general practitioners. But you really [need] a better coverage globally.”

Addressing Gaps With Grassroots Action

While the WHA resolution sets a framework for success, programs are stepping in to address needs from the ground up. The GLODERM x CeraVe Access Grants initiative has awarded $140,000 across 7 community-focused projects this year.⁷

One such effort is led by Cyndy Muliro, MMED, MBChB, a dermatologist and public health advocate based in Nairobi, Kenya. Her project operates in rural Kenya, where dermatologic resources are scarce.

“We have less than 30 specialists. This gives you, I think, a ratio of about maybe 1 doctor to maybe 3 million people, and that’s quite a gross underserving of the community,” Muliro explained.

To close these gaps, her initiative employs mobile outreach, community education, and teledermatology to extend services far beyond urban centers.

“I’m very passionate about community dermatology and working toward ensuring or improving access to dermatological care, especially in underserved communities,” she said.

Karolyn Wanat, MD, a mentor in the GLODERM program, explained that each grantee is providing care and building lasting local capacity.

“They’re going to train individuals: community health workers, primary care providers, other dermatology trainees. And then those people are going to have a domino effect,” she said.

Training, Technology, and Task Sharing

Increasing access in dermatology deserts requires a rethinking of how care is delivered. Training generalists, nurses, and community health workers to recognize and treat common skin diseases is key, especially in areas where specialists are unavailable.

“In rural areas of sub-Saharan Africa, a lot of dermatology care is delivered by nondermatologists,” Fuller noted. “That’s fine, if they are appropriately trained and resourced.”

To meet this need, the International League of Dermatological Societies (ILDS) has expanded regional training centers, including the Regional Dermatology Training Centre in Tanzania and the Pacific Dermatology Training Center in Fiji. These institutions have already produced hundreds of midlevel providers and consultant dermatologists, strengthening workforce pipelines across underserved regions.⁷

Technology is also helping to close gaps. French described how the ILDS collaborates with WHO and tech partners to develop artificial intelligence tools and mobile apps for diagnostic support in low-resource settings.

“This is being more and more developed and extended worldwide, so that access to care and diagnostics can be done at a distance,” he said.

Mapping Need and Measuring Progress

French emphasized that reliable data are essential for sustainable change despite these advances. Without it, underserved regions remain invisible to policy makers.

“We’re collecting data on how many dermatologists there are, what are gaps in access to care around the world, to have really a map that can tell us where the need is the highest,” French said.

This effort is part of the Global Access to Skin Health Observatory, a collaboration between the ILDS and Harvard’s Esther Freeman, MD, PhD, supported by L’Oréal. It aims to create a comprehensive snapshot of global dermatologic capacity and access.

“This information...should help policy makers also allocate the resources that are needed appropriately,” French added.

From Policy to Patients

Ultimately, it will take collaboration across all levels, from frontline workers to national governments, to ensure the WHA resolution translates into real improvements.

“Our role will be multifaceted,” French said. “[The ILDS will] continue...to serve as a bridge between dermatology professionals, governments, global health institutions such as the WHO and others.”

He stressed that the ILDS will remain committed to practical, patient-centered progress.

“Most importantly, we will always remain patient centered. Our focus is reducing suffering, improving access to care, improving quality of life for patients, and addressing the social consequences of skin diseases worldwide,” French said.

Fuller reflected on how far the specialty has come and how the resolution gives skin health a seat at the table in global public health.

“There is no dermatology department, no dermatologist, no emphasis or unit within the World Health Organization that considers dermatology.... Up until now, the only way WHO has considered skin health has been through technical advice from ILDS. That changes with this resolution,” she said.

References

1. Dermatology societies from around the world welcome milestone WHA resolution on skin diseases. News release. ILDS. May 27, 2025. Accessed July 15, 2025. https://www.ilds.org/news-events/news/milestone-wharesolution-skindiseases/

2. Pearlman RL, Brodell RT, Byrd AC. Enhancing access to rural dermatological care: the time to start is now. JAMA Dermatol. 2022;158(7):725-726. doi:10.1001/jamadermatol.2022.1470

3. Yardman-Frank JM, Nambudiri V. Ending the pandemic of inaccessibility in dermatology. Clin Dermatol. 2023;41(2):280-283. doi:10.1016/j.clindermatol.2023.04.003

4. Tsang MW, Kovarik CL. Global access to dermatopathology services: physician survey of availability and needs in sub-Saharan Africa. J Am Acad Dermatol. 2010;63(2):346-348. doi:10.1016/j.jaad.2009.09.038

5. Urban K, Chu S, Giesey RL, et al. Burden of skin disease and associated socioeconomic status in Asia: a cross-sectional analysis from the Global Burden of Disease Study 1990-2017. JAAD Int. 2020;2:40-50. doi:10.1016/j.jdin.2020.10.006

6. Roberson L, Ugwu-Dike P, Stevenson PA, Collier SM. Geographic access to dermatologic care in urban underserved communities. J Am Acad Dermatol. 2024;90(2):410-412. doi:10.1016/j.jaad.2023.09.079

7. GLODERM and CeraVe award grants to expand access to dermatological care in underserved communities globally. News release. ILDS. April 14, 2025. Accessed July 15, 2025. https://www.ilds.org/news-events/news/2025-GLODERM-CeraVe-Access-Grants/