Amalgam phase out: Mercury-free dentistry has come to Africa- Brown

Photo caption: Charlie Brown.

President of US-based World Alliance for Mercury-Free Dentistry, Charlie Brown, was in Abuja, Nigeria’s capital city recently during his visit to three African countries in continuation of efforts to phase out amalgam use in Africa.

He spoke with selected news men on the vision of Abuja Declaration that started in 2014 and how it has turned to global campaign prototype, the group activities in 23 other African countries and the second Abuja Declaration among others. Excerpts:

 

In 2014, you were here for the first Abuja Declaration to phase out dental amalgam in Africa. How has the journey been so far?

The Abuja Declaration became the prototype for the whole world. After the Abuja Declaration, we did the Dakar Declaration, for Asia for mercury-free dentistry, the Declaration for Latin America, the Chicago Declaration for mercury-free dentistry in the United States. Then the Bonn Declaration.

All these came from the Abuja Declaration because it just sounds governmental, it sounds official. It really was just eight of us in the room. We had the West African group, Dominique Bally from Ivory Coast, along with people from Benin, Senegal, Ghana, off course Nigeria and Tanzania. Everybody was so excited. So, the Abuja meeting actually started the campaign in East Africa too.

Abuja Declaration is what those of us see as a vision Africa should have. Did we know what we were doing? Not yet. Did we have a plan? No, not yet. We had a vision and that was the Abuja Declaration. So, now is time for Abuja Declaration 2.

You said the Abuja Declaration is a vision that started in 2014. How far have you realised the objectives of that vision?

Oh, it’s fantastic. We have campaigns across Africa in 23 countries, we have six regions in Africa – West, East, North, Central, South and Nigeria. Those are our six regions, and we have campaigns everywhere, and successes everywhere. Mercury-free dentistry has come to Africa. Gabon has ended amalgam, in Tanzania is banned for children, for pregnant women, breastfeeding women and by law phased out by a date in the future – date selected 2029, it’s over.

Mauritius, end for children; Tunisia, end for children and pregnant women; Zambia, not for children; Benin, not for the military. We’ve shown that mercury-free dentistry categories or overall can happen and it is happening, and the campaigns are really on. In Cameroon, it is over for the whole Baptist Hospital system. In Cameroon, we’re very close to victory, in Zambia we are very close to victory, we have one victory in Gabon, in Nigeria there is tremendous focus of ours and we see the action here, we see the shift in dentistry, we see the mobilisation of the public, and in fact Nigeria was the first to issue consumer protection brochure from the Consumer Protection Agency of the federal government.

You’re appear to be okay with the process of phasing out amalgam in Nigeria, aren’t you?

Well, no, we’re not satisfied. Because the only answer is victory, its ending amalgam, that’s the end. As long as some children still get it, we have to stop it. We have to banish it. It’s an environmental menace, it’s a workplace menace for dental workers. Mercury is the most vaporous of the heavy metals, it’s a horrible historical mistake and its outrageous how the global leadership of dentistry have stuck with mercury fillings despite its implications to health and the environment.

So, we have to have not a general phase out someday, we need an endpoint – a definite, by law endpoint, then the dental students will stop paying any attention to amalgam, the public will recognize that if it’s going to be banned, they should never have it. One main reason that they know it is over is that the manufacturers are getting out. The largest manufacturer of dental products in the United States stopped making amalgam in 2020 when the Food and Drug Administration acted. The number two company in the United States, we pushed them hard and got out in 2021. When the Food and Drug Administration acted, they realised that they better get out.

There were only three publicly traded dental products companies who made amalgam, two Americans got out years ago, the third one hung in there to their dishonour. That is the Southern Dental Industries Limited in Australia. They announced on August 24, 2024, that they would get out, but not fast. They’re going to get out 2028. The good news is that they’re getting out too, the bad news is that they’re hanging around for years and keep milking profits that they shouldn’t do so we will make it rough on them.

So, the supply is fading away and in fact as of this Europe bans as of this January bans all amalgam. So, we are not just working on dentistry, we are working on consumer education, advocacy but also supply; and cutting off the supply and that is worth it.

You are here for the Second Abuja Declaration. What do you intend to achieve?

The objective is to set an end date for amalgam use in Africa. Civil society usually needs to come first. It’s a reality. American founder, Thomas Jefferson, said that price of liberty is eternal vigilance. Government, industry, institutions don’t seem to move on their own, you know. We need to step up, so we have stepped up. And I think the Abuja Declaration and hope that as we formulate it, it will set an end date for the trade that is to cut off the imports. We cut off the imports on day one and a little later we cut off all use. Once no more is coming in, we can regulate the use and have end the use. So, I’m hoping that’s where we go but that will be the decision of the African NGOs and will be written here and sent to the African NGOs.

In NGO communities, 23 countries have been named and we have allies in several more countries. It’s just our budget, our budget right now can absorb that and thank goodness for Dr Myron Wentz. Funding by Dr. Myron Wentz has been the sine qua non for our success in Africa.  His decision seven years ago to fully fund the Africa campaign, and keeping that commitment, has meant we have campaigns with NGO partners in 23 African nations spanning the continent and encompassing the majority of Africans, creating the momentum for a mercury-free continent.

Dr Wentz sure has done quite a lot. Can you shed some more light on this worldwide plan to end the use of amalgam as the EU has set a January 1, 2025, date.

Right, January 1 which is less than a hundred days from now.

Is it realistic?

It’s over. They know it’s over. It’s banned. Yes. There’re exceptions that are going to be very hard get through them. So, there may be some tine bit of use. But important for Africa and for Asia and for Latin America likely banned exports. January 1 amalgam cannot be exported.

We have been clear in our advocacy that we are not going to have a situation like lead paint, which was banned in the West. I thought it was banned. It wasn’t banned; off course it was being shipped to Africa and Latin America and South Asia. So, we are not going to do that. We have to take the Europe ban, which is also a model to the world. If Europe can do it, why not all of us?

So, 27 countries, that’s the EU, most of Europe, the rest of continental Europe has ended amalgam as well – Switzerland, Norway, the non-EU countries, UK is left but now Northern Ireland, that part of the UK is ending amalgam. So, we don’t see how the UK could remain an island of mercury if you will, why won’t they want to be with the rest of Europe’s mercury-free?

The Southern Dental Industries Limited timeline to end manufacture of amalgam still looms large – 2028. And way off in comparison to the EU ban date. Any steps by the World Federation regarding this?

Oh, we don’t like it. SDI saw this treaty not as a way to reduce amalgam, they saw it as an entry point. They were bragging that they would extend amalgam use because the US companies got out, they would expand in America, they would expand in Brazil, they would expand in the developing countries. They saw the amalgam treaty as the exit of other companies and their increase, and we just went straight at them. We threatened boycott from all over Asia with our Asian team, we went to Geneva, I had a meeting with the Australian government, and said this is an outrageous company that is marketing to the black and brown people of the world, while it is fading away in Australia, that this is against the Minamata Convention; this has to stop. But that was where the Southern Dental Industries (SDI) was in 2022.

In 2024, they said amalgam sales are way down, we have a replacement product now, its sales are up, we’re fading out and we’re going to end in 2028. So, it’s a reversal of where they are. They are faster now, but they are totally opposite where they were in 2022 when they thought they’re sales were going up – they’re sales were going down fast. They know we are paying close attention, when they finish, we write them letters.

So, is a reversal or bringing back the SDI 2028 timeline a possibility, or has the World Federation resigned to playing along with the set date?

Well, the SDI said by 2028, but we’re telling them that they have to get out sooner. Can we do that? I don’t know. But with the American company, we pushed them for 10 years, we went to shareholder meetings that didn’t supply. Well, in 2020, they got out. Started working on them probably in 2014, we go to shareholder meetings with some catholic nuns, who are big religious advocates for your cause, and we had them with us.

The UN Environment Programme (UNEP), the treaty, has a deadline date of 2030. It’s the same with the first Abuja Declaration, it’s a vision, it’s a goal, it’s in brackets. Because it’s in brackets, it means it’s not legally binding. So, we’ve stated the worldwide goal.

You’ve committed a lot of resources over the years to phase out amalgam. What do you want to see at the end of the day? What is your goal?

Our goal is to shut down our organisation. If amalgam is out of business, we can all go home. We’re a single metric NGO and we want to finish, get them out and over. Our goal is to have a worldwide treaty or country-by-country bans, not worldwide but sets an end date; it’s over, it’s over.

You came in from Freetown, and from here in Nigeria you’re going to South Africa. What will be your message to the African countries on phasing out dental amalgam?

Well, first is that the supply of amalgam is going to fade away, it’s been cut off. There are always road sellers, and we have to avoid that. In ending amalgam, we have to reduce the supply in the gold fields, it is being illegally black marketed to the goldfields and dental mercury because it can get into a country very easily. Third is mercury-free dentistry is here, it can work, it clearly works, its better, it’s better for public health, its environmentally friendly. Dental mercury poisons the fish that children eat, and the dental workers will work in a safe environment rather than a toxic environment.

So, its idealist time has come, it has come for America, it has come for Africa.

What are the alternatives to dental amalgam?

The main alternative materials are glass ionomer and composite resins. The composite is very durable, its tooth friendly, cavity preventing. The glass ionomer costs the same as amalgam, they are tooth friendly, you don’t need a drill to put them in, you can do it through what’s called ART. The alternatives are being researched and improved every year. Whereas the amalgam no one is researching them, it has no future. So, the alternatives are here.

Any messages for the NGOs across Africa that you’ve been working with?

The message is to carry on, you are the force to a change, the environmental and consumer NGOs, we hope that by working with us you’ve seen the prototype to victory, how you can defeat dental amalgam, it’s a prototype of what you can do around the world. It also tells of what a benefactor like Dr Myron Wenz can do, digging into his pocket for seven to eight years, fully funding the African campaign year after year. And he made sure that each year we expanded.

Dramatically I think in Congo we’ve a programme and we’ve now gone into the interior in Lubumbashi for campaigns, we’ve reached Egypt, we’ve made a point of touching all races from Morocco to South Africa, from Mauritius to Senegal, and its 22 countries West, Central, East, South, North, and we’ve had regional conferences, one in Arabic in Cairo, we had a conference in Zambia for the Southern and East Africa, we had one in West Africa in Lome last year for 12 NGOs from 12 different countries – that’s how broad the campaign is West and Central Africa.