Injuries and Violence Prevention: WHO's approach

1. Injuries and Violence Prevention: WHO's approach Etienne Krug, MD, MPH Director, Department of Injuries and Violence Prevention, World Health Organization

2. Leading causes of death, both sexes, 2002 > 5,000,000 Deaths per year Source: Global Burden of Disease Project for 2002, Version 5

4. Inequalities More exposed to risks Less exposed to prevention Less access to quality trauma care and rehabilitation

5. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US)

6. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US) Speed : for 1 km/hr less, 2-3% less fatal collisions

7. Injuries are preventable • Child restraints: 35% reduction in fatal traffic injuries among children (US) • Speed : for 1 km/hr less, 2-3% less fatal collisions • motorcycle helmets: Thailand: 41% less head injuries and 21% less deaths

8. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US) Speed : for 1 km/hr less, 2-3% less fatal collisions motorcycle helmets: Thailand: 41% less head injuries and 21% less deaths drowning: fencing, swimming pools

9. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US) Speed : for 1 km/hr less, 2-3% less fatal collisions motorcycle helmets: Thailand: 41% less head injuries and 21% less deaths drowning: fencing swimming pools drowning: swimming lessons

10. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US) Speed : for 1 km/hr less, 2-3% less fatal collisions motorcycle helmets: Thailand: 41% less head injuries and 21% less deaths drowning: fencing swimming pools drowning: swimming lessons burns: safer stoves

11. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US) Speed : for 1 km/hr less, 2-3% less fatal collisions motorcycle helmets: Thailand: 41% less head injuries and 21% less deaths drowning: fencing swimming pools drowning: swimming lessons burns: safer stoves child abuse and neglect: e.g. home visitation contributed to a median reduction of 40% of cases

12. Injuries are preventable Child restraints: 35% reduction in fatal traffic injuries among children (US) Speed : for 1 km/hr less, 2-3% less fatal collisions motorcycle helmets: Thailand: 41% less head injuries and 21% less deaths drowning: fencing swimming pools drowning: swimming lessons burns: safer stoves child abuse and neglect: e.g. home visitation contributed to a median reduction of 40% of cases alcohol related violence: e.g. reduction of 43% of assault related ED visits

13. Public health

14. Public health Justice Transport Diplomacy Education Police Labour

15. Public health Epidemiology Advocacy Research Services Prevention Policy Evaluation

16. Inter - personal violence Road traffic Burns Drowning Suicide Falls War Health Trans port Police Interior

17. Inter - personal violence Road traffic Burns Drowning Suicide Falls War Health Health Trans port Justice Police Police Interior Interior Health Health Health Health Health Health Diplo macy Trans port Police Defense Welfare Police Interior Police Police Interior Interior Welfare

18. Political support (WHA, UN GA, etc) Model region/ country programs Funding World report Consultative process Advocacy Technical support (guidelines, best practices) Regional/ country programs

19. Inter - personal violence Road traffic Burns Drowning Suicide Falls War

21. 2003 - Implementing the recommendations of the World report on violence and health, WHA56.24 2004 - Road traffic safety and health, WHA57.10

22. Traffic injury prevention UN passes historic resolution on Road Safety United Nations General Assembly 2005 - Resolution A/60/L.8 "Improving global road safety"

23. Inter - personal violence Road traffic Burns Drowning Suicide Falls War Policy Data Research Prevention Services Advocacy

24. Prevention • Preventing violence • Handbook for documenting violence prevention programmes • Framework for child maltreatment prevention (upcoming) • Road safety best practice documents • Helmets • Seat-belts • Drinking and driving • Best practices on child injury prevention (upcoming)

25. Cross-cutting: Capacity building

26. Inter - personal violence Road traffic Burns Drowning Suicide Falls War

27. Child injury prevention Good Practices booklet April 2005 2008 May 2007 March 2006 November 2005

28. Collaborating Centres Partnerships Network of Ministry of Health Focal Persons

29. Make sure the different elements of a system are being developed: • National report National plan • Data collection • Primary prevention • Services • Capacity building Role of Focal Persons: in the country • Lead injury/violence prevention in the country • Be a catalyst • Coordinate public health efforts • If needed and appropriate, coordinate multi-sectoral efforts • Promote scientific approach • Fund raising

30. Role of Focal Persons: internationally • Contribute to regional and global policy making • Contribute to regional and global estimates • Share best practice • Mentor

31. Network of Ministry of Health Focal Persons WHO

32. Conclusions • an enormous public health challenge • more attention from policy makers • Important recent WHA and UN GA resolutions • Ministries of health and WHO have an important role to play and can gain from collaboration • sometimes "all injury" approaches are best, sometimes approaches should be by "injury type" • Whatever the approach, there are common elements • Key role in setting priorities and catalysing action • We lack indicators • A major priority is to develop successful prevention programmes

33. Dr Etienne Krug Director Injuries and Violence Prevention World Health Organization 20 Avenue Appia 1211 Geneva, Switzerland Tel: 41 22 791 3480 E-mail: kruge@who.int