Developing Policies on Injuries and Violence Prevention

1. Developing Policies on Injuries and Violence Prevention 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

5. Recommendation 1: Create, implement and monitor, a national action plan for violence prevention Recommendation 3: Prepare a national road safety strategy and action plan

6. 2003 - Implementing the recommendations of the World report on violence and health, WHA56.24 2004 - Road traffic safety and health, WHA57.10 2005 – Prevention of injuries in the European Region, EUR/RC55/R9

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

8. Examples • Child Safety Action Plan for Europe • Austria: Action Plan for Unintentional Injury • Netherlands: Sustainable safety • Finland: Action Programme to Prevent Intimate Partner and Domestic Violence 2004–2007 • Norway: Road Safety in Norway, Strategy 2002–2011 • Latvia: National action plan for reduction of poverty and social exclusion

9. Review of policy documents • 192 Documents

10. Review of policy documents • 192 Documents • Titles varied: 1/3 plans of action or strategic plans; ¼ strategies; rest, policies or programmes or other names.

11. Review of policy documents • 192 Documents • Titles varied: 1/3 plans of action or strategic plans; ¼ strategies; rest, policies or programmes or other names. • Date: < 1/5 between 1985 and 1999; most between 2000 and 2005.

12. Review of policy documents • 192 Documents • Titles varied: 1/3 plans of action or strategic plans; ¼ strategies; rest, policies or programmes or other names. • Date: < 1/5 between 1985 and 1999; most between 2000 and 2005. • Multi sectoriality: ¼ multi-sectoral government wide plans. Rest mainly from one sector, most commonly health (1/3), transport (1/3), or police/justice (<10%).

13. Review of policy documents • Origin: 35 countries in all continents. Canada (32), Australia (29), the United Kingdom (27), and the USA (25). • Scope: • 4 documents addressed all types of injuries and violence • 34 focused on all types of unintentional injuries • Most focused on a subtype of violence or injuries

14. Conclusions • seems to be a surge in the number of countries producing policy documents • only small proportion have comprehensive documents (e.g. multi sectoral plan of action) • focus often only on a subtype of injuries • most documents produced by one sector

15. Launched on 2 April 2006, Durban, South Africa

16. 3 phases • Phase 1: design process • Phase 2: formulation • Phase 3: approval and endorsement

17. Document Process Phase 1: design process

18. Phase 1: design process • Assessment • Contact stakeholders • Define process • Appoint focal persons and leadership

19. "A safe New Zealand – injury free" Phase 2: formulation • Goal

20. E.g. Australia: National Road Safety Strategy 2001–2010 National Road Safety Action Plan 2001– 2002 Phase 2: formulation • Goal • Time frame

21. human rights, social justice and equity, right to health care, respect for the individual’s dignity and autonomy, cultural appropriateness, gender, community involvement, … • national constitution & health policies; international treaties and resolutions • public health approach; intersectoral collaboration Phase 2: formulation • Goal • Time frame • Principles

22. Reduce number of children killed or seriously injured by 50% and people killed or seriously injured in road accidents by 40% (UK) By 2010, road deaths should be reduced by at least 50% and injuries by 40% compared with the 1986 baseline figures (NL) Decrease the mortality, number of disabled and handicapped people due to injury (Mongolia) Phase 2: formulation • Goal • Time frame • Principles • Objectives

23. number of car crashes decreased by 50% in 5 years • set/enforce speed limits (e.g.: reduce average speed on highways to 80 km/h by 2007) • enforce alcohol impairment laws • regulate drivers’ hours of work in commercial and public transport. Phase 2: formulation • Goal • Time frame • Principles • Objectives • Interventions

24. Phase 2: formulation • Goal • Time frame • Principles • Objectives • Interventions • Lead agency

25. Phase 2: formulation • Goal • Time frame • Principles • Objectives • Interventions • Lead agency • Monitoring

26. 3 phases • Phase 1: design process • Phase 2: formulation • Phase 3: approval and endorsement

27. Warning policy documents alone are not enough • real political commitment • appropriate levels of funding • monitor and review regularly • adapt when needed

28. Conclusions • Injuries and violence prevention requires well-targeted and coordinated multisectoral efforts • resolutions and world reports have invited governments to develop national policy documents for that purpose • many countries still have to start • process is very important • new guidelines

29. 1st Global UN ROAD SAFETY WEEK 2007 23-29 April Young road users