Injuries and violence: the global magnitude Etienne Krug Director, Violence and Injury Prevention and Disability World Health Organization

HIV TB Malaria Deaths (millions)

HIV TB Malaria Deaths (millions) Violence Unint. Injuries

Leading causes of injury deaths Road traffic crashes 23% Poisonings 6% Falls 8% Fires 6% Drownings 7% Self-inflicted injuries 15% Violence 11% War 3% Other 21%

Leading causes of death 2004

Leading causes of deaths 2004 vs. 2030

Road traffic deaths in India

Rank 0  4 years5  14 years15  29 years30  44 years years≥60 years All Ages 1 Perinatal conditionsLower respiratory infectionsHIV/AIDS Ischaemic heart disease 2 Lower respiratory infectionsRoad traffic injuries TuberculosisCerebrovascular disease 3 Diarrhoeal diseasesHIV/AIDSMaternal conditionsRoad traffic injuriesHIV/AIDS Chronic obstructive pulmonary disease Lower respiratory infections 4 Childhood diseasesDrowningsSelf-inflicted injuriesMaternal conditionsTuberculosisLower respiratory infectionsHIV/AIDS 5 MalariaChildhood diseasesTuberculosisIschaemic heart disease Chronic obstructive pulmonary disease Trachea, bronchus, lung cancers Chronic obstructive pulmonary disease 6 Congenital anomaliesFiresViolenceSelf-inflicted injuriesTrachea, bronchus, lung cancersDiabetes mellitusPerinatal conditions 7 HIV/AIDSTuberculosisLower respiratory infectionsViolenceCirrhosis of the liverHypertensive heart diseaseDiarrhoeal diseases 8 Protein-energy malnutrition DrowningsCerebrovascular diseaseRoad traffic injuriesStomach cancerTuberculosis 9 SyphilisMeningitisFiresLower respiratory infectionsSelf-inflicted injuriesTuberculosisTrachea, bronchus, lung cancers 10 MeningitisLeukaemiaWar injuriesCirrhosis of the liverStomach cancerColon and rectum cancersRoad traffic injuries 11 DrowningsCongenital anomaliesIschaemic heart diseasePoisoningsLiver cancerNephritis and nephrosisChildhood diseases 12 Road traffic injuriesFallsPoisoningsFiresLower respiratory infectionsAlzheimer and other dementiasDiabetes mellitus 13 TuberculosisPoisoningsFallsWar injuriesDiabetes mellitusCirrhosis of the liverMalaria 14 Endocrine disordersViolenceLeukaemiaDrowningsBreast cancerLiver cancerHypertensive heart disease 15 FiresLeishmaniasisRheumatic heart diseaseLiver CancerHypertensive heart diseaseOesophagus cancerSelf-inflicted injuries

Regional differences in injury death rates AFROAMRO EMROEUROSEAROWPROWorld

Regional differences: The Eastern Mediterranean is the region with the highest road traffic and war injury death rates the 3 rd highest death rates for burns and for drowning

Behavioural changes smoking alcohol drugs Cancer Cardio-vascular diseases Other NCDs Mental consequences Depression Anxiety, insomnia, etc Injuries HIV and other STDs Suicide Unwanted pregnancies Abortion + consequences Disability Wide ranging health consequences

Economic impact Road traffic crashes: 1 - 3% of GDP –Examples: Bangladesh 1.6%, Uganda 2.3%, USA 2.3%, 11 HICs (excluding USA) 1.4%, Malawi 5%. –China, RTIs cost $12.5 billion: Four times the total public health budget. In LMICs, economic cost of RTIs alone estimated at nearly US$100 billion. –Twice the sum of all development assistance. Violence: 1 - 2% of GDP

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