2. International Safe Community Certifying Centre -a NGO

3. Chair Leif Svanström General manager Guldbrand Skjönberg May 2014 International Safe Community Certifying Centre

4. The International Safe Community Movement The Scientific Base Leif Svanström* Chair International Safe Community Certifying Centre And Department of Public Health Sciences Karolinska Institutet Stockholm Sweden

5. Economic Burden of Disability Adjusted Life Years (DALYs) of Injuries (Health, 2015, 7, 487-494) Koustuv Dalal & Leif Svanström

6. Methods: Data from the World Bank and the World Health Organization websites were used. Disability adjusted life years (DALY) and gross domestic product (GDP) per capita were used to estimate the economic loss for RTIs.

7. According to the estimate of the World Health Organization’s Global Burden of Disease Study, unintentional injuries resulted in more than 3.9 million deaths in 2004. Among the 15 - 29 years old of age group, road traffic injuries, drownings, burns, poisonings, falls and other unintentional injuries accounted for top five of the 15 leading causes of death

8. The actual economic burdens of injuries at the national level are unknown. In the current study we have tried to explore the economic burden of disability adjusted life years (DALYs) due to injuries at the country level and then distributed at World Bank’s income group levels. We have also presented the economic loss of DALYs due to injuries as percentage of respective country’s GDP

9. The total economic loss of the world during 2004 by means of DALYs due to injuries was 613. 144 billion USD, corresponding value of 848.205 billion USD in 2014. DALYs burden of injuries were concentrated (almost 75%) among low and lower middle income countries.

10. Economic burdens of injuries were concentrated (over 80%) among higher middle and high income countries. Iraq had lost almost one-fifth of its GDP due to injuries. The USA had the highest amount of economic loss for injuries (169.136 billion USD) among all countries.

11. Economic burdens of injuries were concentrated (over 80%) among higher middle and high income countries. Iraq had lost almost one-fifth of its GDP due to injuries. The USA had the highest amount of economic loss for injuries (169.136 billion USD) among all countries (but 1.43% of its GDP).

12. Top ten countries for accumulating injury costs as percentage of own GDP (2004) by means of DALYs loss Iraq (19.35%) Somalia (9.78%) Sri Lanka (8.82%) Sudan (8.20%) Cote d’Ivoire (7.53%) Myanmar (7.20%) Angola (6.98%) Sierra Leone (6.53%) The Russian Federation (6.51%) Colombia (6.30%).

13. According to income groups, countries of the lower middle income group have the highest proportions of injury mortalities (60%), the highest proportions of DALYs loss due to injuries (61%) and less than one-fifth (18%) of the proportions of economic value of DALYs in absolute term. Low income countries constitute 16% of DALYs loss due to injuries and only 2% of DALYs-based economic losses in the world.

14. Low income countries Countries (Economic Loss as % of Respective GDP) Somalia (9.78%) Myanmar (7.20%) Angola (6.98%) Sierra Leone (6.53%) DR Congo (6.21%) Burundi (6.08%) Liberia (5.93%) Uganda (5.27%) Central African Republic (5.21%) Zimbabwe (4.94%).

15. Lower middle income countries (Economic Loss as % of Respective GDP) Iraq (19.34%) Sri Lanka (8.82%) Sudan (8.20%) Cote d’Ivore (7.53%) Indonesia (5.65%); Yemen (5.31%) Beliza (3.89%) Nigeria (3.81%) El Salvador (3.77%) India (3.68%).

16. Upper middle income countries (Economic Loss as % of Respective GDP) Russian Federation (6.51%) Colombia (6.30%) South Africa (5.03%) Kazakhstan (4.44%) Belarus (4.22%) Venezuela (3.71%) Lithuania (3.46%) Dominican Republic (3.43%) IR Iran (3.32%).

17. High income countries (Economic Loss as % of Respective GDP) Saudi Arabia (3.15%) Latvia (3.11%) Estonia (3.03%) Trinidad and Tobago (2.28%) Poland (1.76%) Finland (1.72%) Uruguay (1.70%) Slovakia (1.59%) Republic of Korea (1.58%) Hungary (1.56%).

18. DO SOMETHING !!!!!!!! TOP DOWN THE WHO MUST ALERT THE MEMBER STATES! BOTTOM UP THE SAFE COMMUNITY MOVEMENT !

19. The International Safe Community Movement The Scientific Base Leif Svanström* Chair International Safe Community Certifying Centre And Department of Public Health Sciences Karolinska Institutet Stockholm Sweden

20. Safe Community- A WHO Concept formulated 1970-80 with local applications in Lidköping, Falköping and Motala in Sweden I The intervention was based on an "all ages – both genders – all environments – all situations" approach in eight steps (Schelp, L., 1987): Epidemiological mapping, Selection of risk groups/environments, Forming multidisciplinary working and reference groups, Joint planning of the action program, Implementation, Evaluation, Modification, and Transfer of experience to the rest of the county.

21. Safe Community- A WHO Concept formulated 1970-80 with local applications in Lidköping, Falköping and Motala in Sweden I Three years after the onset of the programme, the total rate of injuries in Falköping had decreased by 23% (from 113/1,000 inhabitants), home injuries by 27%, occupational injuries by 28%, traffic injuries by 28% and “other injuries” by 0.8%

22. Safe Community- A WHO Concept formulated 1970-80 with local applications in Lidköping, Falköping and Motala in Sweden I Lidköping became the second trial, and Ekman, R. (1996) described its five intervention elements: “surveillance, provision of information, training, supervision, and environmental improvements”. Child injuries decreased in 1983 to 1991, at an average annual rate of 2.4% for boys and 2.1% for girls, Fall fractures in the elderly showed a significantly declining trend for both genders (females -6.6% and males -5.4% annually), with one control area showing a minor decrease and Sweden as a whole an increase.

23. Safe Community- A WHO Concept formulated 1970-80 with local applications in Lidköping, Falköping and Motala in Sweden I The studies in Motala demonstrated the success of the original Safe Community model by showing a decrease in injury events by 13%, from 119/1,000 population-years, and no change in a control area (Lindqvist, K., et al., 2001, Timpka, T., et al., 2001, Lindqvist, K., et al., 2002). The relative risk of child injury decreased more (odds ratio 0.74) than in the control area of Mjölby (0.93).

24. Safe Community- A WHO Concept There are now studies from all over the World showing 25% decrease of injuries in well structured programs I Recently a published study from Iran (Moghisi A. et al. 2014)The highest incidence rate of fatal motor-cycle was found in Niriz City, which did NOT implement the Safe Community Program and the lowest rate in Arsanjan City –participating in Safe Comm Program. Yhe same trend showed in Busher province. The conclusion:” The Safe Community Program is a promising model to prevent death from fatal motorcycle accidents in urban areas in Iran”