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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Date: May 2013

Non-communicable diseases like cardiovascular diseases, cancers, diabetes and injuries have become the major causes of disability and death in Pakistan, according to a report by a group of researchers that included Johns Hopkins Bloomberg School of Public Health professor, Adnan A. Hyder. Furthermore, while rates of death and disability from non-communicable diseases are expected to continue to increase, Pakistan’s health care system is unprepared to handle the rising burden. The report suggests that if current trends continue, nearly 4 million people between the ages of 30-69 will die from cardiovascular disease, cancers and chronic respiratory disease by 2025.

The study, “Non-Communicable Diseases and Injuries in Pakistan: Strategic Priorities,” published as part of The Lancet series on Health Transitions in Pakistan, also examined the prevalence of non-communicable diseases  such as road traffic injuries, noting that enforcement of traffic safety laws is weak. Both seat belt and speeding laws are enforced poorly, as is the helmet law for bicycle and motorcycle riders, where hospital-based surveillance data indicates that more than 90 percent of riders do not wear helmets. No legislation exists for vehicle standards, road safety audits or promotion of safer transportation systems.

“Pakistan is the sixth most populous country in the world. The recognition of injuries as a key component of the national disease burden is an important first step. This issue needs some serious attention from policy makers,” said Hyder, director of the Health Systems program in the Bloomberg School’s Department of International Health and head of the Johns Hopkins International Injury Research Unit.

According to the report, Pakistan was one of the first developing countries to implement an integrated national action plan for non-communicable diseases, but the high-level, government buy-in the plan had initially was withdrawn. The report goes on to explain that the economic effect of non-communicable diseases and injuries is devastating, estimating a cumulative production loss at approximately $3.47 billion.

Hyder and his colleagues recommend several strategies for preventing non-communicable diseases, which includes implementing policy, legislation and programs to support and promote healthy diet and physical activity; directing generated revenue from the increased excise tax on cigarette sales toward prevention initiatives, thereby mitigating the cost of the suggested measures; and re-prioritizing of funds from international donor agencies to fund non-communicable diseases and injuries. The target goal is to reduce the number of premature deaths due to cardiovascular, cancers and respiratory diseases by 20 percent in 2025. The researchers also stress that efforts must also be directed towards prevention of injuries and mental disorders.

The report was published as part of four papers in the Lancet Series which examine the transitions in Pakistan’s health system and focus on the country’s past and present performance in health, specifically after the 18th amendment to the Constitution abolished the federal Ministry of Health. The series also calls for a unified vision for universal and equitable health access across the nation.  Other papers in the Series focus on reproductive and maternal health, non-communicable diseases and injuries, and recommendations for future health reforms.


On Thursday, May 16, 2013, Dr. Krishnan Rajam, from Malaysia, visited the Johns Hopkins International Injury Research Unit.

Dr. Rajam, who trained as a pediatrician in India and was also a professor in the Department of Primary Care Medicine at the University of Malaya, Malaysia, initially came to Johns Hopkins as a visiting scholar for the Department of Pediatrics and Infectious Disease in early 1991. He later returned to work with JH-IIRU director, Adnan Hyder as a visiting scholar in 2002-2003 as a Fulbright Scholar.

Dr. Rajam subsequently became a technical officer in the Violence and Injury Prevention Unit in the Regional Office for the Western Pacific at the World Health Organization (WHO).

During his visit, Dr. Rajam discussed injury prevention work in Malaysia with members of JH-IIRU, including associate director, Abdul Bachani.

Dr. Rajam published one of the first books on injury prevention in Malaysia.

Visit Krishnan Rajam
Left to Right: JH-IIRU associate director, Abdul Bachani, Krishnan Rajam, JH-IIRU director, Adnan Hyder


Recently, several Johns Hopkins Bloomberg school of Public Health (JHSPH) students, including Health Systems PhD candidates, Casey Branchini and Veena Sriram –both JH-IIRU research assistants—published a paper on their work at the school on gender-based violence (GBV).

The report, a reflection on the students’ experiences organizing activities to coincide with the “One Billion Rising” campaign to demand an end to violence against women and girls.  The students organized events spanning two days—February 13 and 14, 2013—that not only highlighted this global epidemic, but got students and faculty across departments actively involved.  The events, including a panel discussion, lectures, photo essays and a performance of the One Billion Rising  flash mob, coincided with events taking place in more than 200 countries around the world. This was the first time the Bloomberg School took part.

Said co-organizer, Casey Branchini, "Gender-based violence is an issue that impacts everyone.  At JHSPH, we are uniquely positioned to address it. With students from over 70 different countries and from a variety of backgrounds, there is the potential for us to have a broad impact. As public health professionals, it is our responsibility to bring this issue to the forefront and finally do something about it."

Co-organizer Veena Sriram echoed Casey’s sentiments: "Addressing gender-based violence requires many perspectives and approaches. At JHSPH, we have a diverse, multi-disciplinary and talented student body, and we believe that by encouraging students to research or take action on this issue through their own topic areas or regions of the world, we can spark a broader conversation about violence."

One Billion Rising marked the 15th anniversary of V-Day, a global activist movement to end violence against women and girls and inspired by Eve Ensler’s play, The Vagina Monologues.

Both co-organizers are hopeful that these events will spur further action, both around the world and here at the Bloomberg School: Said Veena, “"We had tremendous support from other student groups and the student body as a whole. We are excited about continuing this momentum in the fall, and creating a base for students to organize and take action on the issue."

"The One Billion Rising Campaign at JHSPH truly demonstrates the school's commitment to the issue. From security staff to professors, every person that we approached was engaged and willing to help. It was because of them that this event was a success," said Casey.

“’One Billion Rising’ at Johns Hopkins Bloomberg School of Public Health: A Reflection,” appears in the latest issue of Reproductive Health Matters. You can access the paper here:

For more information on One Billion Rising, click here:

For more information on V-Day, click here:


Johns Hopkins has been working on a new, cross-divisional endeavor that will bring together a wide variety of faculty members and students from public health, medicine, nursing, engineering, economics, and public policy to build a "pipeline of discovery" to advance lifesaving international efforts in the areas of injuries, nutrition, the health of women and children as well as both non-communicable and infectious diseases.

The new Global Health Initiative will focus on broad, global perspectives and on innovative, multi-faceted interventions to develop and implement evidence-based solutions for these critical issues, and improve life for millions.

This new global health initiative is part of a joint fund-raising effort between the university and health system, “Rising to the Challenge: The Campaign for Johns Hopkins,” which aims to create 300 endowed professorships and generate nearly $700 million for undergraduate financial aid and graduate student fellowships. It also will support interdisciplinary research teams seeking answers to worldwide problems in areas like health, education, water resources and revitalization of cities.

The Johns Hopkins International Injury Research Unit welcomes this new initiative to implement life-saving solutions, and prepare future global health leaders to solve critical problems, including the global burden of injuries.

Watch the Global Health Initiative video here:

The Johns Hopkins International Injury Research Unit is pleased to announce the winners of our Second UN Global Road Safety Week photo contest!

First place winner (of an iPod Nano!) is Dr. Animesh Biswas, with a photo titled “Urban Children at Risk” taken in Dhaka, Bangladesh. Our second place winner (of an iPod Shuffle!) is Subramanya Shastri, with a photo titled, “No Place to Walk!” taken in Bangalore, India. Congratulations to our winners and all who entered! See their photos on our Facebook page:

Starting today, May 6, 2013,  the UN will hold its Second Global Road Safety week, dedicated to pedestrian safety.   The week, requested by the UN General Assembly, is part of global efforts to draw attention to the growing burden of road traffic injuries, specifically the more than 270,000 pedestrians who are killed each year. A greater awareness of the impact of road traffic injuries is key to getting decision- and policy-makers involved. Enacting appropriate laws, enhancing enforcement and ensuring links with other modes of transport can save lives. Join the week and participate:

 WINNER: Urban Children at Risk by Animesh Biswas

Second Place
Second Place: "No Place to Walk!" by Subramanya Shastri

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