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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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In Pakistan, injuries and trauma are among the top ten contributors to the burden of disease and disabilities. Other related factors, such as poverty, political instability, and natural disasters as well as the lack of legislation or enforcement of preventative measures contribute to the population’s susceptibility to injuries.

While police and hospital records provide some data on injuries, a recent commentary published in Public Health suggests that it is essential that the public health sector invest in injury prevention by creating a strong, evidence-based strategy, improving national polices, and collaborating with the private sector to promote injury prevention.

In “The challenges of injuries and trauma in Pakistan: An opportunity for concerted action,” JH-IIRU director, Adnan Hyder and Aga Khan University professor, Junaid Razzak, examine the current status of injury prevention and control in Pakistan  as well as the burden and the policy context for interventions in the country.

The commentary goes on to suggest that, because injury prevention and emergency care have been proven to be some of the most cost-effective interventions in the health sector, investing in such measures as traffic enforcement, speed control, helmets, child resistant containers and trained emergency personnel makes sense from both an economic and public health viewpoint.

Drs. Hyder and Razzak are directors of the JHU-Pakistan Fogarty International Collaborative Trauma and Injury Research Training Program (JHU-Pakistan ICIRT). The goal of JHU-Pakistan ICIRT is to build a strong network of professionals and help develop sustainable research capacity on acute care of trauma and injuries and emergency medicine in Pakistan.  For additional information on the program, click here:

http://www.jhsph.edu/faculty/research/map/PK/1227

To access the paper, click here: http://www.sciencedirect.com/science/article/pii/S0033350612004696#

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.

In a newly published article, Dr. Hadley Herbert, Dr. Adnan Hyder and other authors consider how injury and violence relate to global health, discussing the increasing burden of injury as well as the current global recommendations regarding prevention initiatives.

The article, entitled Global Health: Injuries and Violence, was published in Infectious Disease Clinics of North America in an issue devoted to "Global Health, Global Health Education and Infectious Disease: The New Millennium, Part II."

In the article, Dr. Herbert, a trauma specialist with the Johns Hopkins International Injury Research Unit, and Dr. Hyder, director of the Unit, emphasize that injury and violence rank among the 10 leading causes of death worldwide. In summarizing the evidence, the article serves as a call to action to increase injury research and prevention efforts. The public health community should play a leadership role, they assert, “in galvanizing a multisector response to injury and violence, to advocate for investments at national and international levels, and to catalyze sharing of knowledge and lessons learned across communities and nations.”

Click here to download the full article. For more information on the work of the Johns Hopkins International Injury Research Unit, please contact us.

The Johns Hopkins International Injury Research Unit is excited to announce the launch of its Facebook and Twitter pages. Please join us as a fan and follower as we post updates and news about international injuries – from all over the globe.

To start, the Unit’s experts will be posting from the ground during Safety 2010 in London next week.

Please click here to join: Facebook and Twitter.

Screenshot of the International Injury Research Unit's newly developed Facebook page.


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