Injuries in developing countries: policy response needed now
Anthony B Zwi, Sam Forjuoh, Shiva Murugusampillay, Wilson Odero, Charlotte Watts
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How important are injuries? The World Health Organization (WHO) predicts that injuries will be responsible for more deaths, morbidity and disability combined than communicable diseases by the year 2020. Injuries currently account for one in 7 healthy life years lost world-wide; by 2020 they will account for one in 5, with low and middle income countries bearing the brunt of this increase (WHO Ad Hoc Committee “on Health Research, 1996, forthcoming report). World-wide, intentional injuries (suicide, homicide and war) account for almost the same number of disability-adjusted life years (dalys) lost as either sexually transmitted diseases and human immunodeficiency virus (HIV) infection combined or tuberculosis. Unintentional injuries cause as many dalys lost as diarrhoea, and more than those lost from cardiovascular disease, malignant neoplasms, or vaccine-preventable childhood infections (MICHAUD & MURRAY, 1994). In developing regions of. the world, in 1990, injuries in males aged 15-44 vears led to 55 million dalvs lost. over one-third of those iost from all causes in ihis sex and age group (MURRAY et al., 1994). In Mexico, homicide has recently been shown to be the leading cause of dalys lost (LOZANO et al., 1995). In Zimbabwe, the number of reported traffic crashes has increased from 19 558 in 1985 to 30 248 in 1994 (54.6% increase). Traffic-related injuries increased by 59% over this period, and traffic-related fatalities by 415%. Almost wherever one looks in the developing world, injuries, both intentional and unintentional, are increasing dramatically.