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December 23, 2005

Preventing Injury Death Around the World: ‘The 1,000,000 Lives Campaign’

At least five million people around the world die from trauma each year, with enormous disparities in survival rates for patients injured in high-income and low-income countries. Calling for a 20 percent reduction in this death rate, two researchers at the Harborview Injury Prevention & Research Center outline six scientifically sound interventions that can lead to achieving what they call “an ambitious but feasible goal.”


“The 1,000,000 Lives Campaign” is a guest editorial by Dr. Frederick Rivara, a University of Washington  professor of pediatrics and epidemiology, and Dr. Charles Mock, a UW professor of surgery. The editorial is published in December 2005 issue of Injury Prevention.


Rivara and Mock indicate six areas of injury control where a set of interventions could combine to save a million lives:



  • Modest improvements in trauma care: “In rural areas, there was a sixfold difference in mortality between high- and low-income countries for patients with life-threatening, but salvageable injuries,” the authors write. Improving trauma care in low-income countries, including establishing minimum levels of staffing and training, physical resources, and administrative mechanisms, could reduce injury mortality by 8 percent, saving 400,000 lives annually.
  • Prevention of road traffic injuries: Interventions to achieve this goal should include an injury surveillance system with a feedback loop to those responsible for traffic and roads, development of safe roads, setting and enforcing speed limits on all roads, requiring seatbelt and helmet usage (as appropriate), and implementing laws for driving while intoxicated. These approaches have been proven to reduce the risk of death to drivers, passengers and pedestrians, and could combine to save 300,000 lives a year.
  • Treating depression to prevent suicide: Depression, which is estimated to affect more than 100 million people in the world each year, is the leading risk factor for suicide. Treatment for depression, which can be done at the primary-care level, is feasible in most countries and could save 160,000 lives annually.
  • Eliminating child labor: Despite child-labor laws in the U.S., many children in the U.S. and other countries are injured while working. In one study in Brazil, 28 percent of children and adolescents who worked reported being injured on the job. Eliminating child labor could save 57,000 lives each year
  • Reducing deaths from intimate partner violence: “Approximately 50,000 women die each year from interpersonal violence; many more probably die from violence but are miscoded as burns, fall, or drowning,” the authors write. “Elimination of even half of these deaths would save 25,000 lives.”
  • Reducing drowning of young children: Children under the age of 15 are the victims of approximately half of worldwide drowning deaths. Installing fencing around swimming pools has resulted in as much as a 73 percent reduction in early-childhood drowning fatalities. Similar barriers around wells, cisterns, fish ponds, and irrigation ditches could reduce drowning deaths by one half, saving 58,000 lives each year.


“Prevention of 1,000,000 lives lost from injuries is within our grasp by working on these six different areas of injury control in the world,” Rivara and Mock write. “This does not require striking new research breakthroughs nor does it require redirection of enormous sums of money. It does require adopting the vision and having the will to accomplish this goal.”


Rivara and Mock call on their colleagues in the field of injury prevention to join in moving “beyond research studies and limited intervention trials to the larger world of public policy in order to raise the profile of injuries worldwide as a preventable problem.”