Primary prevention remains one of the most important ways to reduce the burden of injuries. However, much death and disability could be prevented by strengthening trauma and emergency care services. Research has shown that there are very large discrepancies in outcome among the injured in countries at different economic levels. For example, one study showed that mortality among the seriously injured increased from 35% in the US to 55% in middle-income Mexico to 63% in low-income Ghana. These results show that similarly injured people are nearly twice as likely to die in a low-income setting than in a high-income setting.¹

Many injury deaths in low-income settings could probably be treated well, and economic constraints are only part of the reason for the disparities in trauma outcomes between countries at different economic levels. There is much that can be done to strengthen trauma and emergency care services through improved organization and planning. Studies of the effect of improving organization and planning of trauma care in high-income countries have consistently shown survival gains of 8–50% through the improved organization and planning that comes with trauma systems.²

Strengthening trauma and emergency care services could have an important public health benefit. Even under the conservative assumption of reducing mortality among all injured patients by only 8%, an estimated 400 000 lives could be saved each …