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- trauma care
- multiple injury
- traumatic brain injury
- spinal cord injury
- clinical care
Many people are working hard, often in the face of considerable difficulties, to create innovative solutions for improving trauma care in their countries. Their efforts received notable support in 2007 when the World Health Assembly (WHA) adopted WHA Resolution 60.22 on trauma and emergency care services.1 2 The Resolution, which calls for increased attention to the issue by Member States and the WHO, recommends several concrete steps that could be taken to strengthen trauma care globally.
During the debate of this WHA Resolution 60.22, 27 governments spoke in support of its adoption, underlining the importance of the issue for their countries. Many highlighted the growing burden of injuries and violence and the challenge to develop adequate responses in low-resource settings. Others drew attention to the role of the international community, noting in particular WHO's contribution to the development of guidelines and compilation and sharing of best practices. Many noted that the issue needs to be placed higher on the agenda of development agencies.
To better promote the low-cost and sustainable improvements recommended by WHA Resolution 60.22, WHO and other partners have been collaborating to increase advocacy for trauma care. To this purpose, WHO convened the Global Forum for Trauma Care in Rio de Janeiro, Brazil in October 2009. The Forum, sponsored by the Ministry of Health of Brazil and the State government of Rio de Janeiro, came to a consensus that WHO should lead efforts to create a global alliance.
Since the Forum, WHO has initiated creation of the ‘Global Alliance for Care of the Injured’, following a formal consultation with a group of key stakeholders from around the world. Based on the Forum and these subsequent discussions, the structure and working modalities of the Alliance have been finalised. The Alliance will be formally launched in early 2012, bringing all key stakeholders under one umbrella to promote the cause of caring for the injured and working towards common objectives (see box 1).
Box 1 Objectives of the Global Alliance for Care of the Injured
To advocate for affordable and sustainable improvements in care of the injured, including greater implementation of the core essential trauma care services recommended by WHA Resolution 60.22 and by WHO guidance documents.
To increase the priority given to care of the injured, especially among governments, donors and international organisations.
To increase resource availability for care of the injured.
To promote exchange of information among participants about successful programmes to strengthen trauma care system-wide, especially those that increase governmental attention to care of the injured.
As envisioned, the Global Alliance for Care of the Injured will be a network of organisations active in advocating for improvements to trauma care in their countries and regions. It will build on existing networks, such as those of professional societies of medical specialties involved in trauma care. The Alliance will have a group of ‘core participants’ comprising major international organisations with global outreach and significant stake in improving the care of the injured. These are the AO Foundation, the Bone and Joint Decade, the International Society of Surgery, the USA Centers for Disease Control and Prevention and WHO.
In its initial stages, the Alliance will work towards defining a strategy for advocacy around set priorities including sustainable improvements for care of the injured globally, increased resource allocation, and improved mechanisms for sharing information among stakeholders. It will develop a global research agenda for trauma care, and a set of indicators that may be used to measure progress. It will also strategise about ways to help low-income and middle-income countries to build the capacities of healthcare workers and those who manage trauma units and ensure that the core essential services or the care of the injured (see box 2) are provided.
Box 2 Core essential services for care of the injured
There are three broad sets of essential services that all injured people need:
Life-threatening injuries are appropriately treated, promptly and in accordance with appropriate priorities, so as to maximise the likelihood of survival.
Potentially disabling injuries are treated appropriately, so as to minimise functional impairment and to maximise the return to independence and to participation in community life.
Pain and psychological suffering are minimised.
WHO's role in the Global Alliance for Care of the Injured will be to provide technical, administrative and management support. A number of technical documents prepared by WHO and partners over the years are currently in use in many countries, guiding efforts to improve trauma care systems. The Alliance would promote greater implementation of these technical documents. In terms of administration and management, WHO will support annual meetings of the Alliance and will manage its membership and regular communications on behalf of the members.
The Global Alliance for Care of the Injured will also benefit from and add value to other ongoing global initiatives related to injury and violence prevention. These include, for example, the Decade of Action for Road Safety 2011–2020, for which the Global Plan has a specific ‘pillar’ or set of activities on post-crash care, as well as the Global Campaign for Violence Prevention.
In conclusion, it is hoped that the Alliance will give further impetus towards supporting Member States and their partners to achieve the recommendations of WHA Resolution 60.22, and ultimately save lives.
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.
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