WHO's violence prevention activities

WHO's violence prevention activities 21 st IPPNW World Congress, Astana, Kazakhstan Dr Christopher Mikton

Outline 1. Scope of the problem 2. WHO strategy for responding to the problem VPA Capacity development TEACH-VIP GSRVP 3. Challenges and how IPPNW members can help

1. Scope of the prolbem Malaria Road traffic Tuberculosis Violence HIV/AIDS 0.8 1.1 1.3 1.5 1.6 0 0.5 1 1.5 2 Millions of deaths per year Source: WHO Global Burden of Disease estimates, 2011 update.

Global estimates of prevalence of non-fatal violence

Health consequences V I Suicide Homicide War deaths Injuries Disability O L E N C E Mental health Depression Anxiety, insomnia, etc. HIV and other STDs Unwanted pregnancies Behavioural changes Smoking Alcohol Drugs Suicidal behaviour Abortion + consequences Cancer Cardio-vascular diseases Other NCDs

Why is violence a health problem? Violence CJS, social work Health because: Health care personnel deal with victims of violence Violence has long-term and far-reaching health consequences Information and capacity to do prevention work Well-placed to identify victims of violence

2. The prevention of violence strategy Focus: Low- & middle-income countries & interpersonal violence Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

World report on violence and health - 2002 First comprehensive review of the problem on a global scale Magnitude and impact Key risk factors Interventions and policy responses Recommendations Violence can be prevented and its impact reduced Public health approach

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

Political support 2003 - Implementing the recommendations of the World report on violence and health, WHA56.24 2003 WHO regional Committee for the Americas 2004 WHO Regional Committee for Africa 2005 WHO Regional Committee for Europe 2014 WHA Strengthening the role of the health system in addressing violence, in particular against women and girls, and against children

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

The Violence Prevention Alliance Established in 2004, following WRVH Part of Global Campaign for Violence Prevention Secretariat in WHO/VIP/PVL Informal network of governmental, non-governmental, international & private organizations and research institutions All dedicated to preventing interpersonal violence using an evidence-informed approach

VPA growth 2004-2012 2004 12 founding participants: E.g. US-CDC, the Ministries of Health of Belgium, Jamaica, and the Public Health Agency of Canada, and the California Wellness Foundation. 2014 Over 60 participants E.g.; IPPNW, the International Society for the Prevention of Child Abuse and Neglect; the Norwegian Health Directorate; UNDP; UNODC; the World Bank; and the International Red Cross and Red Crescent Societies.

VPA project groups 1. Communications PG 2. Parenting to Prevent Violence PG 3. Research Agenda PG 4. Training PG 5. Academic Collaboration PG

VPA's Plan of Action for the GCVP 2012-2020

GCVP Plan of Action 2012-2020 Three aims: 1. Increase priority of violence prevention as a global public heath issue 2. Build the foundations for violence prevention 3. Implement violence prevention strategies Parenting support Life skills training Social and cultural norms change Reduce access to and misuse of alcohol Reduce risks of firearm-related deaths and injuries Promote access to services

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

Capacity development

Teach VIP Free & comprehensive injury & violence prevention curriculum Classroom-based delivery 67 lessons: 22 "core" lessons and 45 "advanced" lessons Materials: PowerPoint presentations Guidance for students Guidance for instructors Evaluation materials Audience: public health students, allied medical and nursing students, injury prevention and response practitioners, health professionals, staff within government agencies, etc. Often included in university curricula http://www.who.int/violence_injury_prevention/capacitybuilding/teach_vip/en/

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

Technical support

Synthesizing the evidence

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

Increasing country-level demand for WHO violence prevention support No of countries receiving WHO support 50 45 40 35 30 25 20 15 10 WPRO SEARO EURO EMRO AMRO AFRO 5 0 2004/5 2006/7 2008/9 2010/11 Year

Country work: child maltreatment prevention Southern Africa Readiness assessments ToT & training National baseline study 2014 Development of parenting programmes Philippines ACE study Country Situation Report National Consultative Meeting Global plan of action 2012-2020 Large-scale implementation of parenting programme?

The strategy Political support & Policy development WRVH Funding Advocacy Capacity development Model Country programmes & scaled up regional/ country programs GSRVP Technical support

Global status report on violence prevention Assess how far countries have implemented science-based recommendations Indicate gaps in prevention nationally, and priorities for intervention Establish baselines and set targets Stimulate national violence prevention activities Increase global support

GSRVP: Categories of information A. National plan and mechanisms for collaboration and exchange B. Capacity for collecting data Homicides Non-fatal violence C. Primary prevention responses Policies Programmes Laws D. Health, social services, and legal services Child maltreatment Youth violence Intimate partner violence Sexual violence Elder maltreatment Armed violence Gang violence Violence related to organized crime

GSRVP: Method National Data Coordinators Multisectoral respondents Consensus meeting Validation Government sign-off on data

GSRVP: Progress Data collection, analysis, and writing complete 133 countries in final report Findings under strict embargo until: 15 December 2014

3. Challenges Inadequate appreciation of life-long & far-reaching consequences Sub-types of interpersonal violence addressed separately Prevention involves complex behaviour change few simple or "passive" prevention strategies Capacity for EB prevention in many LMICs limited Evidence-base still sometimes thin & mainly from HIC

How IPPNW members can help Research and data collection Magnitude Developing, adapting and testing interventions Capacity development training TEACH-VIP Advocacy: increasing political priority of VP

Thank you!! http://www.who.int/violence_injury_prevention/violence/en/ http://www.facebook.com/whoviolenceprevention http://twitter.com/whoviolencenews