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working definitions for this and the subtypes of violence that have been adapted from the most reliable scientific sources (see Box 1-1).

The moderator of this session, Sir George Alleyne, M.D., opened the discussion by observing a change in the session title. The title of this chapter was the original title of the session, but the version of the agenda he received titled it “Why the World Should Be More Invested in Violence Prevention.” He believed that greater investment is really the thesis for discussion and one of the major themes of this workshop. If the question were asked, he said that the answer would be because of the tremendous returns on such investment. Another rationale of the workshop, he stated, was to reenergize ourselves and energize those who can invest in violence prevention by reawakening our sensitivities and sensibilities, which he stated had been “repeatedly dulled by the pictures and images of violence coming through our living rooms.” From his own background in public health, he has come to believe that (1) health can be used as a platform or bridge to reduce some forms of violence, as we would see from the program in Bogotá, Colombia, and (2) tools of public health can be applied to address some aspects of both interpersonal and collective violence. Presentations by Etienne Krug, Irvin Waller, Bernice van Bronkhorst, and James Garbarino explored violence prevention from several different perspectives—health, criminal justice, economic development, and human development.


Dr. Etienne Krug began by contrasting the 1.6 million annual deaths globally attributed to violence to other public health priorities. Tuberculosis results in roughly the same number of deaths as violence, but more people die from HIV/AIDS, while fewer die from malaria. Of the 1.6 million deaths from violence, half of them are due to suicide, 35 percent to interpersonal violence, and 11 percent to collective violence, which can include organized violence, forms of war, and gang violence. He suggested that we have a counterintuitive or inverse level of attention, especially from the media, paid to collective violence when epidemiology shows us that the greater issue within types of violence is suicide. His professional experiences dealing with the consequences of collective violence, such as amputating the legs of people who have stepped on land mines, treating babies cut by machetes, and treating women who have had their breasts cut from their bodies during war, are horrific reminders of the importance of addressing collective violence, but he pointed out that other hugely important public health aspects of violence receive much less attention.

In terms of the pattern of distribution of violence globally, the disproportionate burden of death due to violence is in low- and middle-income countries (LMICs)—91 percent compared to 9 percent in high-income or

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