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Violence Prevention in Low- and Middle-Income Countries: Finding a Place on the Global Agenda - Workshop Summary
community is immune.” We are not, however, Mandela goes on to say, “powerless against it” (WHO, 2002a, p. ix). Eleven years ago, the World Health Assembly (WHA) adopted Resolution 49.25, which declared violence to constitute a major, escalating public health crisis. In identifying violence as a public health concern, the WHA said several things about the nature of violence—most importantly, that violence is not an inevitable part of the human condition to which the world must be resigned, but rather that it is a preventable phenomenon (WHO, 2002a). While no country may be immune to violence, several of the workshop presentations identified rationales for developed countries, which are also political powers of the world, to be more invested in global violence prevention. Of the more than $70 billion invested annually toward global public health research, less than 10 percent is devoted to research into the health problems that account for 90 percent of the global disease burden. This phenomenon is known as the “10/90” gap and violence has been identified as one of those health problems constituting the 90 percent burden (see Appendix C, Matzopoulos et al., 2007). Beyond the moral imperative is the recognition that economic strength and stability of nations are tied to a global economy. Data were presented at the workshop indentifying economic stagnation and the wealth of a nation as examples of predictive factors for future conflict. In addition to affecting economies, violence can also play a role in the devastation of societal infrastructure including food and water supply systems; public health services and health care facilities; transportation, power, and communication systems; and ultimately national leadership and governance (see Appendix C, Sidel and Levy, 2007). Destruction of this infrastructure can lead to decreased quality of life, increased mortality and morbidity, disruption of people’s lives, and displacement of people to other nations—possibility across the globe—that do not always have the capacity to absorb the needs of those displaced or affected.
A public health approach to violence prevention necessitates collective and collaborative action, drawing upon fields as diverse as epidemiology, medicine, nursing, psychology, sociology, anthropology, criminology, policy analysis, education, and economics. As identified in several presentations and the commissioned papers that propose and describe frameworks for applying the public health approach to violence prevention (see Appendix C), the input and inclusion of providers for violence prevention and recovery are critical partners in this approach. Primary strategies for prevention in “Preventing Violence in Developing Countries: A Framework for Action” include addressing behavioral and social drivers of violence, emphasizing building capacity for criminal justice and social welfare systems; as well as specific strategies for secondary and tertiary prevention such as engaging professionals from the health sector in efforts to monitor, identify, treat, and intervene in cases of interpersonal and self-directed violence; building and enhancing capacity for provision of social and health services to victims;