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Health

The World Is A Safer Place — Except Where It's Not

And now, some heartening news in the global health world: Injuries are down by a pretty big chunk.

"Injury" in this case encompasses everything from car accidents and falls to suicides and gunshot wounds. Since 1990, the world has managed to cut down the number deaths and disabilities caused by all these factors by a third, according to a report published Thursday in the British Medical Journal.

"As for what has brought about this change, we can only speculate," says Theo Vos, a professor of global health at the University of Washington and the report's senior author. "For example, we've seen a huge decline in suicide in China, whereas in India that is not the case." Going forward, researchers will have to dig beyond the statistics to figure out why some countries are doing better than others.

But while the stats look good overall, he says, "there are a number of parts of the world that are lagging behind," Vos says. In many developing countries, road accidents are up — especially in parts of South America, sub-Saharan Africa and South Asia. In South Africa, for example, over 13,000 people died in road accidents in 2010.

That's likely because more people in the developing world are moving into cities and frequenting not-so-safe city roads, Vos says. "It's true that cars are probably safer today than they were 20, 30 years ago," he notes. "But maybe some of these countries in southern Africa, West Africa and South America need to see what they can do to improve road safety."

To do that, countries that are lagging behind need to look to places like Sao Paolo, Brazil. says Claudia Adriazola, who researches urban transportation and road safety at the World Resources Institute. The city's mayor has reduced speed limits across the city and added more sidewalks and bike lanes. "Maybe more cities can start doing similar things," she says.

And maybe global health organizations can start thinking differently about how they allocate their funds. Dollars traditionally go to combating infectious diseases like AIDS and Ebola. But improving road safety as well as emergency medical care is also critical, says Michael Haglund, a neurosurgeon at Duke University who has been helping train surgeons in East Africa.

"I totally get that some of these developing countries have to first take care of things like malaria, tuberculosis and HIV," Haglund says. "But now we're starting to reign in some of those infectious diseases."

If developing countries started allocating a fraction of what they spend trying to contain and cure those diseases into improving surgical care, Haglund notes, they'd be able to reduce the number of preventable deaths from car accidents, falls and other common injuries.

"Once you're injured, if you're in the U.S. you're probably in the emergency room right away, within minutes," Haglund says. "Imagine you get injured in northern Uganda and it takes 12 hours to get to the nearest hospital for surgery. A simple neck fracture or a blood clot can easily be fixed, but only if you're able to treat it quickly."

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