Around the globe health professionals and their institutions and networks are mobilizing their efforts to prevent and reduce violence. These actors bring unique resources, tools, and local knowledge, along with a nonpartisan public identity and worldwide networks, to the practical task of reducing violence in communities everywhere.

To date the Geneva Declaration has been adopted formally by 108 states, Luxemburg being the latest country to sign up. Commitment to the Geneva Declaration requires states to subscribe to measurable reductions in armed violence by 2015. It also means that states are expected to be transparent and open about the character and severity of armed violence within their borders.

Health professionals address armed violence at IPPNW 19th World Congress Basel, Switzerland

Over 700 medical professionals from over 50 countries gathered in Basel, Switzerland at International Physicians for the Prevention of Nuclear War’s (IPPNW) 19th World Congress on 27-29 August to address the health implications of nuclear and conventional wars and armed violence. Active members of IPPNW’s Aiming for Prevention (AfP) program, dedicated to reducing injuries and death from armed violence, held a number of sessions to educate on issues and develop strategies to build additional capacity for the AfP work worldwide. In particular, to respond to the Geneva Declaration (GD) call for measuring and monitoring of injuries and deaths from gun violence, and to create practical programmes on the ground, where the difference is made in terms of lives and livelihoods. And, for translating data into health promoting policy initiatives. A plenary session was led off by a showing of the film Faces of Violence developed by colleagues of the GD, followed by a keynote by Kidist Bartolomeos of the World Health Organization (WHO) who outlined the need for medical community involvement as a key civil society player in armed violence prevention. See the World Congress website.

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Arms expenditures and MDGs included at UN DPI conference Melbourne

Health was the highlight at the 63rd Annual UN DPI/NGO Conference "Advance Global Health: achieve the MDGs”, in Melbourne Australia 30 August to 1 September, and physicians worked to include the cost of armed violence as a health issue. The final conference Declaration, supported by 1,600 participants representing over 350 NGOs from more than 70 countries, underlines that “it is unacceptable that so many children and adults in low income countries continue to suffer preventable illness, disability and premature deaths each year.” IPPNW’s Cathey Falvo, MD, MPH (USA) was on the planning committee for the meeting. She was an author of the conference declaration and moderated one of the roundtables: Equity, Rights and Progress Toward the MDGs. Dr. Sue Wareham, Medical Association for Prevention of War (MAPW, IPPNW/Australia) was a panelist on the closing roundtable and clearly articulated the connection between military spending and the lack of progress in achieving the MDGs, a point infrequently emphasized during the conference. Due to physician efforts, this point was taken up in the final Declaration that called for the donor community to “cut military expenditures, which will free up resources that can be used for the training and retraining health workers, teachers, and infrastructure.” See the conference proceedings for a copy of the NGO statement and other material.

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Violence a Theme at Safety 2010, London

Violence prevention was a theme that ran throughout all the sessions at the recent four-day 10th World Conference on Injury Prevention and Safety Promotion or “Safety 2010” held in London, September 21-24. Safety 2010 is the major conference to bring stakeholders in the prevention of unintentional injuries and violence from around the world to debate, discuss and exchange information and experiences. The event is co-sponsored by the WHO. The key theme of this year’s conference was “Safe and Equitable Communities.” This theme has been chosen to reflect the disproportionate burden from almost all types of injuries that falls on poorer communities within countries, between countries and even between global regions. The conference programme included numerous oral presentations, scientific posters, and side meetings from around the world on armed violence, ranging from the economic costs of violence to personal stories of victims of domestic violence, national homicide statistics to a new call for intersectoral alliances between criminal justice and health sectors, injury surveillance techniques in Africa to sexual violence in Thailand. The Geneva Declaration secretariat had an exhibit table that was well attended. The film Faces of Violence developed by colleagues of the GD was shown at special film and photography sessions on several days during the program. Abstracts to all the presentations can be found at Injury Prevention journal website. Get information on the next conference Safety 2011, New Zealand 1-5 October 2012.

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Global Response 2010 – experts addressing violent conflict and health

To bring together all actors involved in the prevention and management of the health consequences of violent conflict, the Global Response 2010 process initiated a series of activities, including this conference at the University of Copenhagen that brought 150 experts representing leading academic institutions, civil society organizations and the UN including Harvard, Yale, Oxford universities, UNHCR and WHO, IPPNW, Red Cross, Doctors without Borders and many others. together. The Global Response process focused on three parallel themes: 1) Common causes of and links between violent conflict and ill health; 2) Documentation of health consequences of violent conflict; 3) The role of the health sector and health workers before, during and after violent conflicts. The Global Response event in Copenhagen was organized in by Global Doctors in collaboration with, among others, the University of Copenhagen, the Danish affiliate of IPPNW, the Medical Peace Work Project and the Danish Medical Association. Conference proceedings have been published in a final report and conclusions of presentations and working groups are being synthesized for publication. See the conference report.

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The MDG Review Summit and armed violence reduction

Civil society organizations and interested states have worked since the Oslo Conference on Armed Violence (May 2010) to ensure that armed violence reduction strategies and programs would be promoted through the process leading to the Millennium Development Goals (MDG) Review Summit. A number of these organizations were in New York for the Summit itself (20-22 September 2010) to follow closely the emerging debate around the MDGs. The Summit also provided the opportunity to organize a specific side event, “Achieving the MDGs: Addressing Conflict, Fragility and Armed Violence,” at which high-level representatives from affected states and key international organizations debated the impact of conflict on development and highlighted the need to tackle the broader issue of armed violence as a whole.

The results of these efforts were mixed. Although armed violence was not mentioned in the action plan of the Outcome Document adopted during the Summit, some 64 states, in their official statements at the Summit, mentioned peace and security, armed violence or conflict and fragility as key elements hindering the successful implementation of the MDGs. Following up, civil society organizations and government members of the GD Core Group will meet later this year to agree on strategies that will build on the outcomes of the Summit and continue its commitment towards effective reduction of the impact of armed violence on development. See a copy of the Summit Outcome Document.

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A central pillar of solid advocacy and programming is evidence. Good evidence is based on solid research. The Geneva Declaration process is committed to supporting national and local-level research to inform interventions, but also to promote awareness and understanding of the risks and dangers posed by armed violence and underdevelopment. The following are examples of innovative and path-breaking research that shed light on the interconnections of armed violence and development.

USA: Report on life expectancy and gun violence in New York

Gun violence in New York contributes to an increased gender gap in life expectancy, according to a report from the city's health department. It finds that New York men are significantly more likely than women to die before the age of 65. It concludes that a major contributory factor is the rate of gun-related homicides; half of all homicide victims in the city are men aged 18 to 34, out of which about 75% were killed by guns. In a comment on the report, a journalist commented that “Each murder represents an individual tragedy. But from a cold statistical analysis, the city as a whole suffers….The homicide rate is especially startling among black men ages 18 to 34. The health department puts it at 3 times that of Latino men, 12 times that of white men and 70 times that of men of Asian background. So one sure way to increase life expectancy for young men — among blacks more than anyone else — is to persuade them to drop their guns. See the original article.

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The Mortuary as a Source Of Injury Data: Progress Towards A Mortuary Data Guideline for Fatal Injury Surveillance

Preliminary information for pilot testing a new mortuary data form to better document the context of deaths in low to middle income countries was presented in several sessions at Safety 2010, including by WHO and also representatives from the Global Burden of Disease. Injury is a substantial and preventable public health problem accounting for 10% of deaths worldwide, of which 90% are estimated to occur in low and middle income countries (LMICs). To help bridge the obstacle of inadequate data in LMICs a simple cost effective system for mortuary surveillance of fatal injuries is being developed in consultation with the WHO. This will inform, direct and monitor injury prevention interventions and policies in LMICs. There are many challenges to the establishment of an international guideline for mortuary data surveillance, as outlined here. See abstracts for 1506 Safety 2010. (N Grills, J Ozanne-Smith*, K Bartolomeos Correspondence: Department of Epidemiology and Preventative Medicine, Monash University, Victorian Institute of Forenic Medicine, 6/157 Kent Street, Ascot Vale 3032, Australia)

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Injury surveillance in Africa: update from the Global Burden of Disease Injury Subgroup

A meeting of the Global Burden of Disease (GBD) project in Africa was held in Swansea (Abertawe in Welsh), a coastal city in Wales, United Kingdom on September 17 and 18 of this year. This project aims to improve estimates of the burden of injuries in sub-Saharan Africa and develop national and regional estimates of the burden of injuries in sub-Saharan Africa from all available country data sources. At the meeting results from six participating African countries were presented (Sudan, Ghana, Nigeria, Uganda, Mozambique, Ethiopia). The project is led by the Department of Global Health and Population, Harvard School of Public Health and funded by a grant from the World Bank Global Road Safety Facility. See the website for more details.

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Health Cost Assessment of Firearm Injuries At Kenyatta National Hospital In Nairobi, Kenya

Firearms are among the leading instruments used in the perpetration of violence and injury. Proliferation and abuse of small arms and light weapons has been the major culprit in the East and Central Africa region. This study analyzes the direct costs incurred by patients treated at the Kenyatta National Hospital (KNH) for firearm injuries. This was a 10 year hospital based descriptive retrospective study conducted at the largest Teaching and Referral Hospital in the region. This study was conducted by the authors on behalf of the Institute for Security Studies (ISS). See: Abstract 0234, Safety 2010. (W A Odhiambo, A Muchai, P Njuguna, G Lamb, D Domnique Correspondence: College of Health Sciences, University of Nairobi/Institute for Security Studies, P.O. Box 21253, Nairobi, Kenya)

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Geographic Distribution of Risk of death due to homicide in Puerto Rico, 2000-2007

The use of firearms is the most common method for committing homicides in Puerto Rico. At any given year, the proportion of homicides using firearms is at least 80%. The geographical distribution of the average lifetime cumulative risk of homicide deaths for the eight year period was shown for the 78 municipalities of Puerto Rico, of which 34 reported less than 20 cases in the eight-year period of analysis (43.6%). For these municipalities no cumulative rate or risk was calculated. Of the eleven municipalities in the highest quartile (shown in red color), nine are located in the Northeast region of Puerto Rico where metropolitan San Juan is located (San Juan, Cataño, Toa Baja, Carolina, Loiza, Canovanas, Gurabo, Luquillo and Fajardo). The lifetime risk of homicide death in these municipalities varies from 1 in 18 to 1 in 64 residents. (Reference: “Geographic Distribution of Risk of death due to homicide in Puerto Rico, 2000-2007,” Zavala, DE, Orengo JR, Charneco ML, Concha-Eastman A. Injury Prevention. September 2010. Vol.16, Supplement No. 1. p A40.)

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The Geneva Declaration process encourages all UN member states and NGOs to adopt a proactive and comprehensive approach to armed violence prevention and reduction on the ground. Fortunately, there are literally thousands of efforts underway around the world that aim to reduce violence. Many of these explicitly draw on “developmental” approaches to day-to-day violence. The selection included below only scrape the surface of what is going on every day in affected communities. To encourage learning and to improve practice, the Geneva Declaration Core Group is supporting a number of “focus countries” plan, design, implement and evaluate violence reduction activities. Information on these activities is available at the Geneva Declaration website.

Nigeria: Bringing Peace and Health via independent radio

Radio is the predominant source of news and information for the African public. Studies have pointed to high rates of illiteracy, the importance of oral tradition, and the costs of other media as contributing to a reliance on radio — particularly community radio — as the medium of choice. Few people can afford to buy a daily newspaper, but nearly everyone has access to a radio receiver. In Nigeria, where radio is largely controlled by state broadcasters, there is a particular need to develop community radio stations and worthwhile content to broadcast. The power of radio in Africa has not always been used for the good. The 1994 Rwanda genocide was orchestrated in significant ways through inflammatory radio broadcasts. Since then, UN agencies and NGOs have worked to ensure that the radio waves are used for community development, education, and violence prevention. Medical student members of Society of Nigerian Doctors for the Welfare of Mankind (IPPNW /Nigeria), launched a limited radio series “Bringing Peace to the People” on Silverbird Rhythm FM 93.7 radio, Jos, Nigeria, a city that has seen repeated armed violence. It was designed to educate about heath effects of violence, and inspire people to work for peace in Nigeria, especially youths. SNDWM collaborates with other civil society groups to promote a culture of peace. Silverbird Rhythm 93.7 has a wide audience, especially among Nigerian youth. "Bringing Peace to the People" is one of the first attempts to use radio in Nigeria for community benefit. This project is seeking funding to continue. Contact: Dr. Ogebe Onazi at ogebe.o@gmail.com, also see www.ippnw.org for additional information.

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USA: Urban Networks to Increase Thriving Youth

Urban Networks to Increase thriving Youth (UNITY), a project of the US-based Prevention Institute, is designed to strengthen and support cities in preventing violence before it occurs and to help sustain these efforts. Young people are severely impacted by violence and those who live in urban areas are disproportionately affected. It is time to consider a new approach. To maximize existing resources and promote sustainability, UNITY is proposing a paradigm shift—from programs to strategy. Many cities do not have a collaborative plan or a clear strategy for preventing violence before it occurs. They need help to more effectively prevent violence and improve the lives of young people in our cities. Others are well underway and can share their successes and further strengthen their efforts. All of them need effective policies and resources at the federal level to reinforce and sustain their priorities. UNITY has been envisioned to help. It is supported by the US Centers for Disease Control and Prevention. See the website.

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International: Safe Communities Network

The Safe Communities concept began its formal existence at the First World Conference on Accident and Injury Prevention held in Stockholm, Sweden in September 1989. The Manifesto for Safe Communities, the resolution of the conference, states that "All human beings have an equal right to health and safety." This is a fundamental aspect of the World Health Organization’s (WHO) Health for All strategy and for the WHO Global Programme on Accident Prevention and Injury Control. This premise has led to community action around the world; actions leading to Safe Communities. The Safe Community initiative differs in comparison to other injury prevention programs. In the former, the leading role is played by the community itself. The term Safe Community implies that the community aspires to safety in a structured approach, not that the community is already perfectly safe. Creative methods of education and environmental change joined with appropriate legislation and enforcement are an important beginning for the safety of a community. No single approach is sufficient for changing existing behavior patterns. The media, for example, can be a very powerful tool in heightening public awareness. Programs to prevent and control injuries and accidents must identify and characterize the injury problem and evaluate the effectiveness of injury control interventions. Though epidemiology is not the soul of the safe communities concept, the vital importance of it must be respected. The Karolinska Institute in Sweden is the WHO Collaborating Center that coordinates the Safe Communities Network. More information.

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Control Arms, ATT and the ATT public health message

The Control Arms campaign, organized by Amnesty International, Oxfam and IANSA, recently restructured its Steering Board (CACSB) and it now represents health professionals and is working to incorporate a public health approach along with a human rights message into its statements and actions. Since 2003, the Control Arms Campaign has been calling for a strong and effective Arms Trade Treaty (ATT), a legally binding international instrument, which will draw together and consolidate states’ current obligations under international law. If properly implemented, such an ATT would reduce the human cost associated with the proliferation of conventional arms. It would prevent unscrupulous arms suppliers finding the weakest point in the supply chain, and ensure that all arms exporters and importers are abiding by the same high standards regarding the use, management and transfer of arms, leading to a more secure world. The idea of a global ATT was inspired by Nobel Peace Laureates and developed by lawyers, human rights organizations, and humanitarian NGOs. It now enjoys the support of a growing number of governments (153 States), as well as more than 800 civil society organizations worldwide. Members of the CACSB have been active over the past months at the United Nations First Committee and other meetings addressing the ATT. See the ATT website.

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Intersectoral Action on Public Health and Criminal Justice

The WHO’s Violence Prevention Alliance (VPA) Criminal Justice Liaison Working Group issued an invitation to Intersectoral Action between Public Health and Criminal Justice at a special meeting held at Safety 2010. The invitation was a call for collaboration, partnerships, demonstration projects and engagement of key decision makers by these two sectors in all parts of the world to help stem the tide of violence. The invitation states that “Violence is not an intractable social problem, nor is it an inevitable part of the human condition. We can do much to prevent and address it. The largest part of the burden of violence falls upon the law enforcement/criminal justice and health sectors. Enhanced collaboration between these sectors could make a critical contribution towards reducing the violence…” For more information and to join in this effort: Contact: Detective Chief Superintendent John Carnochan, Violence Reduction Unit (VRU) within the Strathclyde Police force, Glasgow, Scotland john.carnochan@strathclyde.pnn.police.uk or see the Action on Violence site or the VPA site.

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For more publications, also consult the Geneva Declaration website.

Medicine, Conflict and Survival

Medicine, Conflict and Survival is an international journal for all those interested in health aspects of violence and human rights. It covers: The causes and consequences of war and group violence; the health and environmental effects of war and preparations for war, especially from nuclear, radiological, chemical and biological weapons of mass destruction; the influence of war and preparations for war on health and welfare services and the distribution of global resources; abuse of human rights, its occurrence, causes and consequences; ethical responsibility of health professionals in relation to war, social violence and human rights abuses; non-violent methods of conflict resolution; medical and humanitarian aid in conflict situations; relationships between the environment, development and global security; the roles and responsibilities of governments and of international governance in reducing the risk of violent conflict. See the website.

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Preventing intimate partner and sexual violence against women

Intimate partner violence and sexual violence are significant global health problems and human rights issues. As part of the Global Campaign for Violence Prevention, WHO is giving increased attention to the primary prevention of intimate partner violence and sexual violence. Preventing intimate partner and sexual violence against women: taking action and generating evidence is an important new tool for violence prevention researchers, practitioners and advocates provides a planning framework for developing policies and programmes for the prevention of intimate partner and sexual violence. This guide outlines the nature, magnitude, risks and consequences of intimate partner and sexual violence. It outlines strategies to prevent these forms of violence against women and describes how these can be tailored to the needs, capacities and resources of particular settings. It also emphasizes the importance of integrating scientific evaluation into all prevention activities in order to expand current knowledge of what works. It outlines strategies to prevent these forms of violence against women and presents a six-step framework for planning, implementing and evaluating prevention policies and programmes. WHO developed this in partnership with the London School of Hygiene and Tropical Medicine. See the WHO website.

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War and Public Health, revised edition

As the first comprehensive examination of the relationship between war and public health, this book documents the public health consequences of war and describes what health professionals can do to minimize these consequences and even help prevent war altogether. It includes discussions on the human consequences of war, economic sanctions, consequences of nuclear weapons production and testing, chemical and biological weapons, bioterrorism, development of the "Culture of Peace" and more. The editors state that they would like this book to not only illuminate the consequences of war, but to inspire health professionals to work for sustainable peace and nonviolent approaches to conflict resolution, and to work to free resources used for war to apply to important health initiatives. Editors Barry S. Levy MD MPH and Victor Sidel MD. Oxford University Press.

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New online TEACH-VIP (Violence and Injury Prevention) course

TEACH-VIP E-Learning, a free resource designed by WHO and EDC, is an online self-paced curriculum in violence and injury prevention, designed for health and public professionals and other health care providers; staff of public health ministries and non-governmental organizations; and students in schools of medicine, nursing, and public health. TEACH-VIP E-Learning addresses a broad range of issues pertinent to understanding and preventing injuries, violence, and suicide. It includes extensive content on using data to understanding injury problems and creating programmes to address these problems. Learners can choose from 20 lessons to create an experience appropriate to their needs and schedule. Each lesson can be completed in approximately one hour - although optional activities and readings are available that can add to the time needed to finish a lesson. See the website.

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Need for More information: Do you want to share information about activities that are ongoing in your country? Do you have any relevant publications that show the connections between armed violence prevention and reduction with development? If you have some information about successful projects—previous or ongoing—that you think would be relevant, please share them with our readers. To contact the editor, send an email to newsletter@genevadeclaration.org.

This newsletter is edited and distributed by the Quaker United Nations Office (QUNO) in Geneva in order to build awareness on issues relating to development and armed violence and to increase engagement with the Geneva Declaration process. QUNO is mandated by the Geneva Declaration Core Group of states to inform civil society about the Geneva Declaration process.