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Immunization for Drowning Prevention -
The public health approach to save lives in the Asia and the USA
Dr Stephen Beerman BSc, BSR, MD, CCFP, FCFP
President, International Life Saving Federation
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Objectives
Highlights - World Conference on Drowning Prevention
Global Drowning Picture
Child Drowning in the USA
The Drowning Prevention Immunization
Taking drowning prevention to the next level
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ILS is your link to the UN, WHO, IOC, UNICEF & UNOSDP
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ILS Members from the USA
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Goal #4
To reduce by two-thirds the mortality
rate for children under 5 years old.
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DROWNING IN ASIA
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World Conference on Drowning Prevention
May 2011, Vietnam
Dr David Meddings – WHO , May 2011
Drowning is a major public health challenge
In areas where progress on infectious disease reduction
is large – drowning is unmasked
Continued progress on the Child Survival Agenda will
require LMIC nations to reduce drowning.
http://www.worldconferenceondrowningprevention2011.org
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World Conference on Drowning Prevention
May 2011, Vietnam
Dr. Michael Linnan, UNICEF/TASC /International Drowning
Research Centre – Dhaka, Bangladesh
The scale of the child drowning epidemic in Asia has been greatly
underestimated by the global public health community.
Due to methods of estimating drowning deaths
Need for population based data (Household Surveys)
Health system data sources are inaccurate
2 large drowning cohorts in LMIC nations of Asia
Under 5 (1-5) due to lack of adult supervision
Over 5 due to lack of survival swimming ability
Effective and cost efficient interventions are known
http://www.worldconferenceondrowningprevention2011.org
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Drowning is instantly fatal –most often
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What we know today – Drowning in Asia
Injury was overshadowed by other mortality causes
Drowning is under reported
Drowning accounts for ½ of all child injury deaths *
Toddlers 1-4 drowning >90% of injury deaths
Injury deaths as a proportion of all mortality will rise
>75% of the world’s children live in high risk nations
Academic debate of mortality burden -it is large!
Most drowning mortality is preventable!
Prevention interventions are effective
* Child Mortality and Injury Asia: UNICEF Innocenti
Research Centre
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Survival Swimming in High Resource Populations
Conclusions:
Participation in formal swimming lessons was
associated with an 88% reduction in the risk of
drowning in the 1- to 4-year-old children
Informal swimming lessons also reduced
Age 5-19 also showed benefit
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The need for a global alliance is high
Collaborative skill/resource mix is essential
ILS, WHO, UNICEF, TASC, and ILS Members, etc
Academic Public Health
Governments
Funding Partners/Investors
Effective Governance and Management Capacity
Accountability and scholarly approach needed
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Public Health Approach
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The Public Health Approach
Targeted Interventions
Regulation
Fencing, water hazard reduction, safety equipment, facility
regulation, lifeguarding
Primary
Adult supervision
Survival Swimming Skills
Water safety education
Secondary
Lifesaving rescue
CPR
Tertiary
ICU/Specialized care
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Immunizations
Disease prevention
lifelong immunity preferred
Herd immunity
Mortality reduction
Cost effective
Safety
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World Conference on Drowning Prevention
May 2011, Vietnam
Precise Child drowning Intervention Trial
(Bangladesh)
Under 5 – Adult Supervision via Creche/Daycare
Over 5 - Survival Swimming instruction in ponds
Very significant mortality reductions
Cheaper than all the usual immunizations
Life long immunity from drowning and other injury
Herd Immunity
Safely delivered in the project
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Survival Swimming Skills that save lives
There are minor variations of this around the world
Self - rescue
Fall into water
Stay on the surface for 30 seconds
Move forward for 20 meters in any manner
Water safety awareness
Rescue of others
Reaching and throwing
CPR
Can be achieved in few classes with trained instructor
Safety issues are critical to the success of this approach
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Immunization in the USA
The Role of Cost-Effectiveness in U.S. Vaccination Policy
Jane J. Kim, Ph.D.
N Engl J Med 2011; 365:1760-1761November 10, 2011
The public-sector cost of fully vaccinating one person
as recommended through adulthood (not including
annual influenza vaccines) is roughly $1,450 for males
and $1,800 for females.
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Epidemiology Transformation = positive sustainable outcomes
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Drowning in Spain
WHO data for Spain 2056 drown in 2008
Population of 44.6 million
Population under 15 yrs is 15%
Drowning Rate is 4.6 per 100,000 in 2008
WHO data for Spain Road Traffic Accident
2003 5478 deaths
2008 2560 deaths
When a public health approach becomes a priority for
attention, funding and policy – deaths are preventable
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Take drowning prevention to the next level
We need all players on the team
Survival Swimming Skills are an immunization against drowning
for life
cost effective
herd effect
It will reduce disaster mortality
Skills must be imbedded in your community before the disaster
All citizens must be empowered
Barriers exclude the highest risk populations
Work very hard for barrier free delivery
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Compare with Malaria
Global Burden of Malaria
Annual worldwide deaths due to malaria: 1.1 million
April 25 2008 UN Secretary General announced ‘ROLL
BACK MALARIA PARTNERSHIP’
BUDGET $3.6 BILLION ($1.7 BILLION FROM GATES
FOUNDATION = START-UP)
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Drowning Prevention – A Public Health Issue
Take it to the next level
1. Reduce drowning in your community via targeted and barrier free
programs
a) Statutory regulations and enforcement
b) Adult supervision and water safety
c) Survival swimming skills for every child
d) CPR training
2. Learn to apply a public health approach to aquatics to improve
positioning, resources and outcomes
3. Coordination, facilitation and learning with ILS, ILS Members and
collaborative partners
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Thank you
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