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Steve Beerman "Keynote Immunization for Drowning" NDPA Symposium 2012


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Steve Beerman "Keynote Immunization for Drowning" NDPA Symposium 2012

  1. 1. 4/27/2012 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 1
  2. 2. 4/27/2012Objectives 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 2
  3. 3. 4/27/2012ILS is your link to the UN, WHO, IOC, UNICEF & UNOSDP 3
  4. 4. 4/27/2012ILS Members from the USA 4
  5. 5. 4/27/2012Goal #4 To reduce by two-thirds the mortality rate for children under 5 years old. 5
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  7. 7. 4/27/2012DROWNING IN ASIA 7
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  9. 9. 4/27/2012World 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. 9
  10. 10. 4/27/2012World 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 10
  11. 11. 4/27/2012Drowning is instantly fatal –most often 11
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  13. 13. 4/27/2012 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 13
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  18. 18. 4/27/2012Survival 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 18
  19. 19. 4/27/2012The 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 19
  20. 20. 4/27/2012Public Health Approach 20
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  22. 22. 4/27/2012 The Public Health ApproachTargeted InterventionsRegulation Fencing, water hazard reduction, safety equipment, facility regulation, lifeguardingPrimary Adult supervision Survival Swimming Skills Water safety educationSecondary Lifesaving rescue CPRTertiary ICU/Specialized care 22
  23. 23. 4/27/2012 ImmunizationsDisease preventionlifelong immunity preferredHerd immunityMortality reductionCost effectiveSafety 23
  24. 24. 4/27/2012World 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 24
  25. 25. 4/27/2012Survival 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 25
  26. 26. 4/27/2012 Immunization in the USAThe Role of Cost-Effectiveness in U.S. Vaccination PolicyJane 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. 26
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  33. 33. 4/27/2012Epidemiology Transformation = positive sustainable outcomes 33
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  35. 35. 4/27/2012 Drowning in SpainWHO 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 2008WHO data for Spain Road Traffic Accident 2003 5478 deaths 2008 2560 deathsWhen a public health approach becomes a priority forattention, funding and policy – deaths are preventable 35
  36. 36. 4/27/2012Take 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 36
  37. 37. 4/27/2012Compare 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) 37
  38. 38. 4/27/2012 Drowning Prevention – A Public Health Issue Take it to the next level1. 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 training2. Learn to apply a public health approach to aquatics to improve positioning, resources and outcomes3. Coordination, facilitation and learning with ILS, ILS Members and collaborative partners 38
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  40. 40. 4/27/2012Thank you 40