The 15th World Conference on Injury Prevention and Safety Promotion (Safety 2024) was held between 2nd-4th September 2024 at Taj Palace, New Delhi, India. The conference concluded with 16-Point Delhi Declaration.
We, the participants of the 15th World Conference on Injury Prevention and Safety Promotion convened in Delhi, India, hereby reaffirm our commitment to addressing the pressing global challenges of injuries and violence, while emphasising the principles of equity, accountability, and environmental sustainability.
Injuries and violence are a profound global inequity, with over 90% of the burden borne by low- and middle-income countries. Within these countries, those facing the greatest socio-economic disadvantage are most at risk.
We, the delegates of this conference, stand united in the face of this ongoing crisis. Every year, injuries and violence claim 4.4 million lives, disrupt countless families, and leave millions more suffering from non-fatal injuries with long-term consequences. Progress in some regions remains stagnant, making the need for immediate action even more pressing.
The human cost is staggering, with young people aged 5-29 years disproportionately affected, with injuries ranking among the top five causes of death in this age group. Beyond the tragic loss of life, the economic costs are devastating, draining billions from national economies.
However, we refuse to accept this reality. Recognising the need for urgent, coordinated, and sustained preventative action, we declare the following:
1. Equity
The persistent disparities observed in injury, and violence prevention and safety promotion, are faced both globally, nationally, and, within regions. Differential exposure, risk, and recovery outcomes are well acknowledged in the injury literature. Complex social determinants of health, including an individual’s socio-economic and health status, race, ethnicity, rurality, gender, and age, compound the inequities in rates of injury, violence, and lived experiences. Vulnerabilities, determined by physical, social, economic, and environmental factors increase the susceptibility of a community to the impact of hazards. Inequities are also evident in response to insufficient resources, poor infrastructure, capacity, and financial resources, as well as inequitable representation of stakeholders as key determinants. These persistent disparities present a global challenge with significant social, political, and economic implications. We commit to prioritise equity in injury and violence prevention policies by incorporating diverse voices, adopting an intersectional lens, and focussing on dismantling systems that create or perpetuate disparities. We hereby declare the following:
1.1 Co-designing and community-centering: We acknowledge the importance of engaging local communities in identifying injury and violence priorities and understanding risk factors through participatory research and citizen science approaches. We emphasise co-designing culturally appropriate interventions that resonate with diverse populations and address the systems that create the disparities. Additionally, we encourage partnerships with community-based organisations, NGOs, and grassroots movements to mobilise local resources effectively, address local injury prevention needs, guaranteeing policies that are culturally sensitive and attuned to the diverse needs of all populations.
1.2 Mobilising resources for all and strengthening capacity for multi-sectoral action: We advocate for national and international investment that matches the scale of the challenge. We emphasise the need for resources to be directed to multisectoral responses that address significant infrastructural and capacity- strengthening challenges. Additionally, exploring innovative financing mechanisms while promoting cost-effective analyses will further strengthen the economic and social case for this crucial investment.
1.3 Engaging Ethical research and knowledge dissemination: To advance injury and violence prevention, we must prioritise fostering diverse leadership, promoting open access to knowledge, and respecting the unique needs and perspectives of vulnerable populations.
1.4 Driving Policy advocacy and implementation support: It is essential to identify and implement multisectoral responses, particularly in view of our commitment to Universal Health Coverage and Health in All Policies. We advocate for policies that acknowledge and respond to injury and violence prevention. Effective implementation includes influencing transport, housing and urban planning, education, agriculture, finance, taxation, and economic development that promote overall safety.
2. Accountability
The optimisation of global resources is critical for achieving sustainable social and economic development, which requires diverting a significant portion of current expenditures from fossil fuel subsidies, armed conflict, and the implementation of wealth taxes. A genuine policy promoting independence, peace, détente, and disarmament would liberate substantial resources that could be redirected toward peaceful endeavours. We hold ourselves accountable for performance towards our commitments stated below, and advocate for political and financial accountability for safer communities.
2.1 Calling for robust evidence to guide resource allocation: We call upon governments, funders, academia, and policy think tanks to invest in generating robust cost-benefit and cost-effectiveness analyses that support the implementation of known effective solutions across key areas of injury and violence prevention.
2.2 Addressing the Undeniable influence of commercial determinants on injury and violence prevention: We acknowledge the influence of commercial interests, including marketing, advertising, and product design on patterns of injury and violence. We commit to advocating for policies and regulations that prioritise public health over commercial interests, promote product safety and accountability, and reduce exposure to harmful substances and hazards. Moreover, we recognize that commercial and political determinants play a crucial role in shaping injury and violence prevention outcomes. Peace and a commitment to opposing wars and conflicts are integral to both violence and injury prevention.
2.3 Committing to global health and development agendas: We pledge to uphold transparency in our actions and initiatives within the scope of the SDGs, Decade of Action for Road Safety, Decade of Action for Healthy Aging, and the Convention on the Elimination of All Forms of Discrimination against Women. We acknowledge our obligation to align with the SDG targets related to health and well-being, including those specific to injury prevention and safety promotion.
2.4 Accountability through equity-focused indicators: We advocate for the use of equity-focused indicators and metrics to track progress towards reducing disparities in injury and violence rates and ensuring that interventions reach the most marginalised and underserved populations.
2.5 Citizen scrutiny, engagement, and monitoring: We embrace citizen scrutiny and engagement as essential components of accountability. We commit to fostering mechanisms for public monitoring and feedback, enabling transparency and responsiveness in our injury prevention efforts.
2.6 Addressing financial asymmetries: We acknowledge and seek to rectify asymmetries in financial assets that contribute to disparities in injury and violence risk and access to preventive measures. We support initiatives such as the Green Climate Fund and the establishment of a Loss and Damage Fund to address climate-related health impacts, including those related to injury and violence.
2.7 Establishing a Research commission with climate justice perspective: Furthermore, we call for the establishment of a global research commission fostered by a multi-stakeholder partnership of governments, research institutions, and philanthropic foundations dedicated to studying the issues of injury and violence through an equity and social justice lens, specifically integrating a climate justice perspective.
3. Environmental Sustainability
The relationship between climate change and injuries and violence remains complex and is not fully understood. As mobility patterns shift, water-related disasters increase, climate-induced migration stressors emerge, the burden of injuries and violence is poised to increase. To address this, proactive mitigation strategies must consider environmental sustainability and the creation of safe, resilient systems. Additionally, secondary effects of climate change such as drought, sea level rise, and displacement indirectly impact the rate of injuries and violence, including drowning, occupational injuries, interpersonal violence, and self-harm. Recognising these intersections is critical for effective injury prevention within the context of climate health agendas.
3.1 Fostering partnerships across Global health agendas: Recognising the interconnected nature of global challenges, we advocate for the integration of injury and violence prevention into health agendas. By advocating for this integration into key global fora, we aim to raise awareness, shape policies, and garner support for comprehensive interventions that prioritise the reduction of injuries and violence and promote safety on a global scale.
3.2 Integrating Injury prevention in climate health agendas: We advocate for climate health agendas to be inclusive of injury and violence prevention strategies to mitigate heat-related injuries, enhance disaster preparedness and response systems, promote the safety of coastal and small island communities, and protect agricultural workers from extreme weather conditions and the impact of population displacement.
3.3 Decarbonising the research and trauma care sector: Acknowledging the interconnectedness of injury and violence prevention and environmental sustainability, we advocate for the adoption of environmentally friendly research activities, and interventions within the field of injury and violence prevention. This includes promoting sustainable practices in research methodologies, reducing the carbon footprint of trauma care facilities, and encouraging the use of renewable energy sources.
3.4 Embedding climate resilience in injury and violence prevention frameworks: Embedding climate resilience within injury and violence prevention frameworks. This requires fortifying policy and infrastructure to safeguard communities, empowering them through enhanced education and resilience building, and fostering cross-sector collaboration. By implementing these measures, we can effectively mitigate the health impacts of climate-induced stress and minimise injuries and violence in the face of escalating climate-related disasters.
3.5 Recognising children as active agents in climate change adaptation: We advocate for child and youth participation, including those from marginalised groups, in decision-making processes related to climate change and injury and violence prevention plans. We acknowledge their unique perspectives and capabilities, and their right to an active voice on issues and decisions that affect them.
The urgent commitment of the 2030 Agenda and Sustainable Development Goals (SDGs) to ‘leave no one behind’ and ‘reach the most vulnerable first’ is paramount in the context of injury and violence prevention.
