The Global Status Report on Violence Prevention 2014: Where to for the South African health sector?

[1] on 10 December 2014. The report reviews how governments around the world, including in South Africa (SA), are attempting to curb interpersonal violence. There is some good news in the report. In common with many other countries, SA's homicide rate has declined over the past decade: Across the five types of interpersonal violence assessed in the report – child maltreatment, youth violence, intimate partner violence, sexual violence and elder abuse – SA has national action plans for all but two, namely youth violence and elder abuse (and in these two cases, some provinces have action plans). But manifestly it is not all good news. Homicide levels in SA are fluctuating around 32/100 000, and over the past 4 years, the lowest level achieved was 30. Homicide is a robust indicator of the prevalence of other forms of violence, [3,4] so this demonstrates that SA is struggling to reduce violence below the horizon achieved in 2011/2012. That rate is in itself exceedingly high: in 2012, the African Region as a whole had a rate of 10.9/100 000, making SA one of the most lethally violent African countries for which data are available. This is a health sector issue for several reasons. First, the injuries and deaths caused by interpersonal violence place a considerable burden on the health sector. Second, evidence-based public health approaches to preventing violence are increasingly demonstrating their effectiveness. The Global Status Report on Violence Prevention addresses several key areas for violence prevention: action plans, laws and policies, prevention programmes and services for victims of violence, and data on violence, and the SA health sector has a role to play in each. There are two key policy-level public health interventions that are likely to reduce all forms of violence: limiting access to firearms and to alcohol. In terms of firearms control, SA has a comprehensive legal system in place to restrict firearm proliferation and misuse. However, recent experiences of trauma surgeons (A Nicol, A B van As, oral communication, 22 October 2014) and high-profile firearm murders suggest that firearm homicides are increasing after an initial drop. In March 2015, the SA parliament will initiate a national Firearm Summit to review the state of the country's firearm controls with a view to improving them. [7] This review will need evidence – evidence best obtained through injury surveillance in trauma centres and mortuaries. With the National Non-Natural Mortality Surveillance System …