Vision

- Lifesaving care at the scene
- Timely treatment of injuries 
- Restoration of function and independence

GACI’s vision is to provide guidance and support to governments to significantly improve care of the injured in a sustainable and affordable manner through systematic provision of essential trauma services. These services should be available to every injured person in any location without regard to their personal characteristics or ability to pay. 

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The injured need care. Now.

Every year, over five million people die from road traffic crashes, violence, and other causes of injury. Millions more suffer lifelong disability and lost economic productivity. Injury accounts for 11% of the total global burden of disease. By far the greatest part of the burden of death and disability from injury, approximately 90%, occurs in low- and middle-income countries.

Preventing injuries is very important, but improving access and quality of trauma care can also reduce this burden significantly. Gross disparities in outcome of injury exist between low- and middle-income countries and high-income countries. For example, people with life-threatening but survivable injuries are six times more likely to die in a low-income setting (36% mortality) than in a high-income setting (6% mortality).

In an effort to diminish such inequalities and to improve care of the injured globally, WHO has taken several steps. WHO has published guidance documents on technical aspects of planning prehospital and hospital-based trauma care services. WHO has also provided on-the-ground assistance to many ministries of health on implementation of these guidance documents. However, much more remains to be done.

We can save 2 million lives each year.

What is needed is strengthening of trauma care systems, including prehospital care and transport, initial care in emergency departments, definitive hospital-based care, and long-term rehabilitation back to active life. Across all of these points of the spectrum, there is a need for greater attention to detail in planning human resources (staffing and training), physical resources (equipment and supplies), and administration (such as quality improvement programmes). Such improvements could save the lives of 2 million injured people each year.

In order to promote these improvements, government leaders adopted World Health Assembly resolution 60.22 in 2007 to strengthen the provision of trauma and emergency care services globally. The momentum was carried forward and in October 2009, over 100 leaders in trauma care from 39 countries converged in Rio de Janeiro, Brazil to develop recommendations to promote improved services for the care of the injured.  

Trauma system development

Long-term goals

• Encourage improvements in trauma care by promoting trauma system planning, development and monitoring at the country level.
• Promote best practices and policy-level changes for system-wide improvements in care of the injured.

Next steps

• Develop a road map document that contains a description of the elements of trauma systems, which are globally applicable; along with a rating system for each element.
• Develop an assessment guide on how the road map document can be used for both external and internal assessment of the status of trauma systems and for identification of next steps in trauma system development.

Evidence and research

Long-term goals

• Facilitate an up-to-date evidence base that relates directly to the goals of GACI and set an agenda to promote research to address the most important evidence gaps.

Next steps

• Document success stories that are examples of what has worked in advancing trauma systems in different settings globally.
• Develop a list of relevant evidence resources.
• Engage with international research consortia to identify the most important knowledge gaps.

Trauma registry and data

Long-term goals

• Promote wider and more standardized collection of data for injury surveillance and trauma care quality improvement.

Next steps

• Establish a minimum dataset to facilitate trauma registry implementation.
• Compile case studies of good practice in establishing trauma registries globally.

Education and capacity building

Long-term goals

• Identify gaps in current capacity and promote training to address these gaps.
• Share information, experiences, and expertise through development of technical partnerships and other collaborative projects, including exchange visits and direct support to countries.

Next steps

• Develop institutional twinning and individual mentorship programmes that would benefit developing trauma systems, in similar to fashion to the existing Mentor-VIP programme.
• Undertake courses on trauma system planning and on trauma quality improvement at the request of countries and regions.

Advocacy

Long-term goals

• Encourage increased attention and resource allocation for trauma care through advocacy efforts that will ultimately lead to increased access to essential trauma care services for all injured persons globally.

Next steps

• Develop an aspirational statement to guide advocacy efforts.
• Develop advocacy materials to promote GACI’s goals.

Other Participant Activities

Australia-India Trauma Systems Collaboration

Formal trauma systems have proven effective in lowering injury-related death and disability in high income countries, where expensive and complex care structures have evolved. There is, however, little data relevant to limited resource settings where over ninety percent of the world's injured are managed in quite different conditions.

Established with $2.6 million support from the Australia-India Strategic Research Fund Grand Challenge Scheme, the Australia-India Trauma Systems Collaboration (AITSC) brings together clinicians and researchers within the WHO Global Alliance for Care of the Injured, with university, government and industry partners. AITSC aims to develop and test innovative pre-hospital, hospital and post-hospital interventions that could improve care of the injured in countries at all levels of development. Examples include establishing mechanisms and protocols for field communication between pre-hospital care providers and receiving hospitals; telehealth technology allowing metropolitan and rural centres to connect with specialist trauma hospitals for real-time advice; trauma quality improvement training programs; and tailored home- and facility-based rehabilitation prescriptions to improve long-term recovery.

Led by the Australian National Trauma Research Institute, a partnership between The Alfred Hospital and Monash University in Melbourne, and the JPN Apex Trauma Centre at the All India Institute of Medical Sciences in Delhi, the AITSC engages Australian, Indian and international partner organizations from around the world.   

Australia-India Trauma Systems Collaboration (AITSC)