In 2002 the World Health Organization (WHO) released the "World Report on Violence and Health," which summarized worldwide statistics on interpersonal violence, as well as the health, social, and economic consequences of violence. Last month WHO issued an updated report on the topic, "Third Milestones of a Global Campaign for Violence Prevention 2007," and held an international meeting in Scotland to review the accomplishments and progress in member nations and formulate plans for scaling up WHO recommendations through international collaboration and initiatives.

The 2002 report estimated that 1.6 million people worldwide died as a result of self-inflicted, interpersonal, or collective violence. Over half of these deaths were suicides, and about one-third were homicides. The highest homicide rates were found in men aged 15 to 44 from low- and middle-income countries.

One of the main messages in the 2002 report was that violence causes significant public health as well as social and economical burdens and can affect the mental and physical well-being across people's life span. A 2004 WHO study, for example, estimated that the lifetime impact of child sexual abuse accounts for approximately 6 percent of depression, 6 percent of alcohol and drug abuse/dependence, 8 percent of suicide attempts, 10 percent of panic disorder, and 27 percent of post-traumatic stress disorder.

The 2007 report outlined the WHO's follow-up efforts since 2002 to raise awareness of the consequence of violence and the urgent need for more research and documentation on a national level, especially in low- and middle-income countries. A number of programs and initiatives have been implemented by governments' public health ministries, including the surveillance and publication of violence-related data and the impact of violence. The report specifically highlighted the national efforts undertaken in Brazil, Jamaica, Malaysia, Mexico, Mozambique, South Africa, and the United Kingdom.

In addition to publishing surveillance reports and tracking statistics, a number of countries have also adopted WHO guidelines and instituted national violence-prevention policies, according to this report. Outcome studies have confirmed the effectiveness of interventions such as parent training, conducting home visits to monitor children for maltreatment, reducing alcohol availability and access to firearms, and providing adequate emergency medical care.

The 2007 report calls for scaling up violence-prevention programs in more nations and on an international level from the many community-based programs, particularly greater investment by national governments to apply proven strategies and adopt global guidelines for large populations. More scientific research and evidence to evaluate the outcomes of community-based violence programs are critical to further guide efforts, especially in poor countries. The report emphasizes the need to enhance collaboration among different sectors and development agencies; among different regions and countries; and among United Nations agencies, nongovernmental organizations, and WHO.

The meeting, whose theme was "Milestones 2007," was the third in follow-up of the 2002 report and gathered experts, policymakers, and advocates involved in worldwide violence prevention. Two previous milestones meetings were convened in 2004 and 2005.

The report, "Third Milestones of a Global Campaign for Violence Prevention 2007," and information on the meeting can be accessed at<www.who.int/violence_injury_prevention/publications/violence/milestones_2007/en/index.html>. The 2002 report, "World Report on Violence and Health," is posted at<http://whqlibdoc.who.int/hq/2002/9241545615.pdf>.▪