Vision zero in suicide prevention and suicide preventive methods

Abstract

The eradication of smallpox - the first and so far only human disease to be eradicated - generated a tremendous amount of excitement and attention to the idea of disease eradication and elimination. In the twentieth century alone, smallpox had claimed the lives of more than 300,000,000 people (Sneed A, Scientific American, 2014). The last natural case occurred in 1977, almost 200 years after the smallpox vaccine was discovered, and in 1979 the World Health Organization declared that the disease had been eradicated (WHO, Smallpox, World Health Organization. World Health Organization., 2019c). Most importantly, it demonstrated that eradication was possible; that through the use of science, we could change our future for the better in ways that we had not even dared to think about previously. This achievement also helped to focus attention on clear definitions of disease eradication and elimination. Since then, these definitions have been continuously evolving. In 1993, the International Task Force for Disease Eradication (ITFDE I) defined disease control, elimination, and eradication. With that, they evaluated over 90 potential infectious disease candidates and concluded that six were eradicable. Subsequently in 1997, the Dahlem Workshop focused on the science of eradication and defined a range of public health approaches to infectious diseases from control, to elimination of disease, elimination of infections, eradication, and extinction. Three years later, the second International Task Force for Disease Eradication (ITFDE II) convened in 2000 to review the progress over the past decade. Inspired by these efforts, we reviewed our own experience and interviewed leaders of several disease eradication and elimination campaigns to identify lessons learned from a variety of disease elimination campaigns including smallpox, polio, Guinea worm, and onchocerciasis. Our aim was to identify lessons that might be applied to road traffic injuries. We identified 12 lessons from these infectious disease campaigns: (1) this is a cause and effect world; (2) know the truth; (3) coalitions are absolutely essential and absolutely hard; (4) avoid certainty (the Achilles heel of science); (5) measure frequently and build in continuous improvement; (6) respect the culture and work with the people you are trying to help; (7) the best decisions are based on the best science, but the best results, on the best management; (8) the best solutions move us closer to global health equity; (9) do not underestimate the time, resources, or tenacity it will take succeed; (10) eradication does not always require a vaccine or a cure; (11) start in the most difficult places first; and (12) you don't begin at the end. These concepts from infectious disease campaigns have broader public health applications, and we discuss some of the implications for reducing road traffic injuries.