Driving an agenda for preventing drowning in the Western Pacific region

Drowning is a global concern, yet almost a third of the world’s 236,000 drowning deaths in 2019, occurred in the Western Pacific.1World Health OrganizationRegional status report on drowning in the Western Pacific.2021Google Scholar Considering the region’s geography, the pervasiveness of water transport and frequency of disaster-related risk, the true scale of drowning in the Western Pacific region is likely to be even greater. Given this significant, yet preventable drowning burden, there is an urgent need to enhance the evidence around effective interventions across the region and expand their implementation and evaluation. This year represents the tenth year since WHO released the first Global Report on Drowning,2World Health OrganizationGlobal report on drowning: preventing a leading killer.2014Google Scholar which highlighted drowning as a neglected public health issue. The report outlined ten actions to prevent drowning globally, which were followed by seven key recommendations that were refined for the Western Pacific context (Panel 1).1World Health OrganizationRegional status report on drowning in the Western Pacific.2021Google Scholar Below we discuss these Western Pacific recommendations and highlight exemplars and opportunities within the region.Panel 1Seven key recommendations identified to drive drowning prevention in the Western Pacific Region.1.Designate a national lead agency, or support establishment of a multisector coordination body, to drive coordinated drowning prevention efforts.2.Develop and implement a national water safety plan that contains national indicators for drowning prevention.3.Formalise multisectoral mechanisms to address drowning prevention and water safety by establishing partnerships across sectors and assigning clear roles and responsibilities.4.Document and share knowledge gained in drowning prevention efforts, nationally and regionally.5.Perform a comprehensive review of drowning prevention legislation to ensure best practice laws are developed, where absent, and that appropriate resources for implementation and enforcement are available.6.Evaluate drowning prevention intervention plans and programmes from the outset, ensuring evaluation is adequately planned for and funded.7.Strengthen data systems that capture drowning incidents, while improving the availability and quality of reporting. 1.Designate a national lead agency, or support establishment of a multisector coordination body, to drive coordinated drowning prevention efforts.2.Develop and implement a national water safety plan that contains national indicators for drowning prevention.3.Formalise multisectoral mechanisms to address drowning prevention and water safety by establishing partnerships across sectors and assigning clear roles and responsibilities.4.Document and share knowledge gained in drowning prevention efforts, nationally and regionally.5.Perform a comprehensive review of drowning prevention legislation to ensure best practice laws are developed, where absent, and that appropriate resources for implementation and enforcement are available.6.Evaluate drowning prevention intervention plans and programmes from the outset, ensuring evaluation is adequately planned for and funded.7.Strengthen data systems that capture drowning incidents, while improving the availability and quality of reporting. Australia, a global leader in drowning prevention, has pioneered the development of a National Water Safety Strategy,3Australian Water Safety CouncilAustralian Water Safety Strategy 2030. Australian Water Safety Council, Sydney2021Google Scholar via the Australian Water Safety Council. The Australian Water Safety Council, as a national designated agency, leads collaboration across the many and diverse partners which make up the water safety and drowning prevention sector. Efforts of the sector are aligned to the goals of the National Water Safety Strategy,3Australian Water Safety CouncilAustralian Water Safety Strategy 2030. Australian Water Safety Council, Sydney2021Google Scholar exemplifying the first three recommendations for the Western Pacific region (Panel 1). This coordinated effort has seen Australian unintentional drowning rates decline however, significant progress must be made in many life stages, locations and activities to achieve the aspirational goal of reducing drowning by 50% by 2030.4Peden A.E. Scarr J.P. Mahony A.J. Analysis of fatal unintentional drowning in Australia 2008–2020: implications for the Australian Water Safety Strategy.Aust N Z J Public Health. 2021; 45: 248-254Crossref PubMed Scopus (13) Google Scholar Formalised, multisectoral partnerships are central to cooperative drowning prevention which underpins the third recommendation for the Western Pacific region (Panel 1). Such partnerships are vital to address underlying global drivers of drowning risk such as migration and climate. The Pacific Islands Climate Action Plan represents an excellent example of multisectoral partnership,5World Health OrganizationPacific Islands action plan on climate change and health.2018Google Scholar that would benefit from greater recognition and integration of the role climate plays in drowning risk within the region.1World Health OrganizationRegional status report on drowning in the Western Pacific.2021Google Scholar Another example that integrates drowning prevention within broader injury prevention and health strategies serving to improve public safety systems, is China’s Healthy China 2030.6The State CouncilThe People's Republic of ChinaChina publishes health service plan for 2030 Shanghai, China.2016http://english.www.gov.cn/premier/video/2016/11/22/content_281475497503929.htmGoogle Scholar This multisectoral initiative strives for broad health promotion to move from vision to action at the national level,6The State CouncilThe People's Republic of ChinaChina publishes health service plan for 2030 Shanghai, China.2016http://english.www.gov.cn/premier/video/2016/11/22/content_281475497503929.htmGoogle Scholar,7World Health OrganizationHealthy China: World Health Organization.2023https://www.who.int/teams/health-promotion/enhanced-wellbeing/ninth-global-conference/healthy-chinaGoogle Scholar and represents the first medium- to long-term strategic plan to actively invest in the health sector to promote social and economic benefits.7World Health OrganizationHealthy China: World Health Organization.2023https://www.who.int/teams/health-promotion/enhanced-wellbeing/ninth-global-conference/healthy-chinaGoogle Scholar Given the significant economic impacts caused by preventable drowning incidents, applying this lens to the prevention of drowning is key. Meaningful actions cannot be achieved without political commitment and funding. The Commonwealth of the Northern Mariana Islands (CNMI) provides excellent examples of government investment into drowning prevention and resilience through its legislation and funding (Panel 1). With accidental drowning the 8th leading cause of death in the CNMI, the introduction of legislation and resources to implement infrastructure8U.S. consumer product safety commission. Pool Safety Grant Program, 2023Google Scholar and build resilience against climate and weather-related challenges,9The White HouseInvesting in America: President Biden’s Bipartisan infrastructure law is delivering in the Commonwealth of the Northern Mariana Islands. Factsheet.2023Google Scholar serve to reduce drowning risk by supporting drowning prevention implementation within the community. Due to the geography of the Western Pacific region, safe boating interventions aimed at preventing drowning are particularly relevant. Legislation is central to safe boating and shipping regulations2World Health OrganizationGlobal report on drowning: preventing a leading killer.2014Google Scholar but can be difficult to understand and enforce.1World Health OrganizationRegional status report on drowning in the Western Pacific.2021Google Scholar A recent collaboration with Commonwealth of the Northern Mariana Islands and the US Coast Guard saw personnel exchange knowledge, operational data and practices to enhance boating safety, emergency operations and maritime response.10Defense Visual Information Distribution ServiceU.S. Coast Guard works with counterparts in Saipan to sharpen maritime operations skills.2023https://www.dvidshub.net/news/441079/us-coast-guard-works-with-counterparts-saipan-sharpen-maritime-operations-skillsGoogle Scholar This example of interagency collaboration and review of legislative practice embodies key themes of Western Pacific recommendations 4 and 5 (Panel 1), serving to maintain currency of practice, response capacity, and thus mitigate risk.10Defense Visual Information Distribution ServiceU.S. Coast Guard works with counterparts in Saipan to sharpen maritime operations skills.2023https://www.dvidshub.net/news/441079/us-coast-guard-works-with-counterparts-saipan-sharpen-maritime-operations-skillsGoogle Scholar Acknowledgment of disaster-related drowning risk is also increasingly relevant to the region. Japan’s 2011 earthquake and tsunami left 15,900 people dead; more than 90% of which were caused by drowning.11National Police Agency of JapanThe Great East Japan earthquake and the police.2013https://www.npa.go.jp/archive/keibi/syouten/syouten281/pdf/p02.pdfGoogle Scholar As a disaster countermeasure, the Japan Lifesaving Association reaffirmed the importance of integrating water safety programs into disaster prevention through the establishment of Water Safety Week. Recently the Japan Lifesaving Association signed a cooperative, interagency agreement, and are now collaboratively providing water safety education and conducting joint rescue and evacuation training using the tsunami flag. The Japan Lifesaving Association leads rapid, effective, lifesaving disaster response actions with national agencies and local governments. As a lead water safety body in Japan, they have shared their experience and learnings, raising the international profile of disaster-related drowning as a global concern. The sixth recommendation acknowledges that evaluations of drowning preventions are urgently required (Panel 1)1World Health OrganizationRegional status report on drowning in the Western Pacific.2021Google Scholar but rarely proactively coordinated across the region, likely due to challenges around collating robust drowning data systems to drive multisectoral response. The recent COVID-19 response saw Palau launch a comprehensive digital health software which could serve to enhance surveillance and reporting of drowning incidents by improving data collection.12BESLaunching digital health software in Palau Republic of Palau.2023https://www.bes.au/launching-digital-health-software-in-palau/Google Scholar Evaluating the effectiveness of capturing drowning data with this approach, may support similar digital health ecosystem enhancements in other Western Pacific nations, as well as drive future drowning prevention strategies and calls to action. Drowning prevention has benefited greatly from the increased visibility, political attention, and advocacy opportunities afforded by global and regional reports,2World Health OrganizationGlobal report on drowning: preventing a leading killer.2014Google Scholar,3Australian Water Safety CouncilAustralian Water Safety Strategy 2030. Australian Water Safety Council, Sydney2021Google Scholar,5World Health OrganizationPacific Islands action plan on climate change and health.2018Google Scholar United Nations General Assembly and World Health Assembly Resolutions and the advent of World Drowning Prevention Day on July 25.13General Assembly resolution 75/273, global drowning prevention, A/RES/75/273. 2021undocs.org/en/A/RES/75/273Date accessed: April 28, 2021Google Scholar,14World Health Organization76th World Health Assembly adopts first ever resolution on drowning prevention.2023https://www.who.int/news/item/29-05-2023-76th-world-health-assembly-adopts-first-ever-resolution-on-drowning-prevention#:∼:text=Today%20the%2076th%20World,on%20drowning%20prevention%20through%202029Google Scholar In recognition of this year’s World Drowning Prevention Day theme “Do one thing, improve one thing, add one thing”, we propose what we need to (i) do, (ii) improve, and (iii) add, to further Western Pacific drowning prevention efforts:(i)Empower and support lower-resourced countries to develop and implement multifactorial drowning prevention actions. Opportunities for knowledge sharing should be established and partnerships should encourage effective, sustainable and locally-led solutions as intended outcomes.(ii)Bridge the gap between the available data and the urgent needs of program evaluation. Integrated and comprehensive information systems that collect multi-source heterogeneous data should be better supported for information sharing and data-driven decision-making across agencies and countries.3Australian Water Safety CouncilAustralian Water Safety Strategy 2030. Australian Water Safety Council, Sydney2021Google Scholar,12BESLaunching digital health software in Palau Republic of Palau.2023https://www.bes.au/launching-digital-health-software-in-palau/Google Scholar Implementation of new systems and programs will also provide evaluation opportunities that inform future interventions.(iii)Embed drowning in disaster risk reduction agendas. Remote island populations in the Western Pacific are particularly vulnerable to climate-related threats1World Health OrganizationRegional status report on drowning in the Western Pacific.2021Google Scholar and meteorological disasters. In particular the combination of sea level rises and natural disasters, further weaken the geographically dispersed and fragile health systems and hinder prevention capacities.5World Health OrganizationPacific Islands action plan on climate change and health.2018Google Scholar Drowning remains a neglected yet multisectoral issue, that spans the diverse Western Pacific region. How we collectively collaborate, respond, and react to significant threats such as the climate crisis, as well as shifting technological opportunities, will shape the future drowning burden and define how many lives we save over the next decade. Jasmin C. Lawes: Conceptualization, Investigation; Project administration; Resources; Roles/Writing–original draft; Writing–review & editing. Candace Koshiba: Writing–review & editing. Toshinori Ishikawa: Writing–review & editing. Pengpeng Ye: Writing–review & editing. Wilbert Rospel: Writing–review & editing. Amy E. Peden: Conceptualization; Project administration; Supervision; Resources; Roles/Writing–original draft; Writing–review & editing. The authors have no competing interests.