Around the world, low priority is placed on care for the injured, and for emergency care and surgical care more generally, in comparison with the higher priority placed on other health problems. This is especially the case in low- and middle-income countries (LMICs). As just one metric of this, development assistance for health includes funds given to LMICs by high-income governments, foundations, and philanthropy. Such assistance equates to US$41 per disability adjusted life year lost (DALY) due to HIV/AIDS while that for injury is one thousandth as much (US$0.04 per DALY) [1]. Similar discrepancies exist when looking at individual country expenditures [1]. The degree to which HIV/AIDS and other health conditions have been prioritized is in large measure due to the effect of advocacy by concerned lay people, both as individuals and through organizations [2]. Similar advocacy for trauma care has been minimal thus far.

Several groups are trying to fix this problem and to stimulate greater lay advocacy for trauma, emergency care, and surgical issues. In particular, the World Health Organization and the Global Alliance of NGOs for Road Safety have collaborated on a recent publication that provides guidance for non-governmental organizations (NGOs) and the lay public more generally on how to conduct successful advocacy for care for road traffic crash victims [3]. The Global Alliance for NGOs for Road Safety already has a long track record of such advocacy for road safety issues. The recent WHO publication also gives case studies of successful advocacy for emergency and trauma care across a wide spectrum of countries, mostly oriented for improvements at the local or national level. For example, advocacy in Lebanon resulted in increased availability and use of continuing medical education courses (such as ATLS) for trauma care providers in emergency rooms. Advocacy in India resulted in passage of a Good Samaritan protection law and advocacy in Seattle in the USA helped sustain funding for prehospital care [3].

Improvements in trauma care (and emergency care and surgical care more widely) can be engendered by similar advocacy in any country. There is especially ample ground for the lay public and professionals providing trauma care to work together on such advocacy. These two communities (lay public and professionals) should be encouraged to work together. There are many possible groups who might collaborate. I would especially like to alert surgeons and other medical professionals to the existence of a wide network of potential advocates in the form of the over 300 different organizations that constitute the Global Alliance for NGOs for Road Safety. A list of these 300 plus organizations is publicly available online [4].

Information about the recent WHO publication has been widely promoted through the network of local NGOs that are part of the Global Alliance of NGOs for Road Safety. Hence, people in many of the local NGOs may already have heard about that publication and been sensitized to the importance of advocacy for trauma care. Now would be a prime opportunity for surgeons who care for the injured to contact people from the NGOs in their country to collaborate on advocacy. Of course, there are many other groups who could be effective at advocacy and oftentimes several groups working together will be especially effective. The focus of such advocacy would depend on the needs of local hospitals and emergency medical services in each country. However, the more that requests can be realistic and oriented toward affordable and effective resources, the more likely they are to be successful. The case studies noted above all addressed improvements that were affordable and sustainable within the local economies [3].