World Drowning Prevention Day: Bangladesh’s public health diplomacy at the UN

As we observe World Drowning Prevention Day today, Bangladesh has reasons to be proud. The Permanent Mission of Bangladesh to the United Nations in New York has played a pioneering role in advancing the agenda of drowning prevention, culminating in the co-leadership with Ireland of the United Nations General Assembly (UNGA) resolution titled "Global Drowning Prevention".

This historic resolution, adopted unanimously on 28 April 2021, established drowning as a matter of global concern and garnered recognition from all 193 member states. As proclaimed in the resolution, the World Drowning Prevention Day is observed annually on 25 July, serving as a reminder of the urgent need for strategic international action to save lives and prevent countless preventable deaths.

Since 2018, Bangladesh had been leading the "Group of Friends on Drowning," an advocacy group consisting of like-minded UN member states since 2018. Its efforts were supported by organizations such as the Royal National Lifeboat Institution (RNLI) and other actors in the health sector and civil society.

Drowning emerged as a major global cause of mortality, with children aged 1-4 years being particularly vulnerable. Over 90% of drowning deaths occurred in low- and middle-income countries, predominantly affecting children and youth. Shockingly, in the past decade alone, 2.5 million lives were lost to drowning, with estimates excluding deaths related to disasters and water transport incidents. The World Health Organization (WHO) estimated that drowning claims over 235,000 lives annually, translating to approximately 650 deaths per day or 26 deaths per hour. These figures exceed those related to maternal mortality or malnutrition. Drowning is often referred to as a "silent epidemic" due to its under-recognized impact, resulting in limited resources and attention for prevention and awareness efforts.

The economic cost of drowning is also substantial, estimated at USD $146 billion globally each year, with some low-income countries experiencing costs equivalent to 0.8% of their GNI. Drowning represents not only an injury but also an inequity, while its prevention is intricately linked to sustainable development. Success in reducing under-five mortality, and ultimately achieving Sustainable Development Goal 3, relies on preventing deaths from drowning. Investment in education, immunization, and nutrition is compromised by each life lost to water, highlighting the potential contribution of drowning prevention to multiple SDGs.

In the context of Bangladesh, drowning emerged as one of the three leading causes of death among children, with an average of 50 children losing their lives to drowning every day, amounting to over 18,000 deaths per year. Rural areas experienced higher drowning rates among children under-5 (9.7%) compared to urban areas (7%).

Despite these alarming statistics, drowning had not received sufficient international attention, resulting in a lack of policy responses and resource allocation. Among over 26,000 resolutions passed by the United Nations over 75 years, drowning had not been considered until 2021.

Since the adoption of the UN resolution, numerous initiatives have been launched worldwide to address this pressing issue, bringing together governments, NGOs, and communities to raise awareness about drowning risks. Innovative programs have targeted high-risk areas and vulnerable populations, providing training in swimming, cardiopulmonary resuscitation (CPR), and water rescue techniques. The recent World Health Assembly resolution in 2023, a follow up of UNGA resolution, is expected to further accelerate progress.

Bangladesh takes pride in its efforts to scale up interventions for child drowning prevention. Given its geography and numerous communities located near water bodies, including 44 million children under the age of 14, action on this agenda is of critical importance to the country. Bangladesh has based its actions on research, evidence, and best practices, which have yielded positive results. The country recognized drowning as a leading cause of death among children in 1999 and subsequently implemented a series of actions to reduce the drowning rate.

Building upon years of practical interventions to prevent or reduce drowning, Bangladesh passed the Day Care Center Act 2021, ensuring institutional supervision of children. The country has also established the National Alliance for Drowning Prevention to raise awareness within communities. To scale up child drowning prevention interventions, the Government of Bangladesh, through the Ministry of Women and Children Affairs, is in the process of implementing 8,000 community daycare centers (Anchals) to provide care for 200,000 children under five and teach survival swimming to 360,000 children aged 6-10 within four years in 45 subdistricts across 16 districts. The government has allocated $32 million USD in central budget support to extend efforts to 16 districts over 2022-24 fiscal years. Drowning prevention has been included in the Integrated Management of Childhood Illness (IMCI) agenda, and lessons on drowning prevention are now part of school curricula. The introduction of a $20 survival swim skills course in Bangladesh has resulted in an 80% increase in child survival rates. Globally, it has been proven that low-cost, high-impact actions can contribute to child survival and community resilience.

However, it is essential to acknowledge that much more needs to be accomplished. The disproportionate impact of drowning on children in low- and middle-income countries should serve as a wake-up call for everyone. It is our collective responsibility to ensure that every child, regardless of socioeconomic background, has access to life-saving skills and knowledge.

Governments, organisations, and individuals must continue to prioritize drowning prevention in their agendas. Increased funding and resources should be allocated to support comprehensive strategies addressing the root causes of drowning. Education and awareness campaigns should be expanded to reach communities in rural and urban areas alike. Technological advancements and mobile and ICT applications should be leveraged to bridge the gaps and develop affordable and scalable solutions. Continued research is also crucial for better understanding the risk factors associated with drowning and identifying effective preventive measures.

The UNGA resolution marked a significant milestone, drawing international attention and catalyzing collective action. Moving forward, it is imperative to capitalize on the momentum generated by it. With political recognition and will for action secured, as well as clear voluntary actions outlined for all member states, it is now necessary to integrate drowning prevention into relevant agendas, including the SDGs, climate change, public health, disaster risk reduction, and humanitarian efforts at both national and international levels.

While progress has been made, the journey toward a world free from drowning is far from complete. By uniting efforts, sharing best practices, and dedicating ourselves to saving lives, we can make a substantial impact and create a future where no family suffers the devastating loss of a loved one to drowning.

The World Drowning Prevention Day of 2023 serves as a reminder of lives lost and calls us to take active roles and commitments to reduce drowning. The WHO encourages everyone to "Do One Thing" to prevent drowning, regardless of their role or position in life.