Trauma is a significant cause of childhood mortality and morbidity, with injuries one of the main causes of death among children aged 5 to 19 worldwide. Approximately 900,000 children under the age of 18 die each year from trauma globally, with the greatest burden falling on those in low- and middle-income countries (LMICs). Children are also casualties and intentional victims of war. Five hundred million children are at substantial risk of injury whilst living in conflict zones, and it is estimated 2 million children have been killed in war in the last decade. Moreover, tens of millions of children sustain non-lethal injuries resulting in long term disability.

However, most funding continues to support the successful reduction of deaths from communicable diseases rather than injury prevention and care. This is despite the fact deaths from injury are nearly twice that for HIV, Malaria and TB combined and the clear cost effectiveness of injury prevention and basic life support. A trained lay first responder and paramedic cost 7 US dollars per life year gained, compared with 922 US dollars for anti-retroviral use in HIV.

With the widespread global uncertainty over future conflicts related to rapidly progressing climate change, rising geopolitical tensions, and political instability, coupled with rapid urbanisation, the paediatric trauma epidemic requires a multi-pronged approach. A global focus on injury prevention together with investment and research into the optimal care for injured children in LMICs is essential, as is ensuring those health care professionals delivering the care receive timely and appropriate, paediatric specific training.