Intended for healthcare professionals

Observations Improving Trauma Care Worldwide

Tranexamic acid in trauma: we need stronger global health policy

BMJ 2013; 347 doi: (Published 23 July 2013) Cite this as: BMJ 2013;347:f4593
  1. José Caballero Alvarado, Hospital Regional Docente de Trujillo, Peru,
  2. Yashbir Dewan, MIND-Max Institute of Neurosciences Dehradun, India,
  3. Hesham Fathy Elsayed,, Suez Canal University Hospital, Egypt,
  4. Tamar Gogichaishvili, High Technology Medical Centre, Georgia,
  5. Sanjay Gupta, Fortis Hospital Delhi, India,
  6. B J Hunt, Guy’s and St Thomas’ NHS Foundation Trust, UK,
  7. Pius Iribhogbe, University of Benin Teaching Hospital, Nigeria,
  8. Mario Izurieta, Hospital Alcivar, Ecuador,
  9. Hussein Khamis, Mataria Teaching Hospital, Egypt,
  10. Edward O Komolafe, Obafemi Awolowo University Teaching Hospital, Nigeria,
  11. Jorge H Mejía Mantilla, Fundación Valle del Lili, Colombia,
  12. Jaime Miranda, Universidad Peruana Cayetano Heredia, Peru,
  13. Carlos H Morales Uribe, Hospital Universitário San Vicente Fundación, Colombia,
  14. Oluwole Olaomi, National Hospital Abuja, Nigeria,
  15. Fatos Olldashi, University Hospital of Trauma, Albania,
  16. Pablo Perel, London School of Hygiene and Tropical Medicine, UK,
  17. P V Ramana, Care Neurosciences and Trauma Centre, India,
  18. R R Ravi,, Medical Trust Hospital Kochi, India,
  19. Ian Roberts, London School of Hygiene and Tropical Medicine, UK,
  20. Haleema Shakur, London School of Hygiene and Tropical Medicine, UK
  1. Correspondence to: I Roberts ian.roberts{at}

Tranexamic acid substantially reduces death in bleeding trauma patients. So why are the World Health Organization, the United Nations, the World Bank, and Unicef not ensuring global implementation, ask Ian Roberts and colleagues

You might expect that the identification of a highly cost effective treatment for a disease that kills more people each year than HIV/AIDS, malaria, and tuberculosis combined would stimulate an immediate global health policy response, with strong efforts to make the treatment freely available to all those who need it.1 Knowing that the United Nations General Assembly had proclaimed 2011-20 to be a “decade of action” for tackling this particular health scourge, you might feel sure that concerted action was being taken.2 You would be wrong. The “disease” is trauma, and the treatment is a short infusion of a generic drug called tranexamic acid, but there has been no global health policy response.3 4 5 6

In 2010 a collaboration of doctors and …

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