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The World Health Organisation (WHO), says as many as 500 000 people suffer spinal cord injury each year, with survival rates worse in low-income and middle-income countries. The new WHO report dubbed: �International perspectives on spinal cord injuries,� said people with spinal cord injuries are two to five times more likely to die prematurely. It summarises the best available evidence on the causes, prevention, care and lived experience of people with spinal cord injury. The report which was made available to the Ghana News Agency on Monday by Laura Sminkey, WHO Communications Officer in Geneva, noted that males are most at risk of spinal cord injury from 20-29 years and 70 years and older, while females are most at risk from 15-19 years and 60 years and older. Studies report male to female ratios of at least 2:1 among adults, with up to 90 per cent of spinal cord injury cases due to traumatic causes such as road traffic crashes, falls and violence. It said variations exist across regions, for example, road traffic crashes are the main contributor to spinal cord injury in the African Region (nearly 70 per cent of cases) and the Western Pacific Region (55 per cent of cases) and falls the leading cause in the South-East Asia and Eastern Mediterranean Regions (40 per cent of cases). It noted that non-traumatic spinal cord injury results from conditions such as tumours, spina bifida, and tuberculosis. It said a third of non-traumatic spinal cord injury is linked to tuberculosis in sub-Saharan Africa. The report said most people with spinal cord injury experience chronic pain, and an estimated 20-30 per cent show clinically significant signs of depression, while other also risk developing secondary conditions that could be debilitating and even life-threatening, such as deep vein thrombosis, urinary tract infections, pressure ulcers and respiratory complications. It said spinal cord injury is associated with lower rates of school enrolment and economic participation; declaring that children with spinal cord injury are less likely than their peers to start school, and once enrolled, less likely to advance. The report observed that adults with spinal cord injury face similar barriers to socio-economic participation, with a global unemployment rate of more than 60 per cent. It said spinal cord injury carries substantial individual and societal costs. Many of the consequences associated with spinal cord injury do not result from the condition itself, but from inadequate medical care and rehabilitation services, and from barriers in the physical, social and policy environments that exclude people with spinal cord injury from participation in their communities. It said full Implementation of the Convention on the Rights of Persons with Disabilities is urgently required to address these gaps and barriers. �Spinal cord injury is a medically complex and life-disrupting condition,� notes Dr Etienne Krug, Director of the Department of Violence and Injury Prevention and Disability, WHO. �However, spinal cord injury is preventable, survivable, and need not preclude good health and social inclusion.� The report said essential measures for improving the survival, health and participation of people with spinal cord injury include timely, appropriate pre-hospital management: quick recognition of suspected spinal cord injury, rapid evaluation and initiation of injury management, including immobilisation of the spine and acute care appropriate to the level and severity of injury, degree of instability and presence of neural compression. It said essential measures to secure the right to education and economic participation include legislation, policy and programmes that promote physically accessible homes, schools, workplaces, hospitals and transportation, inclusive education and elimination of discrimination in employment and educational settings. International perspectives on spinal cord injuries was developed in association with the International Spinal Cord Society and Swiss Paraplegic Research, and launched on the occasion of the International Day of Persons with Disabilities on December 3.