Professor of Neurology at University of Zürich Senior consultatnt Schulthess Clinic Zürich Senior Editor BJSM Deputy Editor SPINE FIFA Chief Medical Officer since 1994 6 FIFA World Cups Chairman F-MARC 340 original publication 47 books including translations 40 Years Physician, 20 Years Football/FIFA F-MARC

CAN FOOTBALL IMPACT PUBLIC HEALTH?

04.November 2014 GWU04.November 2014 GWU

SCOPE OF MEDICAL SERVICE

 Ensure comprehensive provision of medical services to all FIFA and PMA personnel, including

• 32 PMA teams and their members + dignitaries • 32 PMA training camps • 12 Stadium match venues • 24 Stadium training venues • 24 Match specific team hotels • 13 FIFA hotels + referee hotel • FIFA Conference and related Meetings and everybody else that was constantly on the move by road or air. SCOPE OF MEDICAL SERVICE

Comprehensive, current, state of the art, medical care for all on the Field-of-Play medical events at all matches and training sites.

Video clip “Medical” Medical matters – Medical cases, 3,8 Mio spectators

Injury survaillance 66 Tournaments Women World Cup 1999, 2003, 2007, 2011 (18) Olympic Games 2000, 2004, 2008, 2012 U-19/20 World Cup 2002, 2004 / 2006, 08, 10, 12 U-17 World Cup 2008, 2010, 2012, 2014

Men World Cup 1998, 2002, 2006, 2010, 2014 (48) U-20 World Cup 1999, 01, 03, 05, 07, 09, 11,13 U-17 World Cup 1999, 2001, 03, 05, 07, 09,11,13 Confederations Cup 1999, 2001, 03, 05, 09,13 Club World Cup 2000, 05,06,07,08,09,10,11,12,13 Olympic Games 2000, 2004, 2008, 2012 Futsal 2000, 2004, 2008, 2012 Beach soccer 2008, 2011, 2013 13

Response rate

59 outdoor tournaments 1876 of 2013 matches 61´908 player hours  93% response

14 All injuries

4’595 injuries  2.4 injuries per match or 74.2 injuries per 1’000 hours

15 Injury Recording

Average number of injuries per match at the FIFA World Cups™ 1998 -2014 (orange = all injuries; red = time loss injuries) 17

+ to prevent injuries

steps to prevent SCD

FIFA & rules to prevent doping F-MARC’S for Health to prevent diseases CONCEPT OF PREVENTION

FIFA 11+ warm up programme to prevent injuries

FIFA 11+ IMPLEMENTATION IN ONE SEASON, TWO SCIENTIFIC STUDIES

WOMEN 1,892 players - 35% fewer injuries with “FIFA 11+”

MEN 1,769 players - 50% fewer injuries with “FIFA 11+” FIFA 11+ WORLDWIDE

2009 – today: 79 countries FIFA and Public Health Mandat, ethical duty or unique chance?

Medicine for football Football for Health

24 25 FOOTBALL FOR HEALTH - 10 YEARS RESEARCH, DENMARK, PORTUGAL, , SWITZERLAND (UP TO 150 RESEARCHERS)

• Investigation on children, adults, mature women, ageing man, “homeless” • Diabetes better, Blood Pressure down, Heart function improved, bone density increased) SCIENCE PROVES: THAT PLAYING FOOTBALL ON A REGULAR BASIS

CONTRIBUTES TO EDITORIAL BY JOSEPH S. THE IMPROVEMENT BLATTER & OF PUBLIC HEALTH JIRI DVORAK

• 2 times a week 45 minutes football for all • “The exercise (football) pill – time to prescribe it” • 45 original publication 2010-2014 Health messages and ambassador players 2014

Health message Football skill Ambassador

Playing Play football Chicharito (Mexico) football Respect girls and women Passing Diego Forlan (Uruguay)

Protect yourself from HIV Heading Neymar da Silva (Brazil)

Avoid drugs and alcohol Dribbling Cristiano Ronaldo (Port)

Control your weight Controlling R.Falcao (Colombia)

Wash your hands Defending Carles Puyol (Spain) Drink clean water Trapping Marta (Brazil) Building Eat a balanced diet (Argentina) fitness Vaccinate yourself and your (Ivory Shooting family Coast) “FIFA 11 for Health” to prevent disease, presented to FIFA congress in 2009

Success through partnership -19 Coutries FIFA 11 for Health - 10 years public health policy

• Government, i.e. Ministry of Education, Health • MA’s • FIFA / F-MARC Columbia Role modell • Pilot 2012

• 2013 - 106 schools • 2014-2016 nationwide, 15‘000 schools • 300‘000 children every year

• Costs 2014-2016 - 4,5 Mio USD

• Costs 2017-2019 - 1,5 Mio USD

• Reaching in total 3 Mio children

• Average cost / Child / 2USD incl balls, bips, etc

FIFA 11 FOR HEALTH 2014 BRAZIL: 12 CITIES, 4,000 CHILDREN Play football Respect girls and women Protect yourself from HIV Avoid drugs, alcohol, tobacco Control your weight Wash your hands CHANGE IN Drink clean water HEALTH Eat a balanced diet KNOWLEDG Get vaccinated E Take prescribed medication 0 10% 20% 30% 40% 50% FIFA 11 for Health 2014

Requests Ongoing FIFA 11 FOR HEALTH 2015-2019: IMPLEMENTATION IN APPROX. 100 COUNTRIES

• Growth of programme • Quality: audit and monitoring of effectiveness • Sustainability: commitment from all stakeholders (member associations, government, FIFA) to a nationwide implementation strategy for a minimum of ten years (Columbia model) • The goal to reach sustainable results is at core of the “FIFA 11 for Health” philosophy

g y - Report unusual 1 Drogba illnesses 2 - Know the symptoms Neymar - Seek immediate 3 Xavi medical help 4 - Avoid body contact Ronaldo - Wash your hands and 5 Boateng disinfect - Wear proper Pigue 6 protection

7 - Cook meat properly John Obi Mikel - Always practise safe 8 Boateng sex - Avoid contact with 9 Bale wild animals and bats - Do not touch the 10 Varane dead - Seek help for safe Guardiola 11

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45 FIFA / World Bank - Objectives

• To reach the population at high risk in Siera Leone, Guinea, Liberia, other countries

• National TV’s, Radio, Newspapers, social media

• Street banners, 11 billboards in the remote areas

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