Vison: ‘Middle-income countries are hardest hit’

Etienne Krug, WHO:

‘Unless urgent action is taken, road traffic injuries are expected to be the fifth leading cause of death globally by 2030’

Road traffic injuries are the eighth leading cause of death globally, and the leading cause of death among young people aged 15-29 years. Their impact is felt particularly strongly in low- and middle-income countries, where fatality rates are double those of high-income countries. While the road safety situation has improved in most high-income countries, the situation in many middle- and low-income countries is deteriorating: unless urgent action is taken, road traffic injuries are expected to be the fifth leading cause of death globally by 2030.

In 2010 at the United Nations (UN) General Assembly, governments around the world recognized road traffic injuries as a global health and development problem and declared a Decade of Action for Road Safety (2011-2020), with the goal of reducing the increasing trend in road traffic deaths and saving five million lives. The UN General Assembly resolution also called on the World Health Organization (WHO) to coordinate progress monitoring of the impact of the Decade of Action, through the development and production of a series of Global status reports.

Global status reports

On 14 March 2013, WHO launched the Global status report on road safety 2013: supporting a decade of action which provides baseline data for the Decade of Action. This report contributes to a better understanding of the burden and distribution of road traffic injuries around the world by using police, transport, and health data to develop comparative death estimates. It also monitors progress on the implementation of road safety good practices, drawing on data collected from various sectors in 182 participating nations that cover 99 percent of the world’s population.

Middle-income countries

Comparative estimates reveal that there were approximately 1.24 million deaths on the worlds roads in 2010. Although this estimate suggests no substantial change compared with global data published in the first Global status report on road safety of 2009, in the face of a corresponding 15 percent increase in registered vehicles, it indicates that measures that are being put into place could have mitigated the expected increase in number of deaths.

The fatality data also show that middle-income countries, notably those undergoing rapid motorization, are hardest hit: fatality rates in middle-income countries are more than double those in high-income countries; 20.1 per 100.000 inhabitants in middle-income countries versus 8.7 in high-income countries. Furthermore they are disproportionately impacted, accounting for 52 percent of global registered vehicles but 80 percent of global road traffic deaths.

Strong recommendation: do more for vulnerable road users

The report also highlights the variation in who dies on the roads. Vulnerable road users –pedestrians, cyclists and motorcyclists – make up for half of all road traffic deaths globally. Apart from that, the distribution of road deaths by type of road user varies considerably by region. In Africa, 38 percent of deaths are among pedestrians, while in the Western Pacific region, 36 percent of deaths are among motorcyclists, reflecting the different mobility preferences in the regions. The report makes the strong recommendation that, to effectively reduce global road traffic deaths and thus attain the ambitious goals of the Decade of Action, more must be done to meet the needs of these more vulnerable road users.

Only 28 countries, representing 7 percent, have comprehensive laws on all 5 risk factors

The implementation of road safety legislation, supported by strong enforcement and public awareness campaigns, has been shown to be effective at reducing road traffic injuries. The Global status report is cautiously optimistic about the progress that has been made in this area: 35 countries have passed new laws on the five key risk factors – speed, drink-driving, and the use of motorcycle helmets, seat-belts and child restraints – since 2009. Nonetheless, only 28 countries, representing just 7 percent of the world’s population, currently have comprehensive laws in place on all five risk factors. This figure is virtually unchanged from 3 years ago. The enforcement of these laws, which is critical to their success, is still reported as worryingly inadequate by most countries. The current pace of legislative change needs to rapidly accelerate if the legislative target of the Decade of Action – 50 percent of countries meet the legislative criteria by 2020 – is to be met. The Report encourages governments to urgently pass comprehensive laws and invest sufficient financial and human resources to support the sustained high levels of enforcement that are required to make these laws a success.

The decision to proclaim a Decade of Action for Road Safety was adopted unanimously at the UN General Assembly in 2010 and provides a unique platform from which governments, civil society and international community can work together towards making the world’s roads safer. While much progress has been made in improving road safety in a number of countries, considerable work will be needed for the goals and objectives of the Decade of Action to be realized. There is a strong evidence base on what interventions work. Government action is now the key to ensure their implementation.

 
Auteur: Joske van Lith