Road Traffic Injuries Kevin Watkins

8/3/2019 Road Traffic Injuries Kevin Watkins

1/20

A policy briefing for the First Global Ministerial Conferenceon Road Safety, Moscow, 19-20 November 2009

Kevin Watkins and Devi Sridhar

ROAD TRAFFIC INJURIES:the hidden development crisis


2/20

2 Road trafc injuries: the hidden development crisis


3/20

Road trafc injuries: the hidden development crisis 1

Time for Action. This is the slogan of the FirstGlobal Ministerial Conference on Road Safety.

And if we consider the scale of the road injuryepidemic facing the world, and particularlythe developing world, it is clear that now isindeed the time for action. This issue has beenneglected for far too long. Moscow can bethe turning point, the fork in the road. We canchoose this week to take a new direction forroad injury prevention.

This brieng paper provides conference del-egates with powerful arguments for why road

safety must become a development and healthpriority. As Kevin Watkins and Devi Sridharpoint out, economic self interest alone dictatesthat road safety be acted on by governments.The tragic waste of human life, the draining ofnational wealth, the crippling impact on healthsystems, families condemned to poverty these are the man-made disasters that are theconsequence of ignoring road safety.

We encourage national governments, and those

with responsibility for road safety at regionaland local level, to adopt ambitious strategies toreduce road trafc injuries. For example, minis-ters meeting in Moscow could together committo work for universal seat belt and helmet wear-ing by 2020.

We urge international donors and the develop-ment banks to lead by example. Both interna-tional institutions and individual countries areincreasingly recognising the important role thatroad assessment and subsequent safe road de-

sign can play in reducing casualties across theroad network. This must become a program-matic priority.

And we call on ministers meeting in Moscowto support our call for a Decade of Action forRoad Safety. With political determination andresources commensurate to the scale of thiscrisis, leading road safety experts believe thatve million lives could be saved over the nextten years.

Five million lives are at stake: ve million peoplewhose potential can be realised, and not wast-ed. Five million families who need never knowthe sudden shock and lifelong grief that comesfrom losing a loved one in a road crash.

So let us commit this week, at this historic con-ference, to work together for a Decade of Actionand make roads safe for us all.

Rt. Hon. Lord Robertson of Port Ellen

Chairman, Make Roads Safe Campaign

Foreword: Lord Robertson


4/20


Scan the media headlines in

most developing countriesand you are likely to nd asteady supply of road trafcdisasters. Here are somerecent examples:

29 people killed and 24 seriously injured onthe highway from Nairobi to Mombasa whena truck collided with a speeding bus

10 year old boy crushed to death by revers-ing bus in Delhi, one of more than 100 peo-ple killed in crashes involving a single buscompany in the city last year.

54 people killed in Guatemala when a buscarrying 77 passengers skidded into a ravine

Residents rioted and burnt tyres in the roadin South African township after pedestrians

were killed and injured in two separate hitand run incidents.

Media reporting in developing countries par-tially captures the real risks facing people us-

ing roads. Yet road safety management doesnot make international headlines. The subject isabsent from the agendas of global summits oninternational development. Yet few issues meritmore urgent attention. Road trafc deaths andinjuries represent a global epidemic and thecosts of that epidemic are borne overwhelm-ingly by the worlds poorest countries and peo-ple. Apart from their devastating human conse-quences, road trafc injuries are holding backprogress in economic growth, poverty reduc-tion, health and education. With projectionspointing to a relentless increase in the spreadof the road trafc injury epidemic, governmentscan no longer afford to turn a blind eye.

The rst global ministerial conference on roadsafety to be held on 19/20 November, 2009 inMoscow, the Russian Federation, has an op-portunity to set a new course. This is a sum-mit that can make a difference. There are noquick xes. Enhanced road safety is not justabout redesigning roads, but about rethinking

the relationship between roads and people, andradically changing approaches to the measure-

Road traffic injuries:the hidden development crisis


5/20


ment of national progress in transport policy.Sustained political will and commitment, backed

by the better deployment of existing resourcesand mobilisation of additional resources, will berequired to put in place a long-term strategy forachieving change. The Make Roads Safe cam-paign is calling for a UN Decade of Action toset a new course of action and the Moscowconference needs to back that call.

Business-as-usual is no longer an option. Cur-rent approaches to road safety in the worldspoorest countries are both indefensible andunsustainable. They are indefensible becausethey will result in millions of deaths and injuriesthat could be prevented through affordable in-vestments. And they are unsustainable becauseno country can afford the economic and socialcosts associated with current approaches. Thefact that these costs are hidden from view doesnot detract from their devastating effects.

There are two priorities for the ministerial confer-ence. The rst is to start the process of puttingpeople rst. Too often, governments measure

the success of transport policy in kilometres ofasphalted road, reduced journey times for mo-

torised transport, and the convenience of carand truck drivers. Road trafc injury is seen as a

form of collateral damage the inevitable priceto be paid for a more efcient infrastructure.This logic has to be turned on its head, with thesecurity of vulnerable road users put at the cen-tre of national policy.

The second priority is to set a road-map chart-ing the course to a different future. Less weightshould be attached to the kilometre count forasphalt roads, and more weight should be at-tached to the body count. All countries shouldbe encouraged to set targets for rst stabilisingand then reducing road trafc injuries. Nationalstrategies should set out the road safety ap-proaches and investments needed to convertthese targets into outcomes. And the interna-tional community should back these strategieswith aid and support for capacity building.


6/20


Road transportation provides obvious benetsto countries and individuals. It facilitates the

movement of goods and people, creating em-ployment, supporting economic growth, and en-hancing access to education and health care.The association between roads and human de-velopment is well-established. Data from low-income countries consistently demonstratesthat communities living furthest from roads ex-perience higher levels of poverty, lower levels ofschool attendance and worse health outcomes.But the benets come with costs that have beenwidely overlooked

Headline numbers tell part of the story. Around1.3 million people will be killed on the worldsroads this year. Over 90 per cent of these fatali-ties occur in the worlds poorest countries (seegure 1). Road trafc fatalities are the singlebiggest source of death among 15-19 year oldsin developing countries and the second leadingcause among 5-14 year olds. For every death,up to 50 people are injured or disabled. To putthese gures in perspective, in the course of thetwo day Moscow summit some 7000 will die on

the worlds roads and another 130,000 will beinjured, 40,000 of them seriously.

The future looks worse than the present farworse. Rich countries are making progress in

cutting road trafc deaths and injuries. Poorcountries are moving in the opposite direction.Comparing 2020 with 2000, fatalities are pre-dicted to increase by more than 80% in low andmiddle income countries and by 144% in SouthAsia. By 2030, the projected number of deathson the worlds roads will be roughly double thecurrent level. Long before this - by 2015 - roaddeaths are projected to be the leading cause ofhealth losses for children aged 5-14 years asmeasured by Disability Adjusted Life Years (seegure 2).

Vulnerable road users account for a large pro-portion of road deaths and injuries in develop-ing countries. In the rich world, most of the vic-tims of road injuries are drivers or vehicles andtheir passengers. In the poorest countries, typi-cally around half of those who die in road traf-c crashes are pedestrians, cyclists, or users oftwo-wheel vehicles. Put differently, people forthe most part far too poor to own a car face by farthe highest levels of risk. Pedestrians typically

account for 30 - 40% of road trafc fatalities indeveloping countries (see gure 3).

The global epidemic


7/20


Child pedestrian injury is highest in South Asiaand sub-Saharan Africa. The grim arithmeticdriving future road trafc injury scenarios can bebriey summarised. Poor countries currently ac-count for just under half of all cars on the worldsroads and 9 in every ten fatalities. With car own-ership rising rapidly and governments and do-nors investing heavily in road construction, theratio of cars to vulnerable pedestrians will rise as will the levels of fatality and injuries. A per-son in a poor country is at least twice as likely

to die on a road as the citizen of a high country.That outcome reects the higher levels of risk

on roads and the more limited access to publichealth services.

Current patterns of health spending under-line the relative neglect of road trafc injury innational health priorities. In India, per capitaspending on HIV/AIDS is 13 times greater thanspending on road trafc injury, even though thelatter is a bigger source of fatality and injury.

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000Malaria

Tuberculosis

HIV/AIDS

Road Traffic

Injuries

2005 2015 2030

2222

27 23

2

1

20

4

1

16

4

2

Figure 2: Projected Disability Adjusted Life Years (DALYS) in developing countries:(children aged 5 14)

Source: Mather C, Loncar

D, Updated projections ofglobal mortality and burdenof disease, 2002-2030: datasources, methods and results,WHO, October 2005

No data

19.128.3

16.319.0

12.116.2

11.012.0

Figure 1: Road trafc injury mortality rates (per 100 000 population), 2002

Source: World Report on roadtrafc injury prevention, 2004


8/20


Global statistics of road trafc injury tell an im-portant story. They quantify the broad dimen-

sions of the problem and they make it possibleto compare countries and regions. But data onroad safety capture only part of the cost.

The most important impacts of the road safetycrisis are beyond measurement. There are hu-man faces behind the 1.3 million fatalities. Forevery victim there are grieving parents, broth-ers and friends trying to come to terms with theloss of loved ones. Human grief and loss haveno price. And no simple numbers can be put onthe trauma, anxiety and stress experienced bypeople who have been left disabled, and theircarers, as a result of road trafc injury.

Looking beyond these human costs, there aregrounds for concern that data on road trafc in-jury understates the scale of the problem. Fewdeveloping countries have reliable and com-parable data on road trafc injuries. Countriesuse different criteria for registering fatalities andinjuries, and the effectiveness of police andhealth facility reporting systems varies enor-

mously. What can be said with some certainty isthat under-reporting is widespread and that it

is most widespread in remote areas and amonghouseholds lacking access to health facilities,

or resources to pay for treatment.

Beyond the loopholes in administrative datathe wider costs associated with road trafc ac-cidents are not sufciently recognised. Thesecosts have a direct and powerful bearing notjust on national economic life, but on prospectsfor social progress.

Economic losses. Quantifying the economicimpact of road trafc injury is difcult. On oneestimate, based on value of life calculations,the cost of fatalities alone represents someUS$385bn for low-income and middle-incomecountries. These countries are typically losingon an annualised basis an amount equivalent tobetween 1-3% of GDP. For some, the nancialcosts associated with road trafc injuries out-weigh the amount received in aid (See gure4). Losses of GDP on this scale have adverseimplications for poverty reduction because eve-ry 1 per cent increase in economic growth is es-timated to reduce poverty levels by 0.7%.

The hidden costs


9/20


Strain on health systems. Road trafc inju-ries place an enormous strain on already over-

stretched health systems. The systems are ineffect haemorrhaging resources as nance,equipment and skilled staff are diverted to treatthe victims of road trafc injuries.

In Kenya, road trafc injury patient represent45-60% of all admissions to surgical wards

Studies in India show that road injuries ac-counts for 10-30% of hospital admissions

One hospital in Uganda reports spendingaround US$399 per patient treating roadtrafc injuries. This is in a country with na-tional spending of US$20 per person

Most health systems in developing countriesare not equipped to deal effectively with roadtrafc injury on the current scale. Many patientsrequiring specialised trauma care are beingtreated by general doctors. Meanwhile, short-ages of surgeons and intensive care equipmentare leading to delays in treatment and delay

can have fatal consequences.

Locking vulnerable people into poverty. No-body is immune to the risks associated with

road trafc injury. However, poverty increasesthe risk and it diminishes the capacity of vic-tims to cope with the consequences:

Poor people are more likely to be vulnerableroad users. They are more likely to travelon foot, by bicycle, or by public transport and in many cases public carriers are amajor source of road trafc injury. Researchfrom Bangalore, India, found that mortalityfrom road trafc injuries was twice as highamong the poorest socio-economic groupsas among the richest a nding that held forboth urban and rural areas.

Road trafc injury can dramatically cuthousehold income. The most precious as-set of the poor is their labour and road in-juries or fatalities can erode the value of thatasset. In Bangladesh, 75 per cent of poorhouseholds reporting a road trafc death re-ported a decrease in living standards.

Figure 3: Deaths by road user category

Selected countries, Global Status Report on Road Safety, WHO, 2009

0 20 40 60 80 100

Passengers 4-wheelers

Drivers 4-wheelers

Riders motorised 2 or 3 wheelers

Cyclists

Pedestrians

USA

UK

Thailand

Tanzania

South Africa

Kenya

Indonesia

Costa Rica

China

Bolivia

Bangladesh

Percentage


10/20


Huynh Trong Hieu, 32 years old, lives in theoutskirts of the tourist city of Nha Trang, Viet-

nam. Hieu is married with a son and a daughterand was the breadwinner of his extended fam-ily, including his wife, children, mother, and histwo mentally-disabled sisters. Hieu worked as amotorcycle repairman and because of his me-chanical ability and hardworking attitude, he wasable to earn enough to support his entire family.However, in early 2008, Hieu was in a motorbikecrash. The tragic accident forever changed hisand his familys quality of life. One afternoon,while driving the motorbike of a customer to test

a problem, Hieu crashed while trying to avoid adirect collision with a bicyclist making an irregular crossing. Hieu was not wearing a helmet and suf-fered severe brain trauma and was hospitalized for three months under intensive care. After beingreleased from the hospital, the left side of his body was, and remains, paralyzed, and he is mentallydisabled.

At the time of the accident, Hieu did not havemedical insurance. The family had to mobilizenancial support from family members and bor-row cash from acquaintances. The only propertyof real value in the house, a Honda motorbike,

was sold after the accident. They received onlyUS$150 for the motorbike, which covered asmall portion of Hieus total hospital charge ofUS$4,500.

Hieus pre-RTI income was an average of US$170 per month. A year after the accident, Hieu,using a wheelchair that cost him US$35, becamea lottery ticket seller. His income plummeted toan average US$30 per month -- only enough to cover his acupuncture treatment, rehabilitation fee,and other medical follow-up treatment. His father was absent, his mother had chronic arthritis andhis two sisters suffered from mental illness and were not married. His income therefore supported his

mother, two sisters, and his two children. His wife earned enough to support only herself as a privatetailor before the accident, and following the accident, she was required to stay at home and care forHieu. His accident pushed his family into poverty.

Since Hieu could no longer support his two children, they were separated from their parents and nowlive with their mothers parents. However, the grandparents were too old to provide adequate care forthe children, and Hieus two children are said to be malnourished and poorly taken care of. At the timeof the interview, Hieus relatives indicated that his wife has already shown her dissatisfaction with thefamily situation, and that she is thinking of leaving the family, and possibly obtaining a divorce.

BOX 1:

A family torn apart

Source: Asia Injury Prevention Foundation


11/20


0.0

0.5

1.0

1.5

2.0

2.5

3.0

Ocial developmentassistance(current billion US$ 2007)

Financial costs associatedwith road fatalities(current billion US$ 2007)

BangladeshUgandaTanzaniaMalawiKenya

BillionsUS$

The poorest families are hit hardest by post-injury costs. Poor households are less likelyto have the nancial resources they needto pay the direct and indirect costs related

to road trafc injuries. Many are driven intopoverty by the costs of prolonged medicalcare and rehabilitation. And many more aredenied access to care because they cannotafford costs. One study in Ghana found thatonly one quarter of people injured in roadcrashes used hospital services. The mostcommon reason for not seeking care waslack of money. The long-term costs associ-ated with treating road trafc injuries drivesmany households into debt, diverting re-

sources from other areas (see box 1).

Impacts on education. The effects of road traf-c injury on education have been widely ignored yet they are of great signicance. Every year,around 80,000 children aged 5-14 in developingcountries lose their right to education for a sin-gle tragic reason: they are killed on the worldsroads, often making the journey to school. Manythousands more see their prospects for educa-tion diminished by injury and disability. For chil-dren who are left disabled, access to school can

become a major problem. Post-traumatic stressis another consequence of road trafc injurythat can have devastating consequences forlearning achievement. And the loss of a parentcan leave children with long-term psychosocialproblems. In Bangladesh, road trafc accidentsare the single biggest cause of death by injuryamong fathers and the second biggest cause ofdeath by injury among mothers.

The cumulative costs of road trafc injuries should

propel the issue into the front line of dialogue oninternational development goals. Losing 1-3%

of GDP on an annualised basis is an enormousbrake on development. It holds back job crea-tion and erodes opportunities for development.It also restricts the level of revenue collected by

governments for investment in priority social andeconomic infrastructure. Yet few nance minis-ters appear to have made the link between roadtrafc injury and the national budget.

Much the same might be said of health minis-ters. Front-line doctors, nurses and paramedicsdeal every day with the consequences of theinjuries sustained on national roads. They areaware of the level of resources directed towardsthe treatment of these injuries. Yet there is lit-

tle evidence of health ministries leading calls forthe road safety investments that could releaselarge amounts of nancing for the developmentof basic health provision.

For the individuals most directly affected, roadtrafc injuries are often a one-way ticket intopoverty. Losses of labour caused by disabilitytranslate into lower levels of income, the ero-sion of savings, and reduced investment, trap-ping people in cycles of poverty and vulnera-bility. With limited coping capacity, the poorest

households may have no alternative but to meetthe costs of health treatment by incurring debt,cutting back on nutrition, or taking children outof school, sacricing prospects for a better fu-ture for survival in the present.

All of this has implications for the MillenniumDevelopment Goals. Investment in roads canplay an important role in accelerating progresstowards poverty reduction. By the same token,investment on the current model is generating

a level of human, social and economic cost thatought to be regarded as unacceptable.

Figure 4: Road trafc injurycosts undermine aid effort

Aid data taken from WDIdatabase; Fatal Value of Lifecalculations, McMahon K, 2009


12/20


Addressing road safety management in a com-prehensive manner requires action at many lev-

els and the involvement of many sectors. Roadshave to be designed with the security of vulner-able users treated as a priority, rather than anafterthought. Legislation aimed at lowering riskhas to be not just adopted but implemented. Andgovernments and civil society organisationshave to work together to change the attitudesthat endanger lives. There are no blueprints but there are tried and tested approaches with aproven track record.

When it comes to road design the rst principleis that risk prevention is better than cure. Too of-ten in the past roads have been built with scantregards for the security of vulnerable pedestri-ans. In the rush to lay asphalt and create high-speed highways, planners have overlooked therst rule of road safety: namely, separate motor-ised vehicles and pedestrians.

The consequences can be readily observed onmajor highways across the developing world.Every morning, tens of thousands of primary

school age children negotiate the task of cross-ing a major road, and often a six lane highway,

separating their home from their school. Mil-lions of adults walk or cycle to their place of

employment alongside highways lacking a safepavement. These are problems that can be ad-dressed through retrotting security in the formof a protected overpass or a protected area forpedestrians and cyclists and, where relevant,for motorcyclists. But the better option is toavoid building roads that separate communitiesfrom the schools, health clinics and jobs.

The adoption and enforcement of trafc lawsand vehicle regulation can make an enormousdifference. Rwanda has lower levels of roadtrafc injuries than many of its neighbours notbecause it is richer, or because it has betterroads, but because its government has beenmore stringent in enforcing laws on speeding.In Viet Nam, a law requiring all motorcycle usersto wear crash helmets has saved many lives.Ensuring that public carriers such as bus andtaxi companies meet effective safety standardscould avert tens of thousands of deaths an-nually. Increasing police training and tacklingcorruption are essential steps to improving en-

forcement of speed and drink drive laws, ena-bling vehicle inspection regimes and improving

Charting a new course


13/20


road user behaviour in relation to seat belts andhelmets.

Global and regional initiatives have heightenedawareness of the potential for rapid progresson road safety. There have also been strongcalls for international support. African ministersfor transport and health have adopted a strongstatement the Accra Declaration calling forstrengthened partnerships on road safety. Thattheme was echoed in a 2008 United NationsGeneral Assembly resolution. International do-nors and aid agencies have also acknowledgedthe need for a concerted effort to tackle the roadsafety crisis. Yet the gap between words andaction remains vast:

Only one in three developing countries hasa national road safety strategy that includesspecic targets and has funding allocatedfor their attainment

Legislation is often partial. Fewer than onehalf of the countries covered in the WorldHealth Organisations (WHO) Global Status

Report on Road Safety had a motor cyclelaw requiring both riders and passengers to

wear helmets. While most countries havelaws prohibiting drunken driving, 49% stipu-

late a legal limit above that recommendedby the WHO. Over one-third of countrieshave urban speed limits in excess of the50km/hour threshold considered compatiblewith lower levels of risk.

Even when the legislation is in place en-forcement often remains weak. For exam-ple, in an assessment ranking enforcementon a scale from 0 to 10, only 9% of coun-tries enforce speed limit provisions at a levelhigher than 7 in the WHO assessment. Onlyone in ve countries was found to endorseseat belt laws.


14/20


Looking ahead from Moscow

One international summit cannot resolve a crisison the scale of the road trafc injury epidemic.Real progress will require concerted action onthe part of many actors. Within countries, effec-tive road safety planning requires cooperationacross many ministries and government agen-cies. Achieving that outcome will in turn requirethe development of new coalitions bringing to-gether health professionals, teachers, parentsand others. At an international level, develop-

ment agencies and civil society organisationsneed to start treating road trafc injury as a coreelement in their activities, rather than as is cur-rently the case an appendage.

The Moscow ministerial conference is importantbecause it can signal a new direction, establish alevel of ambition, and put in place practical meas-ures to strengthen international cooperation. TheMake Roads Safe campaign of the Commissionfor Global Road Safety has identied the build-

ing blocs for a concerted international effort toreduce the rising toll of road deaths and injury:

Commit to a decade of action with global

targets. The Moscow summit should call

for a UN Decade of Action on Road Safetywith a commitment to cut the forecast levelof road fatalities by 50 per cent to 2020 anoutcome that would save 5 million lives andprevent 50 million injuries.

Strengthen national planning. Global tar-gets will only be meaningful if they are con-verted into national planning targets and more importantly backed by compre-hensive national strategies. Governmentsneed to set out the legislative and enforce-ment mechanisms that will be put in place toachieve the targets that are set. Adopting asafe systems approach to road safety man-agement will help to establish a clear, ho-listic governing framework for interventions(see box 2).


15/20


2500000

2000000

1500000

1000000900000

1900000

500000

2000 2005 2010 2015 2020

GlobalRTIDeaths

50% FatalityReduction Target

5 Million Fatalities

50 Million Serious Injuries

Do nothing

Decade of Action

Figure 5: Changing Direction: Potential of a Decade of Action for Road Safety

Source: Guria, J. (2009)

BOX 2:

The Safe Systems approach

Taking a Safe System approach can unlock a large potential for raising road safety performance. Itrequires that the road system be designed to expect and accommodate human error, recognisingthat prevention efforts not withstanding, road users remain fallible and crashes will occur.

The basic strategy of a Safe System approach is to ensure that in the event of a crash, the impact ener-gies remain below the threshold likely to produce either death or serious injury. This threshold will varydepending upon the level of protection offered to the road users involved. For example, the chances ofsurvival for an unprotected pedestrian hit by a vehicle diminish rapidly at speeds greater than 30km/h,whereas for a properly restrained motor vehicle occupant in a well engineered vehicle the critical impactspeed is 50km/h for side impact crashes and 70km/h for head-on crashes. The Safe System approachshould therefore guide all aspects of road safety management land use planning; road design; vehiclestandards; speed limit policy; road user training to meet these energy threshold parameters.

The Safe System offers new potential for improvement for countries at the leading edge of road safe-ty performance, and has for example been adopted in the road safety policies of the Netherlands andSweden, but it is appropriate at all levels of road safety performance and economic development.

The interventions adopted will differ from country to country but the synergies achieved by taking acomprehensive approach can accelerate improvement signicantly.

Source: ITF/OECD


16/20


Mobilise additional nancing. Aid donorsshould back national effort by adopting a$300m international action plan to catalysetrafc injury prevention and refocus nationalroad safety policies and budgets. For an in-vestment of $30m a year the leading donornations and major public health philanthrop-

ies could transform the way road safety isunderstood and managed across the devel-oping world.

Integrate road safety into road design.Aid donors and the major multilateral lend-ers should set-aside at least 10% of nanc-ing for road programmes for investment insafety assessment and measures to protectvulnerable users. It is also important thatdonors strengthen their own capacity for

providing support, as very few road safetyspecialists are currently employed within

development agencies or the internationalnancial institutions. It is welcome that theWorld Bank and the main regional devel-opment banks have issued a joint declara-tion A Shared Approach to Managing RoadSafety ahead of the Moscow conference.But now we need to see these words trans-

lated into action.

Deliver road safety vaccines. We have theknowledge and the vaccines to tackle thisepidemic. Road design that puts vulnerableroad users rst; motorcycle helmets andseat belts; enforcement regimes for drinkdriving and speed; vehicle standards anddriver training and licensing these are themeasures that are proven to reduce roadtrafc injuries. Now international and coun-

try level commitment and resources are ur-gently needed to deliver these vaccines.


17/20


Time for Action

The Moscow conference has an opportunity tolift the veil of neglect hanging over road safety.It can chart a new course by pressing the UNto adopt a Decade of Action for Road Safety

aimed at halving the projected increase in theforecast level of road fatalities a goal that, ifachieved, could save 5 million lives and prevent50 million serious injuries.

Translating that goal into action will require lead-ership at many levels. International developmentagencies like the World Bank, one of the largestsources of investment in roads, should ensurethat road safety assessments become a stand-ard part of the toolkit for future funding decisions.

Developing country governments could returnhome from Moscow to draw up national plans for

cutting road deaths through practical regulatorymeasures. International aid donors could cata-lyse and support these efforts by setting up a$300m international action plan, as proposed bythe Make Roads Safe campaign, and encourag-ing interventions to deliver road safety vaccines.

Above all, the Moscow summit provides an op-portunity to rethink the links between transportpolicy and development. We need to shakeoff a business model that measures nationalprogress in terms of kilometres of metal roadsand turns a blind eye to avoidable human suf-fering. And we need to put road safety at theheart of the international development agenda.


18/20


About the authors

Dr Kevin Watkins is Senior Visiting ResearchFellow at the Global Economic GovernanceProgramme, Oxford University. He is currentlyDirector of UNESCOs Education for All Global

Monitoring Report. From 2004-2008, Kevin wasDirector of the United Nations DevelopmentProgrammes Human Development Report Of-ce. He was lead author of three Human De-velopment Reports including the 2008/2009 re-port on climate change. Prior to joining the UN,Kevin was Head of Research at Oxfam, wherehe worked for thirteen years on a wide rangeof issues, including African debt, internationaltrade, education and health policy. Kevin is aboard member of UNICEFs Innocenti Center.

Dr Devi Sridhar is a Senior Researcher at theGlobal Economic Governance Programmewhere she directs the GEGs Global HealthProject. She is also a Fellow in Politics at AllSouls College as well as a Research Associ-ate at Oxfords Centre for International Stud-ies and a Research Associate of the Institute of

Social and Cultural Anthropology, Oxford. Shehas worked at the Kaiser Family Foundation, onthe Oxfam GB Policy Team, as a contributor tothe UNDP Human Development Report, and asa consultant to Save the Children UK and theWorld Health Organization.


19/20


Acknowledgements

Tony Bliss and Rebecca Ivers generously con-tributed their time and thoughts to this paper.Tami Tamashiro assisted with research anddrafting. Kate McMahon provided value of life

economic costings. The paper includes in-put from country background papers preparedby Centre for Injury Prevention and Research(Bangladesh), the Institute for Road Trafc Edu-cation (India), Asia Injury Prevention Foundation(Vietnam), Liliana Escober-Chaves (Colombia),and the Injury Control Centre [Mable Nakitto]& Paul Kwamusi (Uganda). Additional materialprovided by the ITF/OECD Joint Transport Cen-tre and the FIA Foundation.


20/20

For more information visit the MAKE ROADS SAFE website: www makeroadssafe org

Road Traffic Injuries Kevin Watkins

Documents

Transcript of Road Traffic Injuries Kevin Watkins