Sta­tus Re­port on Road Safety

And an agenda to halve road mishaps

Consumer Voice - - Front Page - By Ashim Sanyal

And an Agenda to Halve Road Mishaps

"Ac­ci­dents, and par­tic­u­larly street and high­way ac­ci­dents, do not hap­pen – they are caused." ~Ernest Green­wood

In Septem­ber 2015, heads of states at­tend­ing the United Na­tions Gen­eral As­sem­bly adopted the his­toric Sus­tain­able De­vel­op­ment Goals (SDGs). One of the new SDG tar­gets (3.6) is to halve the global num­ber of deaths and in­juries from road-traf­fic crashes by 2020. In­clu­sion of such an am­bi­tious road-traf­fic fa­tal­ity tar­get is a sig­nif­i­cant ad­vance­ment for road safety. It is a re­flec­tion of the grow­ing recog­ni­tion of the enor­mous toll ex­acted by road-traf­fic in­juries – road-traf­fic crashes are a lead­ing cause of death glob­ally, and the main cause of death among those aged 15–29 years. This ar­ti­cle en­cap­su­lates the key risk fac­tors that per­pet­u­ate road-traf­fic in­juries and also in­forms how leg­is­la­tion on each of th­ese risk fac­tors can have pos­i­tive im­pacts on re­duc­ing such mishaps.

The SDG tar­get is also a recog­ni­tion of the bur­den that road-traf­fic in­juries put on na­tional economies and house­holds, and thus their rel­e­vance to the broader de­vel­op­ment and en­vi­ron­ment agen­das ad­dressed by the SDGs. Adopt­ing a tar­get on road­traf­fic in­juries is an ac­knowl­edge­ment of the strong sci­en­tific ev­i­dence base that ex­ists on what works to re­duce road-traf­fic in­juries. There is con­sid­er­able

ev­i­dence about in­ter­ven­tions that are ef­fec­tive at mak­ing roads safer, and coun­tries that have suc­cess­fully im­ple­mented th­ese in­ter­ven­tions have seen cor­re­spond­ing re­duc­tions in road-traf­fic deaths. Rolling out th­ese in­ter­ven­tions glob­ally of­fers huge po­ten­tial to mit­i­gate fu­ture dam­age and save lives.

Decade of Ac­tion for Road Safety

The Decade of Ac­tion for Road Safety (2011– 2020) calls on coun­tries to im­ple­ment the mea­sures iden­ti­fied in­ter­na­tion­ally to make their roads safer. The UN Gen­eral As­sem­bly in­vited WHO to mon­i­tor progress through its ‘global sta­tus re­port on road safety’ se­ries. This re­port is the third in the se­ries, and pro­vides a snap­shot of the road­safety sit­u­a­tion glob­ally, high­light­ing the gaps and thereby en­cour­ag­ing the need for coun­tries and the in­ter­na­tional com­mu­nity to gal­vanise greater and faster ac­tion.

State of Global Road Safety

The plateau in road-traf­fic deaths, set against a four per cent in­crease in global pop­u­la­tion and 16 per cent in­crease in mo­tori­sa­tion, sug­gests that road­safety ef­forts over the past three years have saved lives. The num­ber of road-traf­fic deaths – 1.25 mil­lion in 2013 – has plateaued since 2007.

This plateau must be seen against a back­drop of a global in­crease in pop­u­la­tion and mo­tori­sa­tion and a pre­dicted rise in deaths. This sug­gests that in­ter­ven­tions im­ple­mented over the past few years to im­prove global road safety have saved lives. This re­port shows that 68 coun­tries have seen a rise in the num­ber of road-traf­fic deaths since 2010, of which 84 per cent are lower middle-in­come coun­tries. Seventy-nine coun­tries have seen a de­crease in the ab­so­lute num­ber of deaths, of which 56 per cent are low- and middle-in­come.

How­ever, low-in­come coun­tries have fa­tal­ity rates more than dou­ble those in high-in­come coun­tries and there are a dis­pro­por­tion­ate num­ber of deaths rel­a­tive to th­ese coun­tries’ level of mo­tori­sa­tion: 90 per cent of road-traf­fic deaths oc­cur in low- and middle-in­come coun­tries, yet th­ese coun­tries have just 54 per cent of the world’s ve­hi­cles.

Here are some trends to take note of: Road traf­fic death rates in low- and mid­dlein­come coun­tries are more than dou­ble those in high-in­come coun­tries. Al­most half of all road-traf­fic deaths are among pedes­tri­ans, cy­clists, and mo­tor­cy­clists. Al­most half of all deaths on the world’s roads are among those with the least pro­tec­tion – mo­tor­cy­clists (23 per cent), pedes­tri­ans (22 per cent), and cy­clists (4 per cent). The like­li­hood of dy­ing on the road as a mo­tor­cy­clist, cy­clist, or pedes­trian varies by re­gion: the African Re­gion has the high­est pro­por­tion of pedes­trian and cy­clist deaths at 43 per cent of all road-traf­fic deaths The rates are rel­a­tively low in the South-East Asia Re­gion. This partly re­flects the level of safety mea­sures in place to pro­tect dif­fer­ent road users and the pre­dom­i­nant forms of mo­bil­ity in dif­fer­ent re­gions.

Key Risk Fac­tors

Five key be­havioural risk fac­tors have been iden­ti­fied for road-traf­fic in­juries: speed, drinkdriv­ing, and fail­ure to use mo­tor­cy­cle hel­mets, seat­belts, and child re­straints. There is a strong ev­i­dence base show­ing the pos­i­tive im­pacts that leg­is­la­tion on each of th­ese risk fac­tors can have on re­duc­ing crashes, in­juries, and deaths

In the last three years, 17 coun­tries rep­re­sent­ing 409 mil­lion peo­ple have amended their laws on one or more key risk fac­tors for road-traf­fic in­juries to bring them into line with best prac­tices that are dis­cussed below.

Re­duc­ing speed

An adult pedes­trian has less than a 20 per cent chance of dy­ing if struck by a car at less than 50 kmph, but al­most a 60 per cent risk of dy­ing if hit at 80 kmph. As av­er­age traf­fic speed in­creases, so does the like­li­hood of a crash. If a crash does hap­pen, the risk of death and se­ri­ous in­jury is greater at higher speeds, es­pe­cially for pedes­tri­ans, cy­clists, and mo­tor­cy­clists. Male and young driv­ers are most likely to speed, while other fac­tors likely to in­flu­ence speed in­clude al­co­hol, road lay­out, traf­fic den­sity, and weather con­di­tions.

Re­duc­ing drink-driv­ing

Only 34 coun­tries rep­re­sent­ing 2.1 bil­lion peo­ple have drink-driv­ing laws in line with best prac­tices. While strong en­force­ment of drink-driv­ing laws im­proves their ef­fec­tive­ness, only 46 coun­tries rate their en­force­ment of drink-driv­ing laws as ‘good’.

Im­prov­ing mo­tor­cy­cle hel­met use and qual­ity

Only 44 coun­tries rep­re­sent­ing 1.2 bil­lion peo­ple have hel­met laws that meet best prac­tice and ap­ply a hel­met stan­dard. Rapid growth in the use of mo­torised two-wheeled ve­hi­cles in many coun­tries has been ac­com­pa­nied by in­creases in in­juries and fa­tal­i­ties among users, but wear­ing a mo­tor­cy­cle hel­met can

In­creas­ing seat­belt use

Wear­ing a seat­belt re­duces the risk of fa­tal­ity among driv­ers and front-seat pas­sen­gers by 45–50 per cent, and the risk of mi­nor and se­ri­ous in­juries by 20–45 per cent. Among rear-seat pas­sen­gers, seat­belts re­duce fa­tal and se­ri­ous in­juries by 25 per cent and mi­nor in­juries by up to 75 per cent.

Im­prov­ing child-re­straint use

Child re­straints re­duce the like­li­hood of fa­tal­i­ties as a re­sult of a crash by ap­prox­i­mately 90 per cent among in­fants and be­tween 54 per cent and 80 per cent among young chil­dren. Ad­di­tion­ally, chil­dren are safer seated in the rear of a ve­hi­cle than in the front. Only 53 coun­tries (rep­re­sent­ing just 17 per cent of the world’s pop­u­la­tion) have a child-re­straint law based on age, height, or weight, and ap­ply an age or height re­stric­tion on chil­dren sit­ting in the front seat.

Weak Laws in the World’s 10 Most Pop­u­lous Coun­tries Put 4.2 Bil­lion Lives at Risk

The world’s 10 most pop­u­lous coun­tries ac­count for al­most 4.2 bil­lion peo­ple and 56 per cent of the world’s road-traf­fic deaths (703,000). None of th­ese coun­tries has laws on all five risk fac­tors, in line with best prac­tice. If th­ese coun­tries were all to bring their road-safety laws in line with best prac­tice, and ad­e­quately en­force them, there would be huge po­ten­tial to save lives and re­duce in­juries re­sult­ing from road-traf­fic crashes. Fur­ther­more, this would go a long way to­wards reach­ing the tar­get re­duc­tion in road­traf­fic deaths iden­ti­fied in the Sus­tain­able De­vel­op­ment Goals.

An anal­y­sis of leg­is­la­tion of th­ese coun­tries (re­fer to fig­ure on ‘Ten most pop­u­lous coun­tries and best prac­tice leg­is­la­tion’) shows that: None of the 10 coun­tries meets best-prac­tice cri­te­ria across all five risk fac­tors No coun­try meets best-prac­tice leg­is­la­tion for speed Only two coun­tries meet best-prac­tice cri­te­ria on drink­ing and driv­ing, rep­re­sent­ing 1.6 bil­lion peo­ple Three coun­tries, rep­re­sent­ing 470 mil­lion peo­ple, have laws meet­ing best prac­tice on hel­mets Five coun­tries have seat­belt laws that meet best prac­tice, rep­re­sent­ing 3.1 bil­lion peo­ple Only two out of 10 coun­tries have child-re­straint laws meet­ing best prac­tice, rep­re­sent­ing 340 mil­lion peo­ple

Pol­i­cy­mak­ers Can Make Ve­hi­cles and Roads Safer

Ve­hi­cles sold in 80 per cent of all coun­tries world­wide fail to meet ba­sic safety stan­dards. Most coun­tries fail to ap­ply min­i­mum UN safety stan­dards to new cars. Over the past three years, there has been a 16 per cent in­crease in the global num­ber of reg­is­tered mo­torised ve­hi­cles – in 2014 there were a record 67 mil­lion new pas­sen­ger cars on the world’s roads, with nearly 50 per cent of th­ese pro­duced in middle-in­come coun­tries. Safe ve­hi­cles play a crit­i­cal role in avert­ing crashes and re­duc­ing the like­li­hood of se­ri­ous in­jury. Over the past few decades, a com­bi­na­tion of reg­u­la­tory re­quire­ments and con­sumer de­mand has led to in­creas­ingly safe cars in many high-in­come coun­tries. Hence, there is an ur­gent need for min­i­mum ve­hi­cle stan­dards to be im­ple­mented by ev­ery coun­try, es­pe­cially the low- and middle-in­come coun­tries where the risk of a road-traf­fic crash is high­est.

En­sur­ing that safety mea­sures are im­ple­mented when road-in­fra­struc­ture projects are de­signed can re­sult in im­por­tant safety gains for all road users. This is par­tic­u­larly true where road de­sign and main­te­nance are un­der­pinned by a ‘safe sys­tem’ ap­proach that makes al­lowances for hu­man er­ror. The use of in­fra­struc­ture in­ter­ven­tions to help man­age speed and re­duce the like­li­hood of a crash (for ex­am­ple, road widen­ing or raised pedes­trian cross­ings), and in­ter­ven­tions to mit­i­gate the sever­ity of the crash (for ex­am­ple, us­ing road­side bar­ri­ers and round­abouts), all re­duce death and in­jury on the road. At present, 91 coun­tries have poli­cies to sep­a­rate vul­ner­a­ble road users from high­speed traf­fic.

Rec­om­men­da­tions

The re­port shows that 1.25 mil­lion peo­ple are killed each year on the world’s roads, and that this fig­ure has plateaued since 2007. In the face of rapidly in­creas­ing mo­tori­sa­tion, this sta­bil­i­sa­tion of an oth­er­wise pro­jected in­crease in deaths is an in­di­ca­tion of the progress that has been made. How­ever, th­ese ef­forts to re­duce road-traf­fic deaths are clearly in­suf­fi­cient if the in­ter­na­tional road-safety tar­gets set by the Sus­tain­able De­vel­op­ment Goals are to be met. Achiev­ing ef­fec­tive and long-last­ing im­prove­ments in road safety has been at­tained in a num­ber of coun­tries that have adopted a broad ap­proach ad­dress­ing many di­men­sions of road safety. The chal­lenge to­day is for the down­ward trends in road-traf­fic deaths seen in th­ese coun­tries to be repli­cated in other coun­tries, but in a shorter time­frame. Political will is cru­cial to driv­ing such changes, but ac­tion is par­tic­u­larly nec­es­sary on a num­ber of spe­cific is­sues: Good laws re­lat­ing to key risk fac­tors can be ef­fec­tive at re­duc­ing road-traf­fic in­juries and deaths. Some progress has been made: over the

past three years, 17 coun­tries (rep­re­sent­ing 5.7 per cent of the world’s pop­u­la­tion) have amended their laws to bring them in line with best prac­tice on key risk fac­tors. None­the­less, many coun­tries lag far be­hind in terms of en­sur­ing that their laws meet in­ter­na­tional stan­dards. ack of en­force­ment fre­quently un­der­mines the po­ten­tial of road-safety laws to re­duce in­juries and deaths. More ef­fort needs to be placed in op­ti­mis­ing en­force­ment ef­forts.

In­suf­fi­cient at­ten­tion has been paid to the needs of pedes­tri­ans, cy­clists, and mo­tor­cy­clists, who to­gether make up 49 per cent of all global road-traf­fic deaths. Mak­ing the world’s roads safer will not be pos­si­ble un­less the needs of th­ese road users are con­sid­ered in all ap­proaches to road safety. Mak­ing walk­ing and cy­cling safer will also have other pos­i­tive co-ben­e­fits if non-mo­torised forms of trans­port be­come more pop­u­lar, in­clud­ing more phys­i­cal ex­er­cise, re­duced emis­sions, and the health ben­e­fits as­so­ci­ated with such changes.

Mak­ing cars safer is a crit­i­cal com­po­nent of sav­ing lives on the roads. Eighty per cent of coun­tries around the world – no­tably low- and mid­dlein­come coun­tries – still fail to meet even the most ba­sic in­ter­na­tional stan­dards on ve­hi­cle safety. The lack of such stan­dards in middle-in­come coun­tries (which are in­creas­ingly be­com­ing ma­jor car man­u­fac­tur­ers) also risks jeop­ar­dis­ing global ef­forts to make roads safer. Gov­ern­ments must ur­gently sign up to the min­i­mum in­ter­na­tional ve­hi­cle stan­dards for man­u­fac­tur­ers and as­sem­blers, and limit the im­port and sale of sub­stan­dard ve­hi­cles in their coun­tries.

Coun­tries need to ad­dress a num­ber of other ar­eas in or­der to im­prove road safety. Th­ese in­clude im­prov­ing the qual­ity of their data on road­traf­fic in­juries and har­mon­is­ing data in line with in­ter­na­tional stan­dards, hav­ing a lead agency with the au­thor­ity and re­sources to de­velop a na­tional road-safety strat­egy whose im­ple­men­ta­tion they over­see, as well as im­prov­ing the qual­ity of care that is avail­able to those who suf­fer a road-traf­fic in­jury. De­spite a strong ev­i­dence base around what works, it shows in­suf­fi­cient at­ten­tion has been paid to road safety and that a heavy price is be­ing paid in terms of lives lost, long-term in­jury, and pres­sure on health­care ser­vices. The in­ter­na­tional at­ten­tion promised to the is­sue of road safety by the new Sus­tain­able De­vel­op­ment Goal tar­get to halve deaths and in­juries from road traf­fic crashes by 2020 presents a golden op­por­tu­nity for much­needed ac­tion, and one that must be seized by all coun­tries. Through this, the pace of progress can be ac­cel­er­ated and an ac­tual de­cline in global road-traf­fic deaths re­alised.

re­duce the risk of death by al­most 40 per cent and the risk of se­vere in­jury by ap­prox­i­mately 70 per cent.

Changes in Leg­is­la­tion on Be­havioural Risk Fac­tors

2011–14 (Num­ber of Coun­tries Rep­re­sented)

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