Status Report on Road Safety
And an agenda to halve road mishaps
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.
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.
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.
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.
Changes in Legislation on Behavioural Risk Factors 2011–14 (Number of Countries Represented)
reduce the risk of death by almost 40 per cent and the risk of severe injury by approximately 70 per cent.