For more than a decade, there has been little progress in reducing road traffic tragedies in low- and middle-income countries (LMICs). Annually, over a million men, women and children are killed, an estimated 28 million are injured and 1.4 million are disabled in these countries. This tragedy will continue unless changes are made to utilize the prioritized, proven, realistic and relevant countermeasures that worked in the rich world.
“For more than a decade, there has been little progress in reducing road traffic tragedies in low- and middle-income countries.”
Never before has there been traffic carnage of this magnitude. The economic losses compound every year. Developing nations pay an estimated US $625 billion annual economic toll for injuries from road traffic crashes directly from family, business or public funds that could be invested in economic growth.
The Raw Dimensions
The 15 LMICs with the largest number of fatalities listed in Table 1 shows the raw dimensions of the issue. These countries have 65% of global annual fatalities and 60% of the population. The average population death rate (deaths per 100,000 population) is 22.5, ranging from 12.3 to 36.2. They have 45% of global registered vehicles. Seven of them have more motorcycles and mopeds than cars.
More raw dimensions are in Table 2 showing the 15 LMICs (with populations over four million) who have the highest population death rates. They have 11.4% of global annual fatalities and 6% of the population. Of those reporting, five of the countries had larger registrations of two- and three-wheeled than four-wheeled vehicles.
These two tables represent the cold facts of road traffic safety in LMICs. The average 2014 GDP per capita for all of the countries in these tables is below US $3,300. The columns representing the potential lives saved if the population fatality rates are reduced to ten in these countries, the approximate current rate of the United States, is roughly what is needed in order to cut global fatalities in half as called for in the 2030 agenda for Sustainable Development Goals.
As a matter of reference, Table 3 shows the 15 high-income nations (with populations over four million) with the lowest population fatality rates. The average rate is 3.9. These countries have 6.6% of the world population, but 17.6% of the world’s registered vehicles. They only have 1.6% of global, annual fatalities. Their average 2014 per capita GDP is US $54,400.
The matter in low- and middle-income countries is certainly urgent, but the response from the global road safety community has not been. The United Nations intervened in 2004 and charged the World Health Organization to turn back the carnage. Since then there have been big plans but feeble results. Incredible though it may be, the UN/WHO seems to have not understood what really happened in the rich world where the same issue appeared unsolvable some 40 years ago.
“Incredible though it may be, the UN/WHO seems to have not understood what really happened in the rich world where the same issue appeared unsolvable some 40 years ago.”
With economic development, LMICs are now experiencing increases in vehicle ownership, traffic volumes and new and inexperienced drivers travelling on safety deficient roads. The means of reducing crashes, injuries and fatalities in the rich world was to make existing roads as safe as possible as soon as possible. This required realizing that roads are a central and critical part of the road traffic safety equation. The American Highway Safety Act of 1973 originated this thinking. Rich countries around the world followed the US model achieving even better results than the US. All seemed to have earned increased public support for road safety programs as a positive side effect.
The WHO 2011 Global Plan for the Decade of Action offers overly complex recommendations of 34 activities and 48 sub-activities with no concepts of what to do when. The Save LIVES; A Road Safety Technical Package, published in 2017 by the WHO, is an improvement as a separate document, but it also confuses the issue as it does not clarify if it is replacing the recommendations in the 2011 Global Plan document. In contrast, we provide a comprehensive program of eight priorities and a model for a new, professional, global road safety agency to specifically aid LMICs, including facilitating project funding as needed.
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