Halving road deaths by 2020: A global health priority

The UN’s very ambitious casualty reduction target poses a significant challenge to governments across the world to reinvigorate their road safety policies and adopt effective strategies for road injury prevention. An unrivalled source of guidance for exactly this is contained in the International Transport Forum’s new publication “Zero Road Deaths and Serious Injuries: Leading a Paradigm Shift to a Safe System”. This report, prepared by an ITF group comprising experts from countries with the most successful performance in road injury reduction, challenges policymakers to envisage a world entirely free from road fatalities and serious injuries.

Rather than blame the victim for road crashes, the report advocates a “forgiving” or “safe system” approach which recognises that while people will always make mistakes, there is nothing inevitable about deaths and serious injuries from road crashes. The report promotes an integrated combination of policies for safe vehicles, safe roads and safe road users, which aims to ensure that when crashes occur the impact forces do not exceed the physical limits of the human body and lead to serious injury or death.

A key message of the ITF report is the importance of accepting a shared responsibility to design, manage and use our road traffic systems in ways that reduce the risk of injury. In practice, this approach encourages policymakers to apply a combination of road infrastructure, vehicle technologies and behavioural measures. Speed management becomes a critical overall policy instrument especially as regards vulnerable road users, who account for nearly half of all road fatalities, and where avoiding any impact above 30 km/h is a critical life-saving requirement.

To achieve the UN’s ambitious target much needs to be done. According to the World Health Organization, too many countries lack the basic framework of laws that are the sine qua non for effective road injury prevention. For example, only 44 countries worldwide have best practice helmet laws; only 34 countries have best practice drink driving laws; and only 40 countries apply the most important vehicle safety regulations. Too often also, new road construction in low and middle income countries raises levels of speed but neglects investment in road side architecture that will protect both vehicle and vulnerable road users alike.

Health ministers and the public health community as a whole have a vital role to play in road injury prevention. They are responsible, of course, for emergency response and post-crash care which is critical to rates of survival and recovery for victims. But in addition, the health sector can act as a powerful catalyst for effective implementation of the “safe system” approach . Data, such as hospital admission records, for example, are an essential resource to help policymakers determine their priority road safety actions.

Another vital issue is funding. With the notable exceptions of the Bloomberg Philanthropies and the FIA Foundation there is a lack of donor support for national, regional, and global road safety initiatives. In 2015 the UN General Assembly adopted a resolution on road safety that called for the establishment of a UN Road Safety Trust Fund. This is a very welcome proposal as it could, if properly resourced, provide much needed support for capacity building in road injury prevention in low and middle income countries that account for almost 90% of the world’s road traffic deaths.

With road safety now firmly on the global health agenda and with policy recommendations so expertly framed by the International Transport Forum really there has never been a better time for concerted global action to make roads safe.

NB: The International Transport Forum (ITF) at the OECD received the 2016 Special Award of the Prince Michael of Kent International Road Safety Awards for “leadership in improving the delivery of road safety across the world”.