Road safety - threats and opportunities for poor countries

Chances are that everyone reading this will either have lost a close friend, relative, or work colleague in a road traffic crash in the last couple of years. Chances are, the reports said it was an “accident”. There might even have been police reports giving the “cause of the accident.” Now, think about the meaning of the word “accident” - most people would agree it is an unpredictable event, one for which you could not possibly have prepared - it just happened. Now, think again. Can we predict what will happen when a cyclist''s unprotected head hits the concrete at 100 kms an hour? Can we predict what will happen when a powerful car races down a road a few meters away from the entrance of a primary school, just as the kids are leaving school? Can we predict what will happen when a matatu (commuter mini bus) driver gets behind the wheel at dusk, after a few bottles of alcohol, heading for a destination six hours away? And can we predict what will happen when a mosquito bites a baby, just after feeding on a person sick from malaria? Well - chances are, the first three scenarios will be called accidental, and the last one will be targeted for prevention! The truth is, all four are perfectly predictable, and preventable. The more than 3, 200 persons dying on the world''s road every day have become predictable - we know they will happen, we know where they will happen, and what kind of people will be involved. Yet the majority of communities and governments still call them accidental, and make no concrete provision for their prevention.On April 7 2004, the WHO and its partners will commemorate World Health Day. This time round, the theme is “Road Safety is no Accident.” Road traffic injuries are a huge public health and development problem that kills between 800 000 and 1.18 million people, and injures or disables another 20 to 50 million more every year¹. Data from the WHO and World Bank show that without appropriate response, these injuries will rise dramatically by the year 2020, particularly in rapidly motorizing countries. In addition, apart from the enormous impact on families and communities, road traffic crashes are costing governments between 1 and 3 per cent of their gross domestic product². Health facilities are over-burdened with victims of road traffic crashes, over-stretching their already meager health budgets.Once we acknowledge that Road Safety does not happen by accident, (and that road safety is the state where we have “no accident”) then we are well on the road to finding solutions. The systemic approach being recommended by the WHO moves from defining the burden of the road traffic injuries (size, nature) to understanding the factors that increase risk and vulnerability, to designing interventions, testing them for effectiveness, and finally, to getting the effective interventions implemented wherever they are needed.