Road safety – WHO experience

Dr Krishnan Rajam, Technical Officer

Injury and Violence Prevention

Presentation on

• Overview, trends

• Data systems – issues

• Lead agencies – coordinating mechanism

• WHO experience in countries

• Way forward

Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily reflect the views

or policies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not

guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use.

Terminology used may not necessarily be consistent with ADB official terms.

Road traffic fatalities are predicted to increase

by the year 2020 esp. in Asia Pacific

Source: World BankWorld Bank data

Road safety – action areas

1. Policy

• Leadership (Cabinet)

• Transport

• Local government

2. Sectors

• Land use – planning of homes / work / rec. places, transport

• Safe roads – audit of new / existing, network safety management

• Safe vehicles – manufacture, import, regular checks

• Legislation, enforcement

• Health – pre-hospital, trauma care, rehabilitation

3. Advocacy

4. Research, Surveillance and Evaluation

Desired situation

Issues in data systems (often police based)

• Different definitions – death at site, < 7, 30 days

• Different sources – police, health, lack of linkage

• Lack of victim follow-up - late deaths / disability

• Emphasis on “human error” as cause

• Misinterpretation of existing data (e.g. denominator)

• Inadequate dissemination/ utilization of data

Cambodia,

RCVIS

Issues 2 - Under-reporting of deaths and serious injuries

Country Reported no.

deaths

Estimated no.

deaths

Cambodia

(RCVIS 2010)1 816 2 348

Lao PDR * 656 1075

Myanmar* 1 638 11 422

Philippines* 1 638 17 557

China* 96 611 220 783

Malaysia – 2009

Deaths – 6 745

Serious injury – 8 849

Minor injury – 15 823

* GSRRS

+ 85% serious inj.

under-reporting

Issues 3 - Despite under-reporting of deaths / serious injuries - inappropriate

use of technology / system – “black spot” methods, GPS, IRAP, etc

Cambodia – GPS to determine crash location

Malaysia – huge investment in “black spot”

determination and treatment

Philippines – not ready for IRAP

Lead agencies for road safety - Source- GSRRS

• 26 participating countries

• All except MIC, TUV & VAN have a lead agency

• Only 9 have endorsed & funded national strategy, set targets

• Only 12 have policy to encourage public transportation

• Only 10 have policy to encourage walking / cycling

• Coordinating mechanisms ineffective – resource imbalance across sectors

– distribution and activity of sector

• Mainly education based, esp. on children, drivers

• Media campaign focused (no concomitant

enforcement)

• Over investment in “black spots”, motorcycle lanes

Interventions - some issues

Research in UK - children can be trained using combination of real-traffic training, peer and adult interactions using computer simulations, and reinforcement.

The large population in USA makes it

difficult to implement this in every school.

NHTSA, 2009

Motorcycle lanes - heavy capital overlay,

maintenance, lighting & difficult integration

with roads ignored in cost benefit analysis

Trauma care cost

• Malaysia – all injuries 3rd leading cause of govt. hospital admissions, 6th leading

cause of deaths

• Cambodia – 2010, 0.8% of population a road crash victim & 1/6 serious injury,

economic cost of RT crashes – 279 million US

• China – survey 1998-2005; 200 million injured / year; 60 million required emergency

care; 14 million admitted; medical cost 9 billion USD ; 1 million permanent disability

• Papua New Guinea – 1993, Mendi provincial hospital; trauma 3rd common cause of

admissions, 43% of surgical cases; 11% of hospital cost

WHO support in road safety• Capacity building – training workshops - national, regional, sub-regional

• Develop national plans - CAM, LAO, VTN, MOG, PHL, TON, VTN

• Decade of Action May 2011 launch – 17 countries

• Data systems – CAM, CHN, VTN, PHL, MOG

• Data collection GSRRS 1 and 2

• Pre-hospital care review – CAM, MNG

• Model community-based projects – multisectoral

Road safety in Healthy Cities – Dalian, Suzhou, Darkhan, Phnom Penh, Vientiane

Road safety in Provinces – CAM, VTN, PHL (Guimaras Province)

Way forward

• Data systems – count all deaths (& injuries); special studies for risk factors

• Capacity building across sectors

• Demonstration projects – implement and evaluate interventions -

“low hanging fruits” – speed, seat belts, helmets, drinking & driving

• Priority countries – CHN, MOG, CAM, LAO, VTN, PHL, MAA, BRU, PICs