Confronting “Death on Wheels” Making Roads Safe in Europe and Central Asia
Executive Summary
“Death on wheels” evokes a bleak image, but an appropriate one for countries in the World Bank’s Europe and Central Asia (ECA) Region. A combination of weak road safety management capacity, deteriorated roads, unsafe vehicles, poor driver behavior, and patchy enforcement of road safety laws, alongside exponential growth in the number of vehicles, have contributed to road traffic injuries and fatalities multiplying at a rapid pace. Read More
Transport is central to development—it facilitates the movement of people, goods, and services; enhances employment opportunities; and improves access to health care, education, and other essential services(World Bank 1996). Most passenger and goods traffic uses roads (for example, close to 80 percent and 50 percent, respectively, in the European Union) (Commission of the European Communities 2001). Transport investments contribute to economic growth in both densely populated cities and major corridors and more sparsely populated suburban, rural, and other areas (Banister and Wright 2005; Straub 2008). In low- and middle-income countries (LMICs), transport investments reduce social exclusion by facilitating mobility; increase access to markets and basic services; and improve health, education, and quality of life.
How should exposure to RTI risk be measured? With the growing level of cooperation between the health and transport sectors, deaths—“fatalities per 1 00,000 population” are becoming a widely used measure of exposure to RTI risk (OECD and ECMT, 2006). The use of population as a denominator permits comparisons with other causes of injury or with diseases.
Chapter III. Interventions and Results: What Is the Evidence?
To prevent the occurrence of road traffic injuries, minimize their severity when they occur, and reduce the severity of victims’ injuries and the impact on others following injury events, various programs and interventions have been designed and implemented in different countries. There is strong evidence of the effectiveness of interventions in high income countries, but evidence from low- and middle-income countries is relatively rare, so international organizations such as the WHO endorse tailoring HIC-proven interventions to LMICs (Peden and others 2004, World Bank 2007a).
Chapter IV. The Role of Health Systems in Preventing RTIs and Helping Victims
In accordance with the vision outlined in “The Tallinn Charter: Health Systems for Health and Wealth” (WHOEURO 2 008b), strengthened health systems have a major role to play as part of a multisectoral effort to improve road safety and other health conditions. The quality and effectiveness of the health system have a direct bearing on achieving road safety goals.
The approach to road safety has evolved in recent decades from “blaming the victim” to “safe systems.” In the 1950s and 1960s, road safety policies emphasized the role of individual responsibility and used legislation, traffic management, drivers’ licensing and vehicle inspections, and information and communication to change road users’ behaviors. Little progress was made in reducing road injuries. This chapter describes the more systematic “safe systems” approach that has evolved, which identifies the risk factors that contribute to crashes and injuries, and then discusses interventions that reduce the risks associated with those factors (Peden and others 2004, OECD/ITF, 2008; and Bliss and Breen, 2009).
Chapter VI. World Bank Support for Road Safety Improvements in ECA and in other Regions
With an understanding of what Europe and Central Asia (ECA) countries are doing and could do to improve road safety, it is appropriate to examine the World Bank’s road safety work, which has been underway for more than two decades. This chapter presents an overview of that work, with special emphasis on efforts in ECA and the lessons the World Bank has learned through various country projects.
Chapter VII. Priorities for Intersectoral Work on Road Safety in ECA
International good practice suggests effective RTIs prevention in ECA countries would need to be implemented systematically over the short and medium terms, with a high level of committed political support and funding under the stewardship of a lead agency to ensure sustainability, tailored to the individual circumstances of each country, sequencing the interventions over time, and in accordance with consistent and harmonized policies and strategies across sectors and disciplines. Building on that knowledge, this chapter outlines broad strategic themes to use to set priorities for moving the road safety agenda forward in ECA.
Chapter VIII. The Task Ahead: Operationalizing an Effective Response in ECA
Drawing from lessons worldwide, the following key considerations have been offered to guide World Bank efforts on road safety, working in partnership with governments, international agencies, private sector entities, and civil society organizations (Saghir 2009): • The scale of the public health crisis from road traffic fatalities in low- and middle- income countries (LMICs) is unacceptable.
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