Road Traffic Accidents Increase Dramatically Worldwide

(March 2006) Road traffic accidents—the leading cause of death by injury and the tenth-leading cause of all deaths globally—now make up a surprisingly significant portion of the worldwide burden of ill-health. An estimated 1.2 million people are killed in road crashes each year, and as many as 50 million are injured, occupying 30 percent to 70 percent of orthopedic beds in developing countries hospitals.¹And if present trends continue, road traffic injuries are predicted to be the third-leading contributor to the global burden of disease and injury by 2020.²

Developing countries bear a large share of the burden, accounting for 85 percent of annual deaths and 90 percent of the disability-adjusted life years (DALYs) lost because of road traffic injury.³ And since road traffic injuries affect mainly males (73 percent of deaths) and those between 15 and 44 years old, this burden is creating enormous economic hardship due to the loss of family breadwinners (see Figure 1).

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Figure 1 Road Traffic Deaths Worldwide by Sex and Age Group, 2002

Source: WHO Global Burden of Disease Project, Version 1 (2002).

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Road traffic injuries are predictable and preventable, but good data are important to understand the ways in which road safety interventions and technology can be successfully transferred from developed countries where they have proven effective. Awareness of the consequences of road traffic injuries is lagging among policymakers and the general public. What's needed is incorporation of comprehensive road safety programs into national planning in developing countries.

Profile of the Problem

In developed countries, road traffic death rates have decreased since the 1960s because of successful interventions such as seat belt safety laws, enforcement of speed limits, warnings about the dangers of mixing alcohol consumption with driving, and safer design and use of roads and vehicles. For example, road traffic fatalities declined by 27 percent in the United States and by 63 percent in Canada from 1975 to 1988. But traffic fatalities increased in developing countries during the same period—by 44 percent in Malaysia and 243 percent in China, for instance.⁴

More than one-half of all road traffic deaths globally occur among people ages 15 to 44—their most productive earning years. Moreover, the disability burden for this age group accounts for 60 percent of all DALYs lost because of road traffic accidents.⁵ The costs and consequences of these losses are significant. Three-quarters of all poor families who lost a member to road traffic death reported a decrease in their standard of living, and 61 percent reported they had to borrow money to cover expenses following their loss.⁶ The World Bank estimates that road traffic injuries cost 1 percent to 2 percent of the gross national product (GNP) of developing countries, or twice the total amount of development aid received worldwide by developing countries.⁷

As in developed countries, driver impairment is an important component of road traffic accidents in developing countries. Driving at excess speeds, while under the influence of alcohol or drugs, while sleepy or tired, when visibility is compromised, or without protective gear for all vehicle occupants are major factors in crashes, deaths, and serious injuries.

In general, pedestrians, cyclists, and moped and motorcycle riders are the most vulnerable road users as well as the heaviest users of roads in poor countries. Most people who use public transportation, bicycles, or mopeds and motorcycles or who habitually walk are poor, illuminating the higher risk borne by those from less privilege.⁸ In Asia, for instance, motorized two- and three-wheelers (such as motorized rickshaws) will make up the anticipated growth in numbers of motor vehicles.⁹ Figure 2 shows the higher proportion of deaths among these groups in developing countries.¹⁰

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Figure 2
Proportion of Road Users Killed in Various Modes of Transport As A Percent of All Fatalities, Selected Countries

Country	Pedestrians	Bicyclists	Motorized vehicles		Others
			Two-wheeled	Four-wheeled
Thailand	47	6	36	12	--
Malaysia	15	6	57	19	3
United States	13	2	5	79	1

*Note: Dates for above data vary according to city and country: Thailand, 1987; Malaysia, 1994; and United States, 1995. 
Source: Dinish Mohan, "Traffic Safety and Health in Indian Cities," in Journal of Transport and Infrastructure no. 9 (2002).