"Sharing Responsability for Safer Roads"

Conference on Global Traffic Injury Prevention

London, UK
10 February 2003

Honourable Ministers, Mr Mosley, Distinguished participants, Ladies and gentlemen,

It is a great pleasure for me to be here today to address road safety. Five years ago, I set two main criteria for how the World Health Organization should set its priorities: to use as our guide the global burden of disease and its trends, and to focus on the potential for poverty reduction and development.

We need to prioritize those conditions, issues and diseases which cause most deaths or disease and which are likely to grow in the years to come unless we take action. And we should focus particularly on those that affect the poor disproportionately, and which hamper developing countries' pace of economic and social growth and development.

For WHO, this means road safety should be high on the priority list. Let me put the figures into a global perspective:

  • according to the 2000 Global Burden of Disease Study, road traffic injuries are the ninth leading cause of all deaths worldwide;
  • the burden of disease, namely the loss of healthy life years, due to road traffic injuries is expected to jump to rank third by the year 2020, surpassed only by heart disease and major depression;
  • deaths from road traffic injuries account for 2.5% of the global mortality for all age groups.

This means that the road kills more people than malaria and puts tens of millions of people in hospital. In fact, in 2000, 1.26 million people died as a result of road crashes. In some low and middle income countries, road crash victims occupy up to 10% of hospital beds.

We all marvel at the sight of Formula One cars crashing at as much as 300 km/h, flipping through the air and landing in a jumbled heap, and then the driver climbing out without a scratch or a bruise. Indeed, the high emphasis on safety and the technological breakthroughs that enable drivers to survive such crashes help make our cars safer.

Yet the reality out on the world's roads is very different. Ordinary cars are not built like racing cars. Furthermore, many cars - particularly in the developing world - are in bad condition and kill or maim if they hit an object at speed.

We have the minibus filled to capacity and beyond, exploding a tyre and rolling over. We have the busy city street with children running out after a ball. The heavy truck losing its brakes and flattening anything that comes in its way. The drunk driver hitting someone on his way home.

Out of hope or hubris, most of us choose to believe we are invincible when on the road. And yet, there are few other features of daily life that are more dangerous.

We see large variations within Europe in the incidence of traffic injuries, but road safety is not primarily an industrialized country problem. Although the number of road crashes is unacceptably high in every country, road safety is first and foremost an issue for developing countries. In fact, 90% of all road traffic fatalities occur in low and middle income countries.

Of the 1.26 million annual deaths, 35% occur in the WHO Region of South East Asia (which includes India), 24% in the Western Pacific (which includes China), 13% in Africa, 11% in the Americas, 10% in Europe (which includes Eastern Europe and the former Soviet Union) and 7% in the Eastern Mediterranean Region which stretches from Morocco to Pakistan.

The human suffering for victims of traffic-related injuries and their families is incalculable.

In strictly economic terms, the costs associated with surgery, prolonged hospitalisation and long-term rehabilitation, in addition to lost productivity, represent tens of billions of euros each year. Road traffic injuries are a major drain on health and health care system resources. The burden put on health systems compromises prospects for development. In countries struggling with infectious diseases like AIDS, TB and malaria, and an increasing burden of chronic diseases, traffic injuries constitute an unnecessary and heavy burden.

But the costs go beyond the health system. Over 50% of all deaths due to road traffic injury occur among young adults aged between 15-44 years, a major loss of human resources and productivity.

Sadly, road traffic injuries cost some countries between 1 and 2% of their Gross Domestic Product. They also have a severe effect on the economy of families, laying a heavy cost burden on families and victims. They most affect the poorest. Many road crash victims are primary breadwinners and their death or disability has serious implications for families and dependants: reduction in quality of life, suffering and poverty.

Vulnerable road users - pedestrians, cyclists and passengers - account for the majority of road traffic crash deaths in low- and middle- income countries. Children, of course, are particularly vulnerable.

I mentioned road crashes compared to malaria. A particular challenge in the fight against malaria is to overcome the widespread resigned acceptance of the disease and its deadly toll. For many, malaria is part of life, and there is little belief that it can be overcome.

Road crashes, too, are such an accepted feature of life. It is often very difficult to convince populations and governments that change is possible. At WHO, we are careful not to speak about "road accidents". Accidents imply that these things "just happen", and that little can be done to prevent them.

Nothing is further from the truth. We can study road crashes just as we study other public health problems. We can identify the causes and address them. For example, car-seats for children were designed after paediatricians and surgeons identified a large and growing number of deaths and severe injuries to children ejected from cars during crashes.

The concept of "designated drivers" was invented by public health experts after epidemiologists had identified the large proportion of crashes involving alcohol. Many other interventions, focusing on addressing the root causes, have shown success. Such efforts are increasing the visibility of pedestrians and cyclists at night, promoting the use of motorcycle helmets and safety devices such as air bags, improving road design and limiting speed.

A few simple interventions, such as compulsory use of safety belts, drunken driving prohibitions, drivers’ education, and safety controls of vehicles, can make an enormous difference when implemented and enforced.

Effective attempts to reduce the burden of road crashes must include many sectors. The car industry, the road and city planning authorities, schools, the health sector and the media, must all pull together if we are to see results.

So it is very encouraging to see such a wide variety of people and sectors represented here today.

Let me outline what the World Health Organization is doing in this area.

WHO has a unique role as the lead coordinating agency for international public health. We are using this unique position to lead an evidence-based and integrated programme of activities in road traffic injury prevention.

To increase the focus on injuries, I created a Department of Injuries and Violence Prevention in 2000, which has led to a major change in the focus and approach to road traffic injuries within the Organization.

In 2001, we presented a 5-year Strategy for Road Traffic Injury Prevention. The FIA has been a strong supporter of the implementation of the strategy.

The goals are to build capacity at national and local levels to monitor the magnitude, severity and burden of road traffic injuries, to incorporate road traffic injury prevention and control into the public health agendas of all regions of the world, and to promote and advocate for action-oriented strategies for prevention and control of the health consequences of motor vehicle collisions.

In addition, our work on alcohol includes efforts to tighten legislation on drunken-driving and to enforce it better, and to inform about the dangers of driving while under the influence of alcohol.

Next year will be a special year dedicated by WHO to road safety. I am pleased to let you be the first to know that the World Health Day 2004 will be dedicated to road traffic injury prevention. The theme is “Safe Roads”, drawing the attention of the world community to the growing problem of road traffic injuries and the need to step up interventions. As many of you know, the World Health Day is one of the major advocacy opportunities for public health. Activities tend to percolate down to national and local levels, engaging millions of people worldwide and raising awareness effectively.

On that same day, 7 April, we will launch the World Report on Road Traffic Injury Prevention. The Report will provide a global reference on the magnitude of the problem and point out directions for road traffic injury prevention. We intend to make this Report not only a wake-up call, but also a tool which will assist governments, industry and civil society in all countries to identify the actions they need to take to reduce this burden in their own country.

A year-long campaign will follow the World Health Day 2004 and the launch of the World Report on Road Traffic Injury Prevention.

Let me end by saying a few words about the potential of motor sport in road safety. Over the past decade, motor sport events organized or supported by the FIA have become among the most widely followed sports events in the world. If we add up the frequency with the global viewer figures, no other sports events reach such a large audience so often.

This carries a huge potential to influence attitudes and educate drivers about road safety. WHO will be very happy to collaborate with FIA to find ways in which a dedication to raising public awareness of road safety can become an intrinsic feature of the sport.

Thank you.