We Can Save Lives Easily. Why Won't We?

What if we told you that there was a deadly disease that wipes out thousands of people globally every day with little fanfare or international attention? It’s the second most common reason for death among those aged 15 to 49 and the number one cause of death for men and women aged 15 to 24. We already know about great policies to tackle this disease: several rich countries have cut their fatality rates from it by 50 percent since the 1970s, such that now 90 percent of the deaths occur in low- and middle-income countries. And yet the disease was ignored completely in the UN’s Millennium Development Goals, and has not been prominent in the post-2015 development discussions either.

Now: Does it matter to you that we aren’t talking about a disease, but rather about road-injury fatalities?

A preventable killer

Road-traffic deaths occur in all countries, but they are more common in developing countries, where the fatality rate is about twice that in high-income countries, despite these countries having far fewer cars per person. In fact, 90 percent of all fatal road traffic accidents occur in low- and middle-income countries. About half the people who die aren’t driving cars but are vulnerable road users like pedestrians, bicyclists, scooter riders and motorcyclists.

Road-injury fatalities are a growing global issue, rising by about 25 percent since 2000 as more people drive but safety regulations and enforcement have not caught up. Looking further into the future, the number of vehicles on the road and the number of road-injury fatalities will both grow. These trends project that in 2030, road-injury fatalities will be the fifth biggest killer globally, compared to far more studied areas like ischemic heart disease, cerebrovascular disease, chronic obstructive pulmonary disease, and lower respiratory infections.

Road-injury fatalities, like many other major global killers, are often preventable. Australia, Canada, France and Sweden have all decreased their road-injury fatality rates by more than 50 percent since the 1970’s, when they had fatality rates comparable to those found in developing countries today. Many of the interventions that lead to this decline are well known, make intuitive sense, are scientifically effective—and importantly for cash-strapped governments, can pay for themselves immediately.

These interventions, like implementing blood-alcohol laws, speed limits, motor vehicle safety regulations, seat belt laws, helmet laws and child restraints, are a menu from which governments can select what is most implementable and culturally appropriate. Fines for noncompliance would mean that saving lives would benefit to government coffers almost immediately, in contrast to the long-term public investments that many other lifesaving investments require. Naturally, oversight would need to be implemented to ensure that the enforcement of new regulations is just.

Five easy fixes

With road-safety interventions effectively implemented, the impact is clear: more lives saved. For example, wearing a motorcycle helmet can reduce the mortality rate by 40%. Drinking and driving results in increased risk of crashes, injuries and deaths, but enforcing sobriety checkpoints and random breath testing can reduce crash rates and is cost effective. Wearing seat belts reduces the fatality rate of both front and back seat occupants, while speed controls in high risk areas like schools and residential areas are effective at saving pedestrian lives. The interventions mentioned above are straightforward, effective and can fund themselves—yet less than 10 percent of the world’s population has adequate laws that address all five risk factors (speed, drunk driving, helmets, seat belts and child restraints).

Additionally, there are more advanced interventions that can reduce road-injury fatalities, including road safety assessments and improvements, improved emergency care for injured persons, and targeted analysis to identify high risk locations/victims, which would enable more targeted local policies and programs.

The world has seen tremendous progress in the past few decades on a number of important health fronts. Maternal deaths are down nearly 50 percent from 1990. Under-five mortality rates have also roughly halved since 1990. The number of people who have died of AIDS-related causes peaked in 2005 and has been steadily declining. At the same time, we shouldn’t ignore the growing catastrophe associated with easily preventable deaths due to road-traffic injuries.