Every year more than 1.17 million people die in road crashes around the world. The majority of these deaths, about 70 percent occur in developing countries. Sixty-five percent of deaths involve pedestrians and 35 percent of pedestrian deaths are children. Over 10 million are crippled or injured each year. It has been estimated that at least 6 million more will die and 60 million will be injured during the next 10 years in developing countries unless urgent action is taken.

The majority of road crash victims (injuries and fatalities) in developing countries are not the motorised vehicle occupants, but pedestrians, motorcyclists, bicyclists and non-motorised vehicles (NMV) occupants.

Road crashes cost approximately 1 to 3 percent of a country's annual Gross National Product (GNP). These are resources that no country can afford to lose, especially those with developing economies. It is estimated that developing countries currently lose in the region of $100 billion every year. This is almost twice as much as the total development assistance received worldwide by the developing countries. These losses undoubtedly inhibit the economic and social development of developing countries.

Improving road safety requires the participation of many different organisations and sectors. No one sector working alone can effectively reduce the number of road casualties.

Either a lead Ministry or a National Road Safety Council (NRSC) or Commission should head the concerted effort. Coordination is best done by a multidisciplinary NRSC supported by a permanent Secretariat of road safety specialists, led by a senior government official or a high-calibre Executive Director.

A simple but effective monitoring and evaluation system is required to track progress of road safety activities and to estimate the safety impact. For action plans in developing countries, initial focus is often on institutional strengthening and capacity building rather than just on reducing of casualties in numeric terms. Monitoring and evaluation systems established as part of implementing action plans and safety initiatives must therefore, where appropriate, be able to indicate progress towards achievement of institutional impact and developmental objectives.

Data is the cornerstone of all road safety activity and is essential for the diagnosis of the road crash problem and for monitoring road safety efforts. It is important to identify what categories of road users are involved in crashes, what manoeuvres and behaviour patterns lead to crashes and under what conditions crashes occur, in order to focus on safety activities.

Teaching safety skills to children can provide lifelong benefits to society, but should be seen as a long term intervention strategy. Experience in many countries has shown that reliance on individuals or organisations visiting schools to give talks on road safety are not effective on their own. Children may remember the messages in the short term, but effective and sustainable development of positive attitudes towards road safety are best achieved by inclusion in the core curriculum, either as a compulsory subject in its own right or as a cross-curricular theme.

With road user error contributing to the vast majority of road crashes, the development of safe drivers, skilled in defensive driving techniques, should be the primary objective of any road safety program. Driving examiners in developing countries are rarely given special training and driving tests an inadequate test of ability to drive safely in traffic on real roads.

In most developing countries the Traffic Police are grossly under-resourced and under-trained to deal effectively with road safety violations. Effective traffic law enforcement can play an important role in reducing traffic crashes.

Improvements in vehicle design, occupant protection and vehicle maintenance have made a significant contribution to crash reduction in industrialised countries. Occupants can be protected by safety features such as seat belts, headrests, air bags, special seats for children. Safety related components should be properly maintained. This can be achieved by periodic vehicle inspections combined with frequent random checking of vehicles on the road. Overloading of heavy goods vehicles is also a serious safety hazard for all road users.

Timely and proper treatment of road casualties is essential for reducing the severity of injury to crash victims. Driver education on first aid procedures and correct transportation of crash victims is important. A single emergency telephone number (for example, "911" is used in USA) can facilitate the simultaneous alerting of police, ambulance and other rescue services and help to reduce response times (depending on the availability of road-side telephones).

Road safety cannot be the responsibility of government alone. The commercial sector, service organisations and non-Governmental Organisations (NGOs) play an important role in increasing road safety awareness. NGOs have an important input at grass roots level.