By Philippe Le Houérou
March 12, 2010, Washington ― A raging but often neglected ‘silent epidemic’ is afflicting the countries of the former Soviet Union, the Balkans, the Baltics, Central Europe, and Turkey. Road traffic injuries and fatalities happen to individuals, but the collective impact on society is often unseen, unspoken, and neglected. Yet, in these countries road traffic fatalities reached epidemic proportions, particularly over the last decade, and people are two to three times more likely to die from road traffic injuries than people in Western Europe.
Road traffic injuries already rank among the top 10 causes of death in countries of Europe and Central Asia, as documented in a recent World Bank report "Confronting ‘Death on Wheels’: Making Roads Safe in Europe and Central Asia". Close to 80,000 people died in 2007 as a result of road traffic injuries; about double the amount of Western Europe. Countries such as Kazakhstan, Russia, Lithuania, and Ukraine, have mortality rates above 20 per 100,000 people as compared to less than 5 per 100,000 in several European Union countries. High rates (two or three times higher than in Western Europe) are also observed in Montenegro, Latvia, Georgia, Belarus, Slovakia, Poland, Armenia, Turkey, and Bulgaria. And, for every death, many more people are hospitalized or have injuries that require medical attention (nearing 820,000 people in 2007 alone).
So what can be done to stop this ‘silent epidemic’?
International good practices show that to reduce ‘deaths on wheels’, countries need to adopt a comprehensive ‘safe system’ approach to be implemented systematically and consistently over a 20-to-30-year time period. It is not just the human toll that should concern policy-makers in Europe and Central Asia – the economic costs are also high.
Road fatalities and disability undermine growth of the human capital that is essential for sustainable long-term economic and social well being. The ‘silent epidemic’ has particularly negative effects on the 15- 44 aged population – the young and working age people in the prime of their lives. Road traffic injuries are already the leading cause of death among children, adolescents, and young adults aged 5-29 years, and the third leading cause of death among those aged 30-44 years. About 80 percent of road traffic death victims are males. ‘Distracted driving’ due to the growing use of cell phones and texting while driving increasingly results in road traffic crashes, affecting young drivers in particular.
The economic cost of road deaths and injuries in countries of Europe and Central Asia is estimated to exceed 1.5 percent of GDP per year. The highest costs per year are in Russia (US$ 34 billion), Turkey (US$ 14 billion), Poland (US$ 10 billion), and Ukraine (US $5 billion).
The impact of road traffic injuries among pedestrians is also severe since most safety measures historically have focused on protecting vehicle occupants rather than pedestrians. Children and the elderly pedestrians are the most vulnerable.
Contributing to the poor road traffic safety situation in the countries of Europe and Central Asia are weak road safety management systems, deteriorated roads, exponential growth in the number of vehicles (usually secondhand) over the last decade, poor driver behavior, and lack of enforcement of road safety laws and regulations. Excessive alcohol consumption – the ‘drunk driving’ syndrome – is also a major contributing factor.
Road transport is central to development as it facilitates the movement of people, goods and services, enhances employment opportunities, and improves access to essential services. Most countries in the region have invested heavily over the last decade in improving their road transport system. Unfortunately, the silent epidemic of ‘death on wheels’ continues to reduce the benefits from these investments, and determined efforts are needed to redress this trend.
So what is needed to make roads safer?
High-level political support and funding and a strengthened road safety management system, including close coordination of actions by a lead agency and involving different ministries (transport, health, the police), the business community, and nongovernmental organizations, across which road safety responsibilities tend to be diffused are fundamental. A focus on results needs to concentrate on the following key aspects:
- strengthened institutional management for road safety, including coordination, sustainable funding, and monitoring and evaluation
- road infrastructure improvements, from planning, design, operation to use
- strengthened road safety laws, standards and rules for entry and exit of vehicles and road users, and their effective enforcement
- public education campaigns to modify risky behaviors
- well-organized emergency medical services
Quick wins are usually possible by the resolute application of good engineering measures that improve road design and make roads safer such as better intersection control, crash barriers, signs, markings, pedestrian crossings and road maintenance; the enforcement of laws and standards like those relating to seat belt wearing, drunk driving, distracted driving, and good driver training and vehicle licensing arrangements; and the introduction of new technologies such as automated speed enforcement. And strengthening post-crash medical care services can help prevent deaths and severity of injuries.
Many countries in Europe and Central Asia already have structures and processes in place to achieve these quick wins and begin to reduce ‘deaths on wheels’. Most of them have a lead agency to coordinate the national response funded by the national budget and national road safety strategies with measurable targets, as well as related laws and regulations. Traffic-calming measures, such as speed bumps, have reduced road traffic injuries, especially pedestrian injuries in some countries, while in other countries random breath testing for detecting drunk driving and mandatory and enforced use of seat belts have been effective measures. Other legal measures such as suspension or revocation of driving permits are helping control speeding. Governments in the region are also making a major effort to improve emergency medical and rehabilitation services in key road corridors across the country to prevent death and lasting disability after a car crash.
However, in spite of progress achieved in recent years in some countries, including countries that are now part of the European Union, the Europe and Central Asia region continues to have one of the worst road safety performances in the world. The World Bank, working in partnership with other agencies such as the World Health Organization and the Commission for Global Road Safety, and other multilateral development banks, stands ready to provide technical and financial assistance in order to help implement the recently-adopted "UN Decade of Action for Road Safety". The time to act is now as thousands of lives are at stake.
Philippe Le Houérou is the World Bank Vice President for Europe and Central Asia