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Road safety WHO experience

Dr Krishnan Rajam, Technical Officer Injury and Violence Prevention Presentation on

Overview, trends Data systems issues Lead agencies coordinating mechanism WHO experience in countries Way forward
Disclaimer: The views expressed in this paper/presentation are the views of the author and do not necessarily reflect the views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the governments they represent. ADB does not guarantee the accuracy of the data included in this paper and accepts no responsibility for any consequence of their use. Terminology used may not necessarily be consistent with ADB official terms.

Road traffic fatalities are predicted to increase by the year 2020 esp. in Asia Pacific

Source: World data World Bank Bank

Road safety action areas


1. Policy Leadership (Cabinet) Transport Local government 2. Sectors Land use planning of homes / work / rec. places, transport Safe roads audit of new / existing, network safety management Safe vehicles manufacture, import, regular checks Legislation, enforcement Health pre-hospital, trauma care, rehabilitation

3. Advocacy 4. Research, Surveillance and Evaluation

Desired situation

Issues in data systems (often police based) Different definitions death at site, < 7, 30 days Different sources police, health, lack of linkage Lack of victim follow-up - late deaths / disability Emphasis on human error as cause Misinterpretation of existing data (e.g. denominator) Inadequate dissemination/ utilization of data

Cambodia, RCVIS

Issues 2 - Under-reporting of deaths and serious injuries


Country Reported no. deaths Estimated no. deaths

Cambodia (RCVIS 2010) Lao PDR * Myanmar* Philippines* China*


* GSRRS

1 816 656 1 638 1 638 96 611

2 348 1075 11 422 17 557 220 783

+ 85% serious inj. under-reporting

Malaysia 2009 Deaths 6 745 Serious injury 8 849 Minor injury 15 823

Issues 3 - Despite under-reporting of deaths / serious injuries - inappropriate use of technology / system black spot methods, GPS, IRAP, etc

Cambodia GPS to determine crash location Malaysia huge investment in black spot determination and treatment

Philippines not ready for IRAP

Lead agencies for road safety


- Source- GSRRS

26 participating countries All except MIC, TUV & VAN have a lead agency Only 9 have endorsed & funded national strategy, set targets Only 12 have policy to encourage public transportation Only 10 have policy to encourage walking / cycling Coordinating mechanisms ineffective resource imbalance across sectors
distribution and activity of sector

Interventions - some issues Mainly education based, esp. on children, drivers Media campaign focused (no concomitant enforcement) Over investment in black spots, motorcycle lanes

Research in UK - children can be trained using combination of real-traffic training, peer and adult interactions using computer simulations, and reinforcement. The large population in USA makes it difficult to implement this in every school. NHTSA, 2009

Motorcycle lanes - heavy capital overlay, maintenance, lighting & difficult integration with roads ignored in cost benefit analysis

Trauma care cost


Malaysia all injuries 3rd leading cause of govt. hospital admissions, 6th leading cause of deaths Cambodia 2010, 0.8% of population a road crash victim & 1/6 serious injury, economic cost of RT crashes 279 million US China survey 1998-2005; 200 million injured / year; 60 million required emergency care; 14 million admitted; medical cost 9 billion USD ; 1 million permanent disability Papua New Guinea 1993, Mendi provincial hospital; trauma 3rd common cause of admissions, 43% of surgical cases; 11% of hospital cost

WHO support in road safety


Capacity building training workshops - national, regional, sub-regional Develop national plans - CAM, LAO, VTN, MOG, PHL, TON, VTN Decade of Action May 2011 launch 17 countries Data systems CAM, CHN, VTN, PHL, MOG Data collection GSRRS 1 and 2 Pre-hospital care review CAM, MNG Model community-based projects multisectoral
Road safety in Healthy Cities
Dalian,

Suzhou, Darkhan, Phnom Penh, Vientiane

Road safety in Provinces CAM, VTN, PHL (Guimaras Province)

Way forward
Data systems count all deaths (& injuries); special studies for risk factors Capacity building across sectors Demonstration projects implement and evaluate interventions low hanging fruits speed, seat belts, helmets, drinking & driving

Priority countries CHN, MOG, CAM, LAO, VTN, PHL, MAA, BRU, PICs