How can road safety be improved? The BMJ asked four experts for their viewsBMJ 2002; 324 doi: http://dx.doi.org/10.1136/bmj.324.7346.1116 (Published 11 May 2002) Cite this as: BMJ 2002;324:1116
More people die on the roads than from malaria, says WHO chief
Etienne Krug is director of the department of injuries and violence prevention at the World Health Organization
Who should be primarily responsible for road safety on a national and international level?
This is an important question. At present road safety is seen as everybody's responsibility and therefore nobody is being held accountable. Clearly, for a problem that globally causes about 1.2 million deaths and injures 10-15 million people a year, responsibilities should be assigned.
Road safety is everybody's responsibility—the road users, governments, donor organisations, academia, and non- governmental organisations. However, what is needed is a commission or agency in each country that will coordinate a multidisciplinary agenda, with clear roles for all, and ensure that this agenda is developed, implemented, and monitored. This commission or agency should have the mandate and resources to carry out this task.
What are the main obstacles to promoting a scientific approach to road safety?
There are many obstacles. Two of the main ones are ignorance and the lack of responsibility. There is ignorance about the size of the problem. Few people realise that more people die on the roads than from malaria, and many people do not know that road traffic injuries are preventable. If policy makers fully grasped how much could be gained by implementing policies on speed, drink driving, motorcycle helmets, and visibility and acted accordingly, many lives could be saved.
On responsibility, as long as it is unclear who is ultimately responsible and accountable for road safety, at national and international levels, it will be difficult to make progress. These two obstacles mean a lack of political commitment and funding for evidence based measures to prevent road traffic casualties.
What do you think is the most important thing to do to improve road safety worldwide?
The two obstacles mentioned above—ignorance and responsibility—must be addressed. What is needed is a strategy. The WHO's five year strategy for road traffic injury prevention was developed with that in mind (www5.who.int/violence_injury_prevention/main.cfm?s=0006).
This strategy, developed by a large group of experts and aimed at the public health community, focuses on strengthening collection of data, research, prevention, and advocacy. The strategy has much potential to build links between the health, transport, political, and other sectors involved in road safety.
Last month the Fédération Internationale d'Automobile committed financial support to the implementation of this strategy. The WHO is making efforts to build bridges with other important partners—such as the World Bank, the Global Forum for Health Research, the US Centers for Disease Control and Prevention, and a number of academic institutions—to strengthen collaboration and strategic planning.