In 2002 a theme issue of the BMJ focused on the unacceptable, and largely neglected, global toll of road traffic crashes.1 The subsequent report by the World Health Organization highlighted that low and middle income countries bear the brunt of this burden, accounting for more than 85% of the deaths and 90% of disability adjusted life years lost from road crashes.2 In contrast, many high income countries (including the United Kingdom) were shown to have sharply reduced their rates of road crashes in recent decades, exemplifying what could be achieved.

It is tempting to bask in the glory of such creditable achievements, but, as always, the devil is in the detail. A heterogeneous and unplanned collection of three papers appearing in this week's BMJ3^–5 and one being published on line6 provides a timely reminder of the extent to which the potential to prevent road traffic injury remains a challenge, …