Millions still die on roads every year – an Akili Initative viewpoint

The Akili Initiative is an oranization that focuses on public health issues facing young people on a global scale . Akili has become the emerging voice of students in global health and focus on road safety as the primary health concern facing young people. Read their article on road traffic injury here.

Alexis Fogel & Ben Campbell
Co-Directors at the Akili Initiative

The Emergency Department at Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania is state-of-the-art. With a newly built complex and a staff of over 70 doctors and nurses, “the ER here in Tanzania is one of the best in all of Africa,” says Dr. Respicious Boniface, MUHAS physician. “But we experience a volume of patients that is still difficult to manage.” This is chiefly due to the huge number of patients with road traffic injuries (RTIs) that end up in the ER. “It still astonishes me how many of our ER patients, who are in critical care or who have died, are victims of road traffic accidents,” says Boniface, who also heads the hospital’s Injury Control Center.  His serious tone captured the gravity of the situation: “there have been significant advances in care, but the number of deaths from accidents remains very high.”

The situation in Tanzania mirrors an urgent global health epidemic facing many countries around the world. An estimated 1.5 million road deaths still occur each year, with the highest toll in developing countries. In many low- and middle-income countries experiencing welcome economic growth, expanded road infrastructure and access to personal transportation are often accompanied by sharp increases in traffic, air pollution, and deaths due to road traffic accidents. According to a recent report by The Institute for Health Metrics and Evaluation, entitled “Transport for Health,” RTI leads to more deaths than HIV, tuberculosis or malaria.  

“For how many people who are killed every year due to RTI, this is an extremely neglected problem,” says Jeff Witte, executive director of Amend, a road safety NGO working in Africa. Furthermore, its disproportionate impact on young people in developing countries, where more than 90% of RTI occurs, has far-reaching consequences for all members of society. “What we see in the countries where we work,” says Witte, “is that those at highest risk—pedestrians and motorcycle drivers, for example—also tend to be young people in the most productive years of their lives.” According to the Global Burden of Disease (GBD) 2010 Study, RTI is the number one cause of death for young people aged 15-24. This is the subset of society on the verge of crucial leadership roles and employment and educational opportunities necessary to continue development in their countries. However, this insidious cause of death and disability remains woefully underfunded and ignored in comparison to other more publicized threats to global health.

So what is being done to curb this epidemic?  One important effort by Bloomberg Philanthropies and The Global Road Safety Partnership targets ten low and middle-income countries, which comprise nearly half of all road deaths around the world.

This partnership advocates for scaling up cost-effective interventions, including the distribution of helmets, seat belts and child restraints, and education on their proper usage, in addition to wider implementation of speed management and data systems. They also work on the ground to build infrastructure that improves physical road maintenance, transportation systems and available emergency treatment in post-crash care settings.

Another effort by the Vision Zero Initiative in Sweden is leading the way in changing how we approach the design of road transport systems, promoting an understanding of human behavior and interaction with roads as the foundation to prevent death and injury in an increasingly mobile world. Their initiatives to prepare for traffic accidents before they happen is based on one simple principle: “In every situation a person might fail, the road system should not,” proclaims Claes Tingvall, Director of Traffic Safety for the Swedish National Road Administration. Where transport systems traditionally place responsibility for safety on road users, the Vision Zero Initiative instead puts this responsibility on road system design, vehicle technology, and innovative information and surveillance. Already adopted in a number of countries outside Western Europe including Russia, Turkey, and Mexico, Vision Zero provides demonstration projects, consultants and support teams, and a safe road design curriculum tailored to each country’s unique traffic culture and injury reduction targets.

With these efforts underway, will road traffic injury finally find a place among other major international health priorities? As we come to the close of the Millennium Development Goal (MDG) era, the world must convene once again to shape the next global development agenda to begin in 2015. Starting to address this challenging task in 2012, U.N. Secretary General Ban Ki-moon appointed a High-Level Panel to make recommendations for the upcoming decades and their final report, entitled “A New Global Partnership,” was recently completed.

The report declares some overarching goals including “Ensuring healthy lives,” which highlights health issues such as AIDS, malaria and TB that are reminiscent of the previous MDGs.  However, nowhere in the 69-page High-Level report is road traffic injury prevention even mentioned.   This is ironic, given the report’s emphasis on the importance of youth in the post-2015 era. 

With an increasing number of young people making up the majority of national populations, especially in developing countries, there must be an explicit inclusion of road traffic injury and its importance to youth in this new development agenda to truly make headway on global development priorities. RTI is a critical issue that needs immediate attention. A global emergency with tremendous human cost, “we need to place this high on the post-2015 agenda,” affirms Witte.

What would a target to reduce road traffic deaths for post-2015 look like?  In his recent report on the post-2015 development agenda, entitled, “A life of dignity for all,” UN Secretary General Ban Ki-moon recommends that reducing the burden of road traffic injuries should be one of the main targets in a new health goal. Several UN agencies have endorsed a target of reducing the 2010 levels of global road traffic deaths by 50% by 2030. This would be a step in the right direction, but will it even make it into the post-2015 agenda?  There is still time for us to make the case, but the window of opportunity is closing quickly. As we enter the final stages of shaping the post-2015 agenda, young people cannot let this momentous opportunity to prioritize RTI and save millions of lives slip through our fingers any longer.