Publications

It is well-documented that road crashes claim around 1.35 million lives each year and rank as the eighth leading cause of death globally, causing huge burdens for economies, health systems, and transport networks. However, beneath the sobering fatality statistics lies a largely unexplored landscape: the staggering toll of disabilities induced by road crashes. Until now, the focus of road safety research and policy discourse has predominantly revolved around fatalities, which has limited our understanding of traffic-related injuries and disability burdens at the individual, community, and national level.

To address this critical knowledge gap, this pioneering study—involving over 2,300 patients hospitalized for road crash injuries—provides valuable insights into the prevalence, causes, and long-term impacts of crash-related disabilities. By broadening the discussion beyond fatalities to the often-overlooked issue of disability, the report paves the way for a more holistic perspective on road safety impacts, which can inform more effective road safety policies.

This report is a call to action for comprehensive and context-specific interventions that encompass both the transport and health sectors. Effective measures may include implementing safety regulations, enhancing emergency services, strengthening rehabilitative care, and expanding social safety nets to ease the financial burden on crash survivors. Collaborative efforts between governments, global and regional organizations, civil society, and other stakeholders will be indispensable.

Road safety is a global health and economic issue that disproportionately affects low- and middle-income countries (LMICs). Precise data is crucial for understanding the full scope of the problem and developing effective interventions, but LMICs struggle to collect comprehensive data due to limited resources, underdeveloped health systems, and inconsistent data collection processes.

To overcome reporting gaps, three major global statistical models are utilized: The Institute for Health Metrics and Evaluation Global Burden of Disease (GBD) study, the World Health Organization (WHO) Global Status Reports on Road Safety (GSRRS), and WHO Global Health Estimates (GHE). However, discrepancies exist among these models and between them and official country statistics. They often estimate significantly higher road traffic fatalities and injuries than official LMIC statistics.

This GRSF study identifies the reasons behind statistical discrepancies and outlines strategies to strengthen modeling efforts. This involved qualitative research, a systematic review of national data availability, and four case studies in Brazil, Cambodia, Ethiopia, and Tanzania.

Key findings include:

• National decision-makers recognize the issue of underreporting but tend to dismiss higher estimates by global statistical models.
• Most countries use WHO GSRRS estimates.
• National health surveys and censuses in LMICs often contain relevant information, and minor modifications can greatly improve their usage for such measurements.
• Incorporating national health survey data into global statistical models can help resolve discrepancies and increase confidence in estimates.

Recommendations include:

• Integrating epidemiological data sources into global statistical models (GBD, GHE, GSRRS) to reduce discrepancies and increase confidence in their estimates.
• Including relevant questions in upcoming national data collections to facilitate epidemiological measurements of road traffic injuries.
• Encouraging local involvement in data production for better estimates.
• Enhancing coordination between the Institute for Health Metrics and Evaluation and the World Health Organization to improve estimates and reduce inconsistencies.

To achieve the goal of the Second United Nations Decade of Action for Road Safety (reducing road traffic fatalities and injuries by 50% by 2030), substantial resources need to be allocated to road safety and accurate reporting and statistical estimates are required.

In developing countries with inadequate public transport and road infrastructure, motorcycles present a fast, cheap, and efficient transport alternative. Motorcycles are widely used in many African countries for personal and public transport, as well as for service delivery. In some African countries, motorized two and three-wheelers constitute the largest proportion of the motorized vehicle population. However, despite their benefits, motorcycles expose their riders and passengers to a high risk of serious injury or death in the event of crashes. Motorcycle safety is therefore a significant problem in Africa. On average, 22.5% of road traffic deaths in 2016 involved riders/passengers of two- and three-wheelers, according to the last data published by World Health Organization (WHO, 2018).

This research study presents comprehensive strategic recommendations on how to improve motorcycle safety in Africa. The study will serve as policy advice and technical assistance to the Bank’s regional member countries (RMCs). The study focuses on motorcycle safety conditions in Cameroon, Burkina Faso, Rwanda, and Uganda, where the use of motorcycles for daily activities is reputedly high. Recommendations are predicated on an examination of the major causes of motorcycle crashes and injuries, as well as an extensive body of knowledge from various sources, notably:

• international literature and good practices on motorcycle safety;
• assessment of motorcycle crashes, regulations, risk exposure data, risk indicators in African countries (with more detailed analysis of Burkina Faso, Cameroon, Rwanda, and Uganda); and
• consultations with stakeholders.

Road safety is a major public health issue in Cambodia. Reducing the number of road crashes is a priority for the government. Accurate data are needed to design the most effective interventions. Improving the current crash data system will furnish a more comprehensive picture of critical road safety issues in Cambodia and provide the basis for developing policies to save more lives.

In the framework of the development of the Asia Pacific Road Safety Observatory (APRSO), the World Bank and the International Transport Forum (ITF), with the support of the Cambodian Government, initiated a project aimed at assessing the crash data system in Cambodia and developing a road map for strengthening this system.

This project follows up on a previous twinning project between Cambodia and the Netherlands, undertaken in the framework of the International Road Traffic and Accident Database (IRTAD) group of ITF in 2010-2014. That project concerned both a review of the Road Crash and Victim Information System (RCVIS), and training and support to develop a national road safety strategy and related indicators.

The current project started in 2019 and was carried out by the World Bank and the ITF, with support from the Global Road Safety Facility (GRSF) and UK AID. The Dutch Road Safety Research Institute, SWOV, was contracted by the ITF to lead the review.

This report provides conclusions and recommendations on the basis of the data review mission undertaken in December 2019.