Publications
1-10 of 23
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Speed Management
Guide for Safe Speeds: Managing Traffic Speeds to Save Lives and Improve Livability
March 2024
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Speed Management
Speed Management Research: A Summary Comparison of Literature Between High-Income and Low and Middle-Income Countries
February 2024
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Speed Management
Speed Management: A Road Safety Manual for Decision-Makers and Practitioners (2nd ed.)
November 2023
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Post-Crash Health Care
Beyond the Numbers: Estimating the Disability Burden of Road Traffic Injuries
November 2023
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Road Safety Data
Improving Road Traffic Injury Statistics in Low- and Middle-Income Countries
November 2023
- 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.
- 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.
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Road Users
Drink-Driving: A Road Safety Manual for Decision-Makers and Practitioners (2nd ed.)
November 2022

Speed is one of the main road safety risk factors and is universally recognized as the leading contributor to road fatalities and serious injuries. But there is good news: the speed problem is solvable. Interventions that are proven to be effective exist, and it is well understood where and how they should be applied.
The newly published “Guide for Safe Speeds: Managing Traffic Speeds to Save Lives and Improve Livability” outlines interventions that work and provides guidance on how to select and implement speed limits that are safe for all road users. It also explains how barriers to changing traffic speeds—which are often based on lack of knowledge or misunderstandings—can be overcome.
A primary feature of the guide is its comprehensiveness. The guide covers all types of roads—from city streets to inter-urban roads and motorways (existing or new); all types of road users—from vulnerable road users such as pedestrians and cyclists to heavy motorized traffic; all types of speed limit changes—from national general speed limits to localized changes based on risk factors; all types of challenging constraints—from lack of resources to lack of data; and all types of countries—from low-income to high-income.

Low- and middle-income countries (LMICs) have been experiencing growth in vehicle travel and mobility but have not yet realized road safety gains experienced by high-income countries. Excessive and inappropriate speed is known to be a major cause of road crashes, injuries and deaths. Thus, speed management is considered a key initiative for improving road safety outcomes worldwide and has been applied successfully in most high-income countries.
Proven interventions do not necessarily have the same impacts in LMICs, or may not be feasible to apply, due significant differences in traffic mix, road user behavior, road design and vehicle standards.
This document summarizes current available knowledge about speed, its effects on safety, mobility and emissions, along with potential safety effectiveness of speed management initiatives in the LMIC context. Knowledge gaps for LMICs are clearly referenced for further consideration.
The knowledge summary provides a useful reference for practitioners wishing to inform themselves about traffic speeds, their selection and impacts on safety outcomes, mobility and emissions. The LMIC knowledge gaps will be useful in considering future research and data priorities.

The WHO, World Bank, FIA Foundation and Global Road Safety Partnership (GRSP) produced a series of good practice manuals, following the publication of the World report on road traffic injury prevention in 2004, which provide guidance on implementation of interventions to address specific risk factors in road safety. The topics covered in the initial series of manuals were: helmets (2006), drinking and driving (2007), speed management (2008), seat-belts and child restraints (2009), data systems (2010), pedestrian safety (2013), road safety legislation (2013), powered two- and three-wheeler safety (2017) and cyclist safety (2020).
Since the series of manuals was first published, the scientific evidence base relating to various risk factors and the effectiveness of interventions have continued expanding. Contemporary research has refined our knowledge about specific risk factors, such as distracted driving, and vehicle impact speed and risk of death for pedestrians. New issues and practices have arisen, such as a tropical helmet standard and an anti-braking control standard for motorcycles. New and existing interventions have been implemented and evaluated, with increasing application in LMICs. Research attention and policy response have also increasingly been applied to emerging road safety issues including e-bikes, drugs other than alcohol, fleet safety, urban mobility, micro mobility options, air and noise pollution, public transport and technological advances.
As a result of these developments, the good practice manuals required revision so that they can continue to be key references for road safety policy implementation and research. This is particularly important, given the emphasis placed on road safety within the framework of the 2030 Agenda for Sustainable Development and because of the global impetus to reduce road deaths and injuries, resulting from the declaration of the two United Nations’ Decades of Action for Road Safety (2011–2020 and 2021– 2030). The manuals have been revised to reflect these developments as they continue to be valuable resources providing evidence-based and cost-effective solutions to save lives and reduce injuries.
The management of speed remains one of the biggest challenges facing road safety practitioners around the world and calls for a concerted, long-term, multidisciplinary response. The speed at which a vehicle travels directly influences the risk of a crash as well as the severity of injuries sustained, and the likelihood of death resulting from that crash. This manual advocates for a strong and strategic approach to creating a Safe System, with speed management at its heart. Reducing motor vehicle speeds in areas where the road user mix includes a high volume of vulnerable road users, such as pedestrians and cyclists, and on non-divided rural roads, is especially important.

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:
Recommendations include:
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.

Across the developing world, countries are experiencing rapid growth in urbanization and motorization. While high motorization rates potentially meant hat more people will be able to claim the benefits of improved accessibility to goods and services as a consequence of enhanced mobility, there are questions about the sustainability of this future. Will countries be able to build and maintain infrastructure to accommodate increasing numbers of vehicles? Will the increasing number of vehicles and their characteristics support attainment of the Sustainable Development Goals (SDGs) Will they put in jeopardy countries’ ability to meet their climate commitments under their Nationally Determined Contributions (NDCs)? From a development impact standpoint, the nature of a country’s motor vehicle stock and how it grows affects three key and tangible outcomes.
First, the quality of the motor vehicle stock affects road safety outcomes—that is, the number of people killed or seriously injured in motor vehicle crashes. The characteristics of vehicles and their fitness or roadworthiness can affect fatality and serious injury outcomes. Second, the quality of the motor vehicle fleet affects air quality, particularly in cities. Motor vehicles are a key source of harmful air pollution, including carbon monoxide (CO), fine particulates (PM2.5), sulfur oxides (SOx), and ozone precursors (oxides of nitrogen and various hydrocarbons), and the amount of these pollutants they emit is directly related to how the vehicle was built and how well it is maintained. Finally, the profile of the vehicle fleet—what is the size and weight of vehicles in the fleet, how big are their engines, what kind of power control technology do they use, and how did their manufacturers engineer the technology of the vehicle to balance power with efficiency—affects the (fossil) fuel consumption of the vehicle stock as a whole, and, consequently, the greenhouse gas (GHG) emissions profile of the road transport sector.
This report presents the World Bank’s Motorization Management (MM) framework, which is intended to support client countries in the development of policies and measures aimed at managing vehicle stocks in a proactive, phased, and systematic manner to make them safer, cleaner, and more fuel efficient. The MM framework reflects a series of policy considerations and programs that can be implemented to improve the quality of fuels and vehicles in a country’s stock.

This manual provides guidance and evidence for decision-makers and practitioners that should lead to an increase in the use of vehicle occupant restraints, such as seat-belts for adults and car seats for babies and children. It draws on experience from countries that have succeeded in achieving and sustaining high levels of vehicle occupant restraint use, and builds on new evidence, including from low and middle-income countries.

Safe, quality helmets reduce the risk of death in a road crash by over six times, and reduce the risk of brain injury by up to 74%. Head trauma is the leading cause of death for riders, and motorcycles continue to proliferate rapidly. Yet the use of helmets in many low and middle-income countries remains low.
The second edition of the Helmets Manual offers guidance to help decision makers and practitioners put in place the comprehensive set of laws, regulations and actions needed to increase the use of safe, quality helmets to save lives.

This manual provides guidance for decision-makers and practitioners to reduce the prevalence of drink driving and associated road trauma. It draws on experience from countries that have succeeded in achieving and sustaining reductions in alcohol-related road trauma, and includes recommendations for developing and implementing drink driving legislation, and advice on how to monitor and evaluate progress.

Road traffic crashes result in an estimated 1.35 million deaths and 50 million injuries worldwide per year with over 90 percent of these occurring in Low-Middle Income Countries (LMICs). Aside from the obvious pain and suffering this inflicts on individuals and communities, these deaths and injuries also place a large financial burden particularly on LMICs, by slowing economic growth.
The scale of the current response to this continuing crisis does not match the size of the problem. In addition, limited road safety resources are often expended on ineffective or suboptimal interventions. While road safety knowledge has improved over recent decades, there is still a need to improve decision making when selecting and applying effective evidence-based road safety interventions. Effective interventions are those that reduce fatal and serious injuries.
The World Bank's Global Road Safety Facility (GRSF) has developed this evidence-based guide on “What Works and What Does Not Work” in road safety in response to the critical need for effective evidence-based solutions.
This guide has been prepared to help readers understand that not all road safety interventions are equally effective and that what appear to be “common-sense” approaches to selecting road safety interventions will often not be the best. Although some provide benefits, others have very limited or even negative impacts, despite being commonly—and mistakenly—recommended or accepted. The guide offers a range of recommendations with a focus on interventions in LMICs, although the information may also be of relevance to all countries. The contents will be valuable to those working on road safety at policy or practitioner levels, including World Bank technical team leaders and others who seek to establish, expand, or improve road safety programs in LMICs.
The guide sets knowledge on evidence-based interventions within a “Safe System” context, providing advice on each of the Safe System pillars (road safety management, safe roads, safe speeds, safe vehicles, safe road users, and post-crash care) while recognizing that evidence-based solutions must be drawn from across pillars to produce effective road safety outcomes. At the core of this document is a summary table with an overview of beneficial and non-beneficial interventions based on sound scientific evidence. This is followed by more detailed information including case studies and references to the evidence base to support the summary.
Many safe road interventions are recommended for adoption, including integrated public transport, roadside and central barrier systems, medians, infrastructure to support appropriate operational speed for road users, roundabouts, grade separation and interventions to reduce exposure to risk at intersections, pedestrian footpaths and crossings, separated bicycle and motorcycle facilities, and traffic signs and line marking (including audio-tactile line marking). Some of these are highly effective, with up to a 70 or 80 percent reduction in fatalities and severe injuries (for example, safety barriers and roundabouts).
Various speed-related interventions also produce significant benefits, with some able to almost eliminate death and serious injury. Examples of effective speed interventions include traffic calming (including humps and chicanes), roundabouts, raised intersections and crossings, gateway treatments, lower speed limits (including 30 km/h (20 mph) zones for pedestrians) and speed cameras.
A variety of road user-based interventions have been implemented over many years, with effective examples including extensive supervised on-road practice and/or graduated licensing systems as part of the driver-licensing system, increased age for driving license eligibility, hazard perception training and testing, public education and campaigns as part of an integrated strategy (especially communicating enforcement to increase general deterrence), enforcement, penalties, alcohol interlocks, fatigue and speed monitoring, and increased helmet wearing rates.
Key vehicle-based interventions include applying minimum vehicle safety standards and vehicle ratings (through the Global New Car Assessment Program, or “NCAP”), seat belts, periodic vehicle maintenance, daytime running lights, under-run guards on trucks, Electronic Stability Control, and other advanced vehicle technologies.
Enhanced post-crash care can also produce better road safety outcomes, including systems to improve emergency response time, better emergency care, improved first aid skills for the public, and improved hospital care.
Equally important, the report also identifies clear examples where interventions are not effective. The worst of these are interventions that increase risk. These include increasing travel speed without improving quality of safety infrastructure, most forms of post-license driver and rider education and training, and many (but not all) forms of regular school-based driver education (such as those that seek to increase car-handling skills). The increase in risk is typically because such initiatives increase the level of confidence leading to an increase in risk taking. Other interventions that have no demonstrated safety benefits are to be avoided. These include license schemes through application or payment, training programs or education within schools that aim to improve road safety knowledge (including ad hoc visits by road safety experts or enthusiasts), and education campaigns conducted in isolation.
There are effective alternative interventions for each of these as described within this document, and these should be applied instead. It is extremely important that resources are not wasted on ineffective interventions on behalf of road safety but rather that evidence-based road safety interventions are employed.
There are a variety of documents available on the issue of road safety intervention effectiveness, many of which are referenced here. However, there are some key points of differences and added value in this guide, including a synthesis of the evidence on a broad range of interventions and a contrast between effective and noneffective interventions, allowing readers to compare options. Where noneffective interventions are identified, viable effective interventions are provided thereby supporting decision making. The guide also provides direct advice to those working in LMICs, drawing on key sources of information where this is available. Importantly, concise yet robust evidence is provided across each of the Safe System pillars.
There is a need to continue building the knowledge base on effective road safety interventions, particularly in LMICs where there are a number of gaps in knowledge. The contents of this guide represent a useful, up-to-date summary of current knowledge for application.