Why is Road Traffic not more of a development issue? It’s killing 1.25m (mainly poor) people a year.

If there was a disease that killed three times more people than malaria, nearly all of them in developing countries, and yet a cure was readily available, don’t you think the aid agencies would be falling over themselves to do something? So why is road traffic in some different category? Kudos to the Economist for regularly drawing attention to the issue of road safety in developing countries. Some extracts from its latest overview.

‘Globally, road accidents kill more people every year than malaria or HIV/AIDS. Spencer James and other researchers at the Institute for Health Metrics and Evaluation (IHME) in America put the death toll in 2017 at 1.24m. According to IHME, the overall number of deaths has been more or less static since the turn of the century. But that disguises a lot of movement up and down in individual countries.

In many poor countries, especially African ones, road accidents are killing more people (see chart). Those countries have swelling, young populations, a fast-growing fleet of cars and motorbikes, and a limited supply of trauma surgeons. It is impossible to know for sure because official statistics are so inadequate, but deaths are thought to have risen by 40% since 1990 in countries that the World Bank defines as low-income, such as Afghanistan. In many rich countries, by contrast, roads that were pretty safe are becoming even safer. In Estonia and Ireland, the number of deaths has fallen by about two-thirds since the late 1990s.

The most important and intriguing changes are taking place in middle-income countries, such as Thailand. These contain most of the world’s people and have some of the most dangerous roads. They also tend to be close to an inflection point. In China and South Africa deaths have been falling since about 2000, according to IHME—though crashes still claim about a quarter of a million Chinese lives each year. In India deaths peaked in 2012. It is possible that the Philippines reached a peak four years ago. In Kenya and Nigeria deaths are still rising.

Rob McInerney, head of the International Road Assessment Programme, a charity, says that countries tend to go through three phases. They begin with poor, slow roads. As they grow wealthier, they pave the roads. Traffic moves faster, which pushes up the death rate (from Australia to Zambia, the physical law is the same: to calculate an object’s kinetic energy, you multiply half its mass by the square of its speed). In the third phase, countries act to make their roads safer. The trick is to reach the third stage sooner, by focusing earlier and more closely on fatal accidents.

How to do that? The answer is probably not education and training, says Soames Job of the World Bank. Some studies suggest that training drivers makes them more dangerous; perhaps they become cockier. Besides, routinely wearing helmets and seat-belts, obeying speed limits and avoiding drink-driving—all things that save lives—are not advanced skills. They are practices which people know they should follow but often don’t. Dangerous driving is not a fixed cultural trait, as some imagine. People respond to incentives, such as traffic laws that are actually enforced.

Countries can make their roads safer even if they are unable or unwilling to make drivers behave better. Many poor and middle-income countries have built concrete medians, especially in and around cities. These prevent head-on crashes—generally the most lethal kind—and give pedestrians a small safe zone halfway across a road. Development banks and groups such as the Millennium Challenge Corporation now insist that the roads they pay for are built to high safety standards.

Roundabouts, chicanes and road humps all reduce speeds and save lives. One study, by academics at the University of KwaZulu-Natal in South Africa, found that the number of pedestrian injuries in two districts of Durban fell from 659 in the two years before speed bumps were built to 519 in the two years after. The number of deaths fell more sharply, from 24 to eight. Mr McInerney points out that fast four-lane roads are still being built through villages in many countries. But in Peru and elsewhere, local people have responded by building illegal speed bumps.’

Previous coverage on this blog:

What are the politics of reducing road traffic deaths?

A successful campaign in India

Credit for image: “calamity” by Kalense Kid is licensed under CC BY-NC-SA 2.0 

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7 Responses to “Why is Road Traffic not more of a development issue? It’s killing 1.25m (mainly poor) people a year.”
  1. Liam Taylor

    In Uganda, where I live, so-called “expats” routinely drink drive. The culprits include those who work for international development agencies or in caring professions, such as teaching. None of these people would drink drive in their own countries. Further evidence that, as the article notes, safer driving is not a cultural issue, but about creating environments where traffic laws are rigorously enforced.
    I once challenged an international school teacher who offered me a lift home after three bottles of beer. His slightly mocking response was to ask whether I was scared of riding in his car – as though I was in any danger sitting in the back of an enormous SUV surrounded by metal bumpers! No, I was rather more worried about the pedestrians walking on streets with no lights or pavements. They are on foot because they cannot afford a car, and almost certainly couldn’t afford health care bills either should they get hit. Apart from anything else drink driving is class (and race) privilege, pure and simple.
    Would an institution like DFID or USAID sack a worker who gets behind the wheel of a car after drinking? My suspicion is that they would turn a blind eye – unless, of course, the individual ended up being arrested by the police, which for various reasons is quite unlikely.
    Of course Ugandans drink drive too, which should also be condemned.But that is no excuse for the behaviour of whisky-soaked foreigners who after-hours habits show complete disregard for the lives of ordinary Ugandans – the very “beneficiaries” that, in their day jobs, they are purportedly here to help.

    • Expats are the same in Cambodia, where I live, even as traffic accidents are the leading cause of death in the country. It’s horrifying and baffling, given how cheap it is for expats to call a cab / a tuk tuk to get home.
      I’m trying to think of an answer to the question the blog title asks, but it’s hard. Halving traffic deaths is one of the SGDs, so it’s not as though this problem hasn’t been acknowledged by major development agencies. Perhaps it’s hard to get donors to fund? Or maybe, for whatever reason, (mostly foreign) aid workers don’t consider traffic deaths an interesting issue to tackle?

  2. Matt

    I don’t have an intelligent response to the overarching question, but I can tell a quick humorous anecdote about being literally run off the road by the entourage of the wife of the President of Haiti (now former President Michel Martelly). As is true of many presidential spouses, she had her causes that she was fighting for . . . one of which was road safety. The irony was not lost on me as I caught my breath from nearly having lost my life by being pushed off the road by four or five big Land Cruisers.

  3. There is an important INTEGRATION of essential factors that need be in place:
    1. Appropriate laws and regulations
    2. Training of monitoring and enforcement officers to include the rationale behind those laws and regulations; methods of monitoring, control and enforcement; professional communication practices with the public regarding infractions; crowd control
    3. Educating and informing the public on the above, including in schools
    4. Actual monitoring and enforcement
    5. Sufficient funds to ensure sustained monitoring and enforcement
    If the above is undertaken, with adequate resources, in some countries there is still the absolute need for:
    6. Continuous training for officers and public
    7. Quick availability of back up officers where crowds are expected. I have witnessed many instances of intimidating crowds overpowering police
    8. Sustained and proper maintenance of roadways.

  4. Jamie Waddell

    Not quite true. the USA has consistently the worst road safety record of the developed world. If you consider that India has a space program, nuclear weapons and spends more on defence than any other countries except USA and China, then it is not just or only down to poverty.

  5. Jamie Waddell

    Driver Training on its-own has never been the solution to road safety. The world leaders in road safety are known as the SUN countries; Sweden, UK and Netherlands. Only by the full implementation of the 5 E’s can this be achieved – Education, Engineering, Enforcement, Emergency and Evaluation. Any deviation or weakness in other will not serve the purpose of intent.

  6. gaawain

    I was talking to an advocate for reducing traffic deaths recently and she had had a big victory – passing legislation requiring child-safety seats for children. Implementation was the next phase, but she was rolling her eyes at herself. “It will never work. You can only fit 2 or 3 of those seats into a car. But families jam 7 or 8 people into a 4-seater. It’s not realistic.” She agreed that there’s a hierarchy of safety measures and the systemic ones are more important – and neglected by policy makers/advocates. Reducing road speed and separating vehicles from pedestrians/bikers is critical. That leads one into planning, design, and infrastructure. Just looking at netherlands v. usa shows 2 transportation/infrastructure pathways with widely divergent health outcomes (along with broader social impacts). Very important to get into that.