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.

Walking is a predominant mode of travel in Addis Ababa representing more than half of the daily trips. The mild climate in Addis Ababa is conducive for this healthy and green mode of transport. However, sidewalks are often narrow, uneven, obstructed, or non-existent, causing discomfort and road safety risks to the most vulnerable road users: pedestrians. Studies done by the WHO and the Government showed that AA has disproportionately high pedestrian fatalities. 

The study on Addis Ababa Sidewalk Safety and Improvement takes the approach of integrating digital technology and Urban Inventory in sidewalk surveys, applies the Global Walkability Index in sidewalk assessments, and adapts the global best practice to the local context. The Addis Ababa Sidewalk Design and Maintenance Guidelines seek to promote the development of quality pedestrian infrastructure and environments, based on the condition’s assessment and global best practices. The design specifications and visual rendering provide recommendations for the policy makers to consider when developing the City’s design and maintenance standards for urban roads, sidewalks, public spaces, and transit-oriented development, some of which are being carried out as part of the technical assistance program of the World-Bank financed Transport Systems Improvement Project (TRANSIP).

The Road Safety Management Capacity Assessment (RSMCA) is an activity within a broader Advisory Services and Analytics (ASA), which aims to gain a holistic and thorough understanding of the road safety management capacity of three selected Pacific Island Countries (PICs)—Samoa, the Solomon Islands and Vanuatu—in order to support their respective governments to develop national strategies and plans of action to improve road safety outcomes, with a focus on crash data management. The ASA will also support a pilot of the World Bank’s Data for Road Incident Visualization, Evaluation, and Reporting (DRIVER) road crash database in Samoa and provide hands on capacity building in crash analysis.

The ASA is being funded by a Global Road Safety Facility (GRSF) grant from the United Kingdom Agency for International Development (UK AID). The GRSF grant will help the Government of Samoa (GoS) to have a clear image of their road safety situation, risks and challenges, and further on to establish the basis for a national crash database. To ensure sustainability through capacity building and awareness-raising activities, knowledge will be shared with local stakeholders.

The key objectives of this ASA are as follows:

• Utilize GRSF recommended methodology to gain a thorough understanding of road safety management capacity;

• Assess institutional management arrangements as an important focus of the analysis of the road safety system in Samoa;

• Consider the existing national road safety strategy—Samoa National Action Plan (SNAP) for the Decade of Action for Road Safety 2011-2020—and propose updates for the next period;

• Provide capacity building on crash investigation and evidence-based road safety measures to ensure success and sustainability, with a focus on vulnerable road users such as females, children, and persons with disabilities; and,

• Focus on crash data management, including providing hands on capacity building and crash analysis.

An auxiliary objective is to build capacity to use crash data to identify problems and implement road safety evidence-based measures in Samoa. Furthermore, given the negative impacts of severe weather events on road safety, which will be further exacerbated by climate change, the ASA will help to address the way that road safety is managed in the face of climate change, by training police officers to gain better skills in crash investigation.

The results from the DRIVER pilot in Samoa will be shared with counterparts in selected other PICs, with the aim of scaling up the system across the region. Only with accurate data can road safety be effectively managed and improved, and results measured. In support of this, as of October 2019, the World Bank’s Environmental and Social Framework (World Bank 2019) calls for road safety to be considered on all World Bank-funded projects.

The World Bank is also currently providing assistance to the road sector in Samoa through several projects, including the Samoa Climate Resilient Transport Project (SCRTP), which commenced in 2018. SCRTP will support the GoS to improve the climate resilience of the road network and provide key assistance required to contribute towards effectively managing climate resilient and safe road sector assets. One of the sub-components of SCRTP is dedicated to establishing and operationalizing a database for recording and analyzing road crash data.

The database will combine the existing siloed data, housed in different government agencies, into a single readily accessible platform under the Ministry of Work, Transport and Infrastructure (MWTI). The system will make use of DRIVER, to be piloted through this road safety ASA. SCRTP has other sub-components and activities focused on road safety, such as Road Safety Audits for project roads, a driver licensing training pilot focusing on women, and a road safety engineering technical assistance activity. This GRSF ASA will provide crucial data and insight for the successful delivery of the road safety program under SCRTP, plus other ongoing World Bank-financed projects.