Publications

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.

The Multilateral Development Banks (MDBs) Road Safety Working Group, established in 2009, is comprised of ten member institutions that are uniquely positioned to support countries in reaching their considerable and challenging road safety financing needs.

In early 2023, the working group reviewed progress made by the MDBs in financing road safety activities in low and middle-income countries (LMICs), and found that MDBs collectively committed $3.6 billion toward road safety initiatives in developing countries during the period 2018-2022. Three standalone road safety projects—in Bangladesh (World Bank), India (Asian Development Bank and World Bank), and Romania (European Investment Bank)—totaled $912 million in MDBs financing, which is more than one-quarter of the amount committed during this timeframe.

The review is based on details of road and urban mobility project financing provided by seven of the working group's ten members.

Road traffic injuries (RTIs) are well known to cause enormous human suffering in terms of both morbidity and mortality, and on a global scale. The economic dimension of the disease burden is far less well understood; but it is important to assess the size of the economic burden so that it can be considered when calculating the cost-benefit ratio of policies to tackle this problem. Because it is, in principle, and to some degree, an avoidable one.

This report focuses primarily on assessing various dimensions of the economic consequences of RTIs, as applied specifically to four Central Asian countries (Kazakhstan, Kyrgyzstan, Tajikistan, and Uzbekistan) – a part of the world in which there is still a major need to reduce RTIs.

This study shows that on top of the harm RTIs inflict upon human health, they also impose a considerable financial burden on health care systems. In 2016, the total estimated health costs of RTIs in these four countries was approximately Int$95 million, ranging from Int$2.8million in Tajikistan to Int$49.3 million in Kazakhstan. In Kazakhstan, the overall health costs resulting from RTIs were similar to the cumulative expenditure for rehabilitative and palliative care within the state-guaranteed basic package. The heavy financial burden on health care systems to manage RTIs in these countries adds weight to the urgency to increase preventive efforts by road safety policymakers, and should motivate appropriate organization of the post-crash response by health care system decision makers. The cost estimates discussed in this report indicate the potential for significant economic cost savings if both deaths and injuries from road crashes could be substantially reduced in these countries.

An evaluation of the various Emergency Medical Services (EMS) models and mechanisms in place in Sub-Saharan Africa (SSA) is critical in order to have a better understanding of what can be improved upon for effective pre-hospital and emergency care services (PECS). With grant funding provided by the World Bank’s Global Road Safety Facility (GRSF), this report aims explore the State of EMS Systems in Sub-Saharan Africa through a review of the models and mechanisms being developed across various States.

The premise of the report focuses on the fundamentals for effectively providing satisfactory treatment to those in need of urgent medical care, while also recognizing that there are multiple pathways, framed by the respective legislative, legal and regulatory enabling environments, towards a more formal and sustainable EMS model. It represents an effort to identify the major similarities and differences, as well as potential opportunities for greater coordination or collaboration, that can lead to the development of sound policy recommendations for fostering and expanding post-crash response services in the region.

High-level system information has been collected through questionnaires distributed to National Respondents in each country, for which 25 of 44 countries substantially responded as of April 2019 (collectively hereinafter referred to as SSA countries): Botswana, Burkina Faso, Burundi, Cabo Verde, Cameroon, Central African Republic, Chad, Comoros, Congo Brazzaville, Gabon, Lesotho, Liberia, Madagascar, Malawi, Mauritania, Niger, Rwanda, Senegal, Sierra Leone, Sudan, Tanzania, Togo, Uganda, Zambia and Zimbabwe. Missing data and discrepancies triggered a detailed review of laws and other regulatory acts, policy and plan.

The Report does not consider the advantages and disadvantages for the EMS models adopted by SSA countries, nor does it take a position on which regulatory approach should be applied, or measure the degree of EMS standards implementation and the success or failure of implementing various EMS policies. The principal aim of this report is to capture the current range of the standards and regulations in key areas of EMS systems across SSA.

The State of Emergency Medical Services in Sub-Saharan Africa is supported by UK Aid through the World Bank’s Global Road Safety Facility.