Publications

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.

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 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.

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.

The World Bank estimates a significant funding gap in road safety of 260 billion to achieve SDG 3.6 and 11.2 in the next ten years, and recognizes that this gap cannot be closed through public funding alone and thus mobilization of private capital is required. The impacts of road traffic crashes reach far into the economy and can cost L/MICs as much as 6% of their GDP. The costs of a road traffic crash do not end at the roadside; they create ripple effects throughout the wider economy. Loss of income, property damage, insurance premiums, loss of taxes, and burdens on the health sector are just some of the far-reaching costs associated with road traffic crashes. Road traffic crashes can cost countries as much as 6 percent of their GDP and trap families in poverty as they lose income generating potential and focus on providing lifetime care.

This report examines the potential for private capital mobilization to close this gap. The report investigates the market failure to appropriately account for the cost of road crashes, which prevents private capital from flowing to road safety investments. The growth of socially responsible investing and the sustainable finance market offers a new opportunity to address this market failure. The report proposes different business models and financing instruments to channel private investment into road safety projects. These investment structures consist of subnational, public-private partnerships (PPPs) and corporate investments that can leverage the growing sustainable finance market, including social and sustainability-linked financings (SLFs).

The report also develops indicators that can be used to tie the cost of financing to the attainment of road safety targets, incentivizing borrowers to commit to road safety as part of SLFs. The report examines the enabling environment for structuring investable road safety projects in a sample of countries, looking at the barriers and opportunities, and proposing risks and mitigation strategies, like blended finance mechanisms and stable revenue sources, for long-term sustainability of road safety investments.

Nearly 30% of all road traffic deaths reported to WHO involve powered two- and three-wheeled vehicles, such as motorcycles, mopeds, scooters and electrical bikes (e-bikes). As these vehicles become increasingly widespread, particularly in low-and middle-income countries, the proportion of deaths involving them is increasing. 

The second edition of the Powered- Two and Three-Wheeler Safety Manual offers guidance to help decision makers and practitioners put in place the comprehensive set of laws, regulations and actions needed to save lives. Rooted in new case studies and evidence, including from low- and middle-income countries, it includes guidelines on developing safer roads, ensuring safer mobility for all road users, vehicle safety standards, and actions to improve emergency responses to crashes.

Cycling has many health and environmental benefits. Yet every year 41 000 cyclists die in road traffic-related crashes worldwide. Many leave their homes as they would on any normal day – for school, work, worship, or meeting friends – never to return. Millions more people are injured in road traffic-related crashes while cycling, some of whom become permanently disabled. These incidents cause much suffering and grief, as well as economic hardship for families and loved ones.

However, the growing focus on sustainable mobility – an increasing effort to shift more travel from motorized transport to the use of public transport, walking and cycling – makes cyclists’ safety an increasingly important component of road safety efforts. Cyclist collisions, like other road traffic crashes, are predictable and preventable and therefore should not be accepted as inevitable.

Cyclist safety: an information resource for decision-makers and practitioners describes the magnitude of cyclist death and injury, the key risk factors, and effective interventions. The document stresses the importance of a comprehensive, holistic approach that includes legislation, enforcement and behavioral measures specifically for cyclists; design of the built environment; as well as integrating cyclist safety into overall road safety and transport strategies. It also draws attention to the benefits of cycling, which should be promoted as an important mode of transport given its potential to improve health and preserve the environment.

We hope that this resource, which is designed for a multidisciplinary audience including engineers, planners, law enforcement officers, public health professionals and educators, will contribute towards strengthening national and local capacity to implement cyclist safety measures in various settings worldwide. We encourage all to bring this resource to the attention of those who will use it to save the lives of cyclists.

The World Health Organization (WHO) coordinated the production of this resource. Soames Job, Head GRSF and Global Lead Road Safety, World Bank was one of the principal writers of this document. GRSF contributions to this document were supported by UK Aid.