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GLOBALSTATUS

REPORTONROADSAFETY2013SUPPORTING A DECADE OF ACTION


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WHO Library Cataloguing-in-Publication Data:

Global status report on road safety 2013: supporting a decade of action.

1.Accidents, Trafc - statistics and numerical data. 2.Accidents, Trafc - trends. 3.Wounds and injuries - epidemiology. 4.Safety. 5.Data collec6.Programme evaluation. I.World Health Organization.

ISBN 978 92 4 156456 4 (NLM classication: WA 275)

World Health Organization 2013

All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased froPress, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857;e-mail: [email protected]).

Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercial distribution should be addressWHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form/en/index.html).

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on tthe World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitafrontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specic companies or of certain manufacturers products does not imply that they are endorsed or recommended by the WorldOrganization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary produdistinguished by initial capital letters.

All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. Howevepublished material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.

Design and layout by LIV Com Srl, Villars-sous-Yens, Switzerland.

Printed in Luxembourg.

Made possible through funding from Bloomberg Philanthropies.


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CONTENTS

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vi

Executive summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

Background. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1The Decade of Action for Road Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1The purpose of this report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Methodology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Section 1. The current state of global road safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Many countries have successfully reduced the number of deaths on their roads, while deaths are increasing in others. . . . . . . . 4Middle-income countries are hardest hit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4The African Region has the highest road trafc fatality rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5Half of all road trafc deaths are among pedestrians, cyclists and motorcyclists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Almost 60% of road trafc deaths are among 1544 year olds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Non-fatal crash injuries are poorly documented. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Harmonizing data collection on road trafc deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Section 2. New road safety laws: progress to date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Reducing speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Progress to reduce excessive speed has stalled. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Reducing urban speeds protects pedestrians and cyclists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14Speed limits need stronger enforcement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Reducing drinking and driving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Drinkdrive laws should be based on blood alcohol concentration levels. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Strong drinkdrive laws protect almost 70% of worlds population. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16More stringent drinkdrive laws for high-risk drivers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Drinkdrive laws need stronger enforcement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16Almost half of all countries lack of data on alcohol-related road trafc deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17

Increasing motorcycle helmet use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Head injuries among motorcyclists are a growing concern. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18More effort is needed to promote helmet standards and quality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Data on helmet use is weak. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20


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Increasing seat-belt use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Progress has been made in tightening up seat-belt laws. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22Enforcing seat-belt laws needs more emphasis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Only half of countries collect seat-belt wearing data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Increasing the use of child restraints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25More countries need to adopt child restraint use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Encouraging child restraint use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Lead agencies are vital to developing a national road safety strategy . . . . . . . . . . . . . . . . . . . . . . . . . 27Involving multiple sectors in national road safety efforts is critical. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27National road safety strategies should include targets to minimize injuries, deaths and key risk factors. . . . . . . . . . . . . . . 27

Section 3. Transport policies neglect pedestrians and cyclists . . . . . . . . . . . . . . . . . 29Governments need to make walking and cycling safe. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30Safer roads reduce crash likelihood and severity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32Action is needed to make vehicles safer for non-car road users. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Public transport can make mobility safer and reduce congestion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

Conclusions and recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

Explanatory notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41Methodology, data collection and validation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42Country prole explanations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Estimating global road trafc deaths. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

Country Proles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53

Statistical Annex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237


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Preface

Progress is being made to make the worlds roads safer, but this criticalwork must be intensied and accelerated.In 2010 the governments of the world declared 20112020 as the Decade of Action for Road Safety. They invited the WorldOrganization to prepare this report as a baseline to assess the state of global road safety at the onset of the Decade, and to beto monitor progress over the period of the Decade. The unanimous support for this Decade of Action from Member States ingrowing awareness that the devastating scale of road trafc injuries is a global public health and development concern.

This report shows that 1.24 million people were killed on the worlds roads in 2010. This is unacceptably high. Road trafc ian enormous toll on individuals and communities as well as on national economies. Middle-income countries, which are morapidly, are the hardest hit.

There is a sound body of scientic evidence behind road safety interventions. Adopting and enforcing legislation relating to risk factors speed, drinkdriving, motorcycle helmets, seat-belts and child restraints has been shown to lead to reductionstrafc injuries. This report illustrates some of the progress made in a number of countries to address these risk factors since pof the rstGlobal status report on road safety (2009). Since 2008, 35 countries have passed new laws or amended existing legislatiocovering one or more of these risk factors. Nevertheless, in many countries these laws are either not comprehensive in scopelacking altogether. Governments must do more to ensure that their national road safety laws meet best practice, and do more

these laws.

Road safety was recognized in global environmental policy deliberations at the recent Rio+20 UN Conference on SustainablDevelopment. A clear link was made between road safety and sustainable development. Encouraging sustainable transport pinclude making non-motorized forms of transport accessible and safe: this report shows that 27% of global road trafc deathpedestrians and cyclists. To date, these road users have been neglected in transport and planning policy. The world must nowits focus on making walking and cycling safer, and protecting these road users from high-speed trafc.

The benets of such a move will be far greater than purely the health benets of reduced road trafc injuries. Benets will inreduced air pollution and greenhouse gas emissions, reductions in trafc congestion, and the health outcomes that come fromphysical activity.

This report shows that, with sufcient political will, road trafc deaths can be averted. In suppthe Decade of Action for Road Safety, governments around the world have shown their politiccommitment to make the worlds roads safer. The Decade offers a unique platform upon whichaddress this issue. The challenge is to keep this pledge and enhance the pace of change. Only tcan the goal of the Decade of Action for Road Safety be met.

Dr Margaret Chan

Director-GeneralWorld Health Organization

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AcknowledgementsTheGlobal status report on road safety 2013 beneted from the contributions of a number of WHO staff:

Tami Toroyan coordinated and wrote the report, with data management and statistical analysis conducted by Kacem Iaych; Marprovided strategic and technical oversight; data collection was facilitated by WHO Representatives and staff at country level; atlevel, trainings, data collection and validation were carried out by: Martial Missimikim and Martin Ekeke Monono (Africa); AsAlessandra Senisse Pajares and Eugnia Rodrigues (the Americas); Rania Saad, Hala Sakr and Hala Youssef (Eastern MediterrFrancesco Mitis and Dinesh Sethi (Europe); Rania Saad and Chamaiparn Santikarn (South-East Asia); and Krishnan Rajam, MDarang and Xiangdong Wang (Western Pacic). Other WHO staff who contributed to the development and production of the reinclude Ala Alwan, Nicholas Banatvala, Oleg Chestnov, Manjul Joshipura, Doris Ma Fat, Evelyn Murphy, Etienne Krug, Jon PaPascale Lanvers-Casasola, Colin Mathers, Florence Rusciano and Jelica Vesic.

Country level data could not have been obtained without the invaluable input of: the National Data Coordinators (see Table A1 in the Statistical Annex); all respondents and attendees of the consensus meetings in countries; government of cials who provided clearance of the information for inclusion in the Report.

WHO also wishes to thank the following contributors whose expertise made this document possible: Jennifer Ellis, Kelly Henning and Kelly Larson from Bloomberg Philanthropies;

Adnan Hyder, Olive Kobusingye, Junaid Razzak and David Ward, who provided expert advice and review comments; Claudia Adriazola-Steil, Abdulgafoor Bachani, Madhav Pai, Nagi Shak, David Ward, Esti Widiastuti,

Gde Yogadhita for providing information for boxes; Alison Harvey for preparing and checking country proles; Angela Burton who edited and proofread the report; Drew Blakeman for valuable editorial input; Graphic designers from LIV Com Srl who produced the design and layout.

Finally the World Health Organization wishes to thank Bloomberg Philanthropies for its generous nancial support for the deveand publication of this report.

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Executive summaryRoad trafc injuries are the eighth leadingcause of death globally, and the leadingcause of death for young people aged1529(1, 2) . More than a million peopledie each year on the worlds roads, and thecost of dealing with the consequences ofthese road trafc crashes runs to billionsof dollars(3) . Current trends suggest thatby 2030 road trafc deaths will becomethe fth leading cause of death unlessurgent action is taken(2) .

Strategies exist that are proven toreduce road trafc injuries and a numberof countries have successfully usedthese strategies to reduce their roadtrafc deaths. In 2004, the World HealthOrganization (WHO) and the World Bank

launched theWorld report on road trafc injury prevention (4).The World reportprovides extensive information on leadingrisk factors for road trafc injuries andevidence on effective interventions, andmakes recommendations to countrieson how to improve national roadsafety. Progress in implementing therecommendations of the World report was

rst reported in theGlobal status report on road safety: time for action (2009)(5) .

In 2010 the United Nations GeneralAssembly unanimously adopted aresolution calling for a Decade of Actionfor Road Safety 20112020, and for furtherGlobal status reports on road safety tomonitor the impact of the Decade atnational and global levels. This reportbuilds on the 2009 report, and providesadditional data in a number of importantareas. It serves as the baseline formonitoring the Decade.

The report shows that there has beenno overall reduction in the number ofpeople killed on the worlds roads: about

1.24 million deaths occur annually.However, this plateau should be consideredin the context of a corresponding 15%global increase in the number of registeredvehicles, suggesting that interventions toimprove global road safety have mitigatedthe expected rise in the number ofdeaths. Eighty-eight countries in whichalmost 1.6 billion people live reduced

the number of deaths on their roadsbetween 2007 and 2010, showing thatimprovements are possible, and that manymore lives will be saved if countries takefurther action. However, of concern isthat 87 countries saw increases in thenumbers of road trafc deaths over thesame period. The report also shows thatthe highest road trafc fatality rates are inmiddle-income countries, particularly theAfrican Region. More than three-quartersof all road trafc deaths are among youngmales. The report notes the need forstandardized data collection on fatalitiesand the need for improvement in thequality of road safety data on road trafcdeaths, non-fatal injuries and disability. Italso stresses the importance of good post-

crash care, both in terms of providing quickaccess for road trafc victims to healthcare, and in ensuring the quality of trainedhospital trauma care staff in mitigating thenegative outcomes associated with roadtrafc crashes.

The rstGlobal status report on road safety highlighted the lack of

Eighty-eight countries have reduced the numberof deaths on their roads but the total number ofroad trafc deaths remains unacceptably high at

1.24 million per year.

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comprehensive legislation on key riskfactors (speed, drinkdriving, motorcyclehelmets, seat-belts and child restraints) forroad trafc injuries(5) . Between 2008 and2011, 35 countries, representing almost10% of the worlds population, passedlaws to address one or more of theseve key risk factors. The action taken bythese countries to implement new lawsindicates that with country commitment progress is possible. However, therehas been no increase in the numberof countries with adequate legislationon all ve key risk factors the 28

countries (representing 7% of the worldspopulation) with comprehensive lawsremain unchanged from the last evaluationin 2009. The report also highlights that

enforcement of these laws, which iscritical to their success, is inadequate.

The report serves as a strong warningto governments to address the needs ofnon-motorized road users. Twenty-sevenper cent of all road trafc deaths occuramong pedestrians and cyclists. In low-and middle-income countries, this gureis closer to a third of all road deaths, butin some countries is more than 75%. Asthe world continues to motorize, walkingand cycling need to be made safe andpromoted as healthy and less expensive

mobility options. However, only 68countries have national or subnationalpolicies to promote walking and cycling,and just 79 countries have policies that

protect pedestrians and cyclists byseparating them from motorized andhigh-speed trafc. Although governmentsincreasingly recognize the need to promotealternative forms of mobility, moreemphasis needs to be given to makingthese modes of transport safe. Addressingthe safety of pedestrians, cyclists andmotorcyclists is critical to successfullyreducing the total number of global roadtrafc deaths.

The report further highlights the importantrole that road infrastructure can play

in reducing injuries among all roadusers, including pedestrians, cyclistsand motorcyclists. It recommends thatgovernments implement regular road

Only 28 countries, representing 449 million people

(7% of the worlds population), have adequatelaws that address all ve risk factors (speed, drinkdriving, helmets, seat-belts and child restraints).

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safety audits to assess safety levels ofboth existing and new road infrastructureprojects. The report also outlines progressthat has been made to implementminimum vehicle safety standards, andencourages governments to work withvehicle manufacturers to ensure thatever-larger proportions of their eets meetthese standards.

Real progress has been made towardsimproving road safety and saving lives,but what this report shows is that fasterand more concerted action is needed

to prevent many more lives being

Over a third of road trafc deaths in low- andmiddle-income countries are among pedestriansand cyclists. However, less than 35% of low- andmiddle-income countries have policies in place to

protect these road users.

needlessly lost on the worlds roads.Therefore the report makes the followingrecommendations:

Governments urgently need to passcomprehensive legislation that meetsbest practice on all key risk factorsto address this preventable cause ofdeath, injury and disability.

Governments should invest sufcientnancial and human resources in theenforcement of these laws, as anessential component for their success.

Raising public awareness can be

an important strategy in increasingunderstanding of and support for suchlegislative and enforcement measures.

Concerted effort is needed tomake road infrastructure safer forpedestrians and cyclists. The needs ofthese road users must be taken intoconsideration earlier, when road safetypolicy, transport planning and landuse decisions are made. In particular,governments need to consider hownon-motorized forms of transport canbe integrated into more sustainable

and safer transport systems.

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In order to guide countries on takingconcrete, national-level actions to achievethis goal, a Global Plan of Action wasdeveloped(5) . This provides a practicaltool to help governments and othernational stakeholders develop national andlocal plans of action, while simultaneouslyproviding a framework for coordinatingactivities at regional and global levels.National activities are based around vekey pillars, as indicated (Figure 2).

The UN General Assembly resolutionalso called for regular monitoring of

global progress toward meeting targetsidentied in theGlobal Plan of Action.These targets are, in part, based on datahighlighted in the rstGlobal status report on road safety in 2009,1 and to this end,the resolution calls for the publication offurther reports to provide and disseminatethis information(6) . This report, the secondGlobal status report on road safety,meetsthis request and will provide the baselinedata (from 2010) for monitoring progressthrough the Decade of Action.

1 The Global status report on road safety: time for action (2009) legislation data were collected for 2008and fatality data for 2007; in both cases these werethe most recent data available. The current reportprovides legislation data updated for 2011 and fatalitydata updated for 2010. Thus comparisons on fatalitydata relate to 2007 and 2010.

The purpose of this report

The specic objectives of this secondGlobal status report on road safety are:

to describe the burden of road trafcinjuries and implementation of effectiveinterventions in all Member Statesusing a standardized methodology, andassess changes since the publication ofthe rstGlobal status report in 2009;

to indicate gaps in road safetynationally across a number of domains

(institutional management, policies,legislation, data collection) to stimulateand prioritize road safety activities;

to serve as a baseline for monitoringactivities relating to the Decade ofAction for Road Safety at national andinternational levels.

Methodology

The methodology used to generate thedata and information presented in thisreport involved collecting data fromeach country, coordinated by a NationalData Coordinator (see Statistical Annex,Table A1). Data collection in turn

was driven by a number of individualrespondents from different sectors withina country, each of whom completed aself-administered questionnaire withinformation on key variables. This groupwas then required to come to a consensuson the data that best represented theircountry, which is presented here. Moredetail on the methodology can be found onpage 42. The report highlights data from182 countries/areas, covering 6.8 billionpeople (98.6% of the worlds population).Response rates by region covered between95% of the population in the AfricanRegion, to 100% in the South-East AsiaRegion. Data collection was carried out in2011: thus, while data on legislation andpolicies relate to 2011, data on fatalitiesrelate to 2010, the most recent year forwhich data were available.

Pillar 2Safer roads and

mobility

Pillar 3Safer vehicles

Pillar 1Roadsafety

management

Pillar 4Safer road users

Pillar 5Post-crashresponse

National activities

Figure 2The ve pillars that guide national road safety plans and activities over theDecade of Action

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SECTION1The current state of

global road safety


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Figure 5Population, road trafc deaths, and registered motorized vehicles a, by country income status

High-income Middle-income Low-income

1%

Population

72% 80%

52%

16%12% 8%12%

47%

Road trafc deaths Registeredmotorized vehiclesa

The African Region has thehighest road trafc fatalityrate

There are large disparities in road trafcdeath rates between regions (see Figure 6).The risk of dying as a result of a road trafc

injury is highest in the African Region (24.1per 100 000 population), and lowest in theEuropean Region (10.3 per 100 000).

There is also considerable disparity inrates between countries within the sameregion. The European Region has the

highest inequalities in road trafc fatalityrates, with low-income countries havingrates nearly three times higher thanhigh-income countries (18.6 per 100 000population compared to 6.3 per 100 000) these are similar to rates in South EastAsia and Western Pacic Regions.

a Registered vehicle data provided only for countries participating in the survey.

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SECTION2NEW ROAD SAFETY LAWS:

PROGRESS TO DATE


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Progress to reduce excessivespeed has stalled

Speeding is a major road safety problemin all countries. Faster driving speedsincrease the likelihood of a crashoccurring, and the severity of the crashconsequences. Interventions to reducespeed can lead to signicant reductions inroad trafc injuries. In urban areas, withhigh concentrations of pedestrians andcyclists, measures to reduce speed arecritical to the safety of these road users.

Excessive speed is a worldwide problemaffecting the entire road network(motorways and highways, and ruraland urban roads). Speed limits vary byroad type and most of the best practiceidentied in this area has come from

REDUCING SPEED

high-income countries(4, 14) . At present,even in high-performing countries, there isdiversity in speed limits used for particularroad types, but most countries follow ahierarchical approach and adopt speedlimits within the following levels:

Higher speed roads: motorways,expressways and multi-lane dividedhighways ideally ensure no contactbetween motorized and non-motorizedtrafc and have barriers to separateopposing directions of trafc. In generalthey have the lowest rates of roadinjuries because of these features. Inmost high-income countries, speedlimits are set at between 90130 km/h.

Rural roads: single lane carriagewaysin rural areas include many different

types of roads, and speed limits inhigh-performing countries vary from70100 km/h. These roads havemuch higher rates of injuries thanhigher speed roads, because of largedifferences in speed between varioustypes of user. However, the widerange of denitions used to classifyrural roads, and the fact that theirspeed needs to be adapted to differentcircumstances along the length of ruralroads, makes it difcult to comparerural road safety across countries.

Urban roads: roads in towns and citiesare usually shared by pedestrians,cyclists, users of public transport aswell as higher speed trafc. While50 km/h is considered best practicefor urban speed limits, there is much

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National urban speed limits 50 km/h and can be modified

National urban speed limits 50 km/h and cannot be modified

Urban speed laws at subnational level

Urban speed laws not comprehensive

Data not available

Not applicable

evidence to support reducing theselimits to 30 km/h as a way of trafccalming in areas with high pedestrianconcentration. However, achieving thisrequires local authorities to have theauthority allowing them to reduce speedlimits that are set at a national level.

Reducing urban speedsprotects pedestrians andcyclists

Setting speed limits according to thedesignated function of particular roads isan effective measure to reduce road trafcinjuries. A number of countries consideredleaders in road safety, such as Australiaand Sweden, have adopted universal urbanspeed limits of 50 km/h, based on theeffectiveness of this measure in reducinginjuries and deaths. Although well overhalf of all countries (114) apply this urbanspeed limit, these countries represent less

Figure 13Urban speed laws by country/area

than half (47%) of the worlds population(see Figure 13). Between 2008 and2011, six countries improved their urbanspeeding laws, protecting an additional246 million people, but more effort isneeded to encourage governments toadopt maximum urban speed limits of50 km/h.

Pedestrians and cyclists are especially atrisk of an injury as a result of excessivevehicle speeds. This vulnerabilitymeans particular attention needs to bepaid to speed limits in areas with highconcentrations of these road users,such as around schools or in residentialneighbourhoods(4, 14) .

Trafc calming measures that reducevehicle speeds in these areas are proveneffective in reducing road trafc injuries.For example, introducing 30 km/h zonesin residential areas in the UK resulted

in overall vehicle speed reductions of15 km/h and cut vehicle crashes with childpedestrians and cyclists by 67%(15) .

However, nearly half of all countries (82)lack enabling legislation that permitslocal authorities to modify nationalspeed limits, thus limiting the ability ofsubnational governments to implementeffective road safety measures within theirjurisdictions. This is further reected inthe low proportion of countries (37%) thathave urban speed limits of 30 km/h or lessaround schools.

Taken together, this means that just59 countries both implement nationalurban speed limits of less than or equalto 50 km/h and allow local authoritiesto further reduce these limits whereappropriate. These countries represent2.67 billion people, or just 39% of theworlds population.

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Speed limits need strongerenforcement

Although most countries have enactednational speed limit laws, theirenforcement is often lacking: only

26 countries rate enforcement of theirnational speed limits at good (8 or aboveon a scale of 0 to 10). Even in high-incomecountries, which tend to have more nancialresources to dedicate to enforcement,speed law enforcement remains weak,

with only 20% of high-income countriesreporting good enforcement. Enforcementof speed limits is essential for successfullydeveloping safer driving behaviour andneeds to be given increasing emphasis inmost countries.

Only 59 countries, covering just 39% of the worldspopulation (2.67 billion people), have implementedan urban speed limit of 50 km/h or less and allow

local authorities to reduce these limits.

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Drinkdrive laws shouldbe based on blood alcoholconcentration levels

Drinking and driving increases the riskof being involved in a crash, as well asthe severity of resulting injuries. Drivingstarts to be impaired at very low levelsof alcohol consumption, with the risk ofcrash involvement growing rapidly asconsumption increases. The vast majorityof adult drivers are affected or impairedwith a blood alcohol concentration (BAC)1of 0.05 g/dl, while at a BAC level of0.1 g/dl the crash risk is approximately vetimes higher than that of someone witha BAC level of zero(16, 17) . Young andnovice drivers who drink and drive have agreatly increased risk of a crash comparedto more experienced drivers(4, 18) .

The effects of alcohol impairment aremagnied when combined with fatigue.This explains why alcohol is considereda particular risk for commercial drivers,who spend long hours on the road andalso have legal responsibilities for thepassengers or cargo they carry.

1 The amount of alcohol present in the bloodstream,usually measured in grams per decilitre (g /dl).

Since 2008, 10 countries haveimproved their drinkdrivinglaws to meet best practice

(blood alcohol concentrationof 0.05 g/dl or less), helpingprotect 186 million people.

REDUCING DRINKINGAND DRIVING

Strong drinkdrive lawsprotect almost 70% ofworlds population

A variety of BAC limits are in place acrossthe world. Setting and enforcing legislationon BAC limits of 0.05 g/dl can lead tosignicant reductions in alcohol-relatedcrashes(4, 19, 20) . Since 2008, there hasbeen progress in strengthening drinkdriving legislation: 89 countries, covering66% of the worlds population (4.55 billionpeople), now have a comprehensivedrinkdriving law, dened as a BAC limitof 0.05 g/dl or less, which is in line withbest practice (see Figure 14). High-incomecountries are more likely to have a legalBAC limit of 0.05 g/dl or less (67%) than aremiddle- or low-income countries (49% and21%, respectively). Even in the 17 countries

where alcohol consumption is legallyprohibited, a drinkdriving law based ona BAC of less than or equal to 0.05 g/dl isrecommended, and is already in place in anumber of countries, such as Mali, Moroccoand the United Arab Emirates. Nonetheless,there remains a need for more action in this

area: 34 of the worlds countries either haveno drinkdriving law at all, or implement alaw based on measures that are less robustthan BAC (such as assessing a personslevel of intoxication, using clinical signs andsymptoms) (see Figure 14).

More stringent drinkdrivelaws for high-risk drivers

Inexperienced young adults driving witha BAC level of 0.05 g/dl are more thantwice as likely to have a road trafccrash than are more experienced drivers(18, 21) , while commercial drivers are alsoconsidered a high-risk group for alcohol-related crashes. Setting lower BAC limits(0.02 g/dl or less) for both groups is aneffective means of reducing crashes relatedto drinkdriving(19) : 42 countries (23%)

apply BAC limits of 0.02 g/dl or less amongyoung and novice drivers, while the gurefor commercial drivers is slightly higher, at27%. High-income countries are more likelyto have these laws in place than are low- ormiddle-income countries (see Figure 15).

Drinkdrive laws needstronger enforcement

Enforcement of drinkdriving laws hasbeen shown to be more effective when itincludes random breath tests for all drivers(not just those suspected of drinking),and when it is carried out at times andin locations when drinkdriving is morelikely to occur(22, 23, 24) . Such measuresthat increase drivers perception of thelikelihood of being apprehended are key tothe success of this intervention(22, 25) .

Random breath testing is used by 74%of the worlds countries to help enforcedrinkdriving laws, but this gure varieswith country income status, with 88% of

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Taken together, this means that 90countries meet both the criteria consideredhere as essential for comprehensivehelmet legislation to be met, that is, theyhave implemented a helmet law thatcovers all road users, all road types andall engine types, and they apply a nationalor international helmet standard. In theWestern Pacic and South East Asiaregions, which have the highest proportionof motorcyclist deaths, the proportion ofcountries covered by such laws is 56% and64% respectively.

Data on helmet wearing isweak

Countries need to implement measuresto periodically assess helmet wearingrates, to target efforts and resourceseffectively, and to evaluate the effects ofhelmet programmes, including the impactof mandatory helmet legislation. In mostcountries, these data come from periodicobservational studies conducted accordingto an acceptable study design that ensuresthe reliability and validity of results.

Only 69 countries have any type of dataon rates of helmet wearing, either ondrivers, passengers or both, with wearingrates ranging from under 10% in Ghanaand Jamaica to almost 100% in theNetherlands and Switzerland. In particular,there is a lack of data on helmet-wearingrates from low-income countries inthe African, Eastern Mediterraneanand Western Pacic regions. Given theincreasingly high proportion of motorcycledeaths globally, governments need tosupport data collection efforts that providegood estimates of helmet wearing rates ona regular basis in their countries.

Comprehensive helmet law and standard

Comprehensive helmet law but no/unknown standard

Helmet law at subnational level

Helmet law not comprehensive

Data not available

Not applicable

Figure 16Motorcycle helmet laws and helmet standards, by country/area

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Seat-belts reduce the risk of a fatal injury by up to50% for front seat occupants, and up to 75% for

rear seat occupants.

Progress has been made intightening up seat-belt laws

Failure to use a seat-belt is a major riskfactor for road trafc injuries and deathsamong vehicle occupants. When a motorvehicle crash occurs, a car occupantwithout a seat-belt will continue to moveforward at the same speed at which thevehicle was travelling before the collisionand will be catapulted forward into thestructure of the vehicle most likely into

INCREASINGSEAT-BELT USE

the steering wheel column if driving, thedashboard if a front seat passenger, orthe back of the front seats if a rear seatpassenger(31, 32, 33) . Alternatively,failure to use a seat-belt can cause driversor passengers to be completely ejectedfrom the vehicle, greatly increasing the riskof serious injury or death(4, 20, 34) .

Wearing a seat-belt reduces the riskof a fatal injury by 4050% for driversand front seat occupants, and between

2575% for rear seat occupants(20, 35) .Seat-belt wearing rates vary greatlybetween countries, and to a large extentare governed by the existence andenforcement of mandatory seat-belt laws.In many countries, drivers and front seatpassengers are legally obliged to use seat-belts, but this does not always apply torear seat occupants.

While the vast majority of countries havelegislation on mandatory seat-belt use, a

National seat-belt law applies to all occupants

Seat-belt law at subnational level

No seat-belt law or law does not apply to all occupants

Data not available

Not applicable

Figure 17Seat-belt laws, by country/area

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number of countries do not apply theselaws to both front and rear seat occupants.Comprehensive seat-belt laws covering alloccupants are in place in 111 countries,meaning 69% of the worlds population(4.8 billion people) are fully protected bythese laws (see Figure 17). Ten countries,covering 182 million people, put in placecomprehensive seat-belt laws since 2008.But more needs to be done to convincepolitical leaders and police authorities thatseat-belt use can save lives, and to work tostrengthen seat-belt legislation in line withbest practice (see Box 6).

Enforcing seat-belt lawsneeds more emphasis

To effectively increase seat-belt wearingrates, governments need to support

Progress has been made to protect rear-seatcar occupants through implementation of

comprehensive seat-belt laws: 111 countries(69% of the worlds population) now have

comprehensive seat-belt laws covering all occupants.

legislation with strong and sustainedpolice enforcement. Despite improvementsin seat-belt legislation in many countries,much more is needed to improveenforcement: only a quarter of all countriesrate their seat-belt enforcement as good(8 or above, on a scale of 0 to 10), showingthat improved enforcement and publicawareness campaigns on seat-belt useare needed to increase compliance withlegislation.

Only half of countries collectseat-belt wearing data

Collecting information on seat-beltwearing rates is an important mechanism

for countries to target resources andevaluate the effectiveness of seat-beltprogrammes. The ability to show an

increase in seat-belt use is important tosustain political and community supportfor enforcement measures.

Just under half of all countries havedata on seat-belt wearing rates, withthis number disproportionately lower inlow- and middle-income countries (6%and 43%, respectively) compared tohigh-income countries (80%). Data thatare disaggregated to show wearing ratesamong rear seat occupants separatelyfrom front seat occupants are useful fortargeting programmes aimed at increasingrates among rear seat passengers.

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restraint laws as good (8 or above ona scale of 0 to 10). Even in high-incomecountries, enforcement of child restraintlaws is lacking, with just 12 countries (24%)rating enforcement of their laws as good(see Figure 20).

Encouraging child restraintuse

Increasing the use of child restraintscalls for adoption and enforcement ofspecic legislation mandating restraintsappropriate for different age groups, as

well as efforts to raise public awarenessabout risks associated with non-use ofrestraints. However, given that cost and

accessibility can limit child restraintuse, governments need to explore waysto feasibly encourage uptake. Theseare particularly important in low- andmiddle-income countries, and may includemechanisms such as loan schemes, orthe subsidized distribution of restraints inmaternity wards.

Governments need to take steps towards:

adopting and enforcing speciclegislation relating to restraintsappropriate for different age groups;

raising public awareness about the risksassociated with non-use of restraints;

exploring mechanisms to encourageuptake of child restraints, given issuesof cost and accessibility particularly inlow- and middle-income countries;

encouraging marketing of childrestraints by vehicle manufacturers andretailers;

collecting data on the extent of use ofdifferent types of child restraints.

National child restraint law

Child restraint law at subnational level

No child restraint law

Data not available

Not applicable

Figure 20Child restraint law, by country/area

The majority of high-income countries (88%) havechild-restraint laws in place, while such laws are far

less common in low- and middle-incomecountries (30% and 43%, respectively).

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Involving multiple sectors innational road safety effortsis critical

Countries need a lead agency for roadsafety, which should have the authorityto make decisions, manage resourcesand coordinate efforts of all participatinggovernmental sectors, including thoseof health, transport, education and lawenforcement. Lead agencies may take theform of a designated stand-alone bureau,or a committee or cabinet representingseveral different government agencies(4) .One hundred and sixty-two countries(89%) have a lead agency for road safety,of which 122 are funded. Most of theselead agencies (81%) fulll coordinationfunctions, while 80% fulll legislativefunctions and 71% are involved in

establishing data systems to monitor roadsafety and disseminate national statistics.

National road safetystrategies should includetargets to minimize injuries,deaths and key risk factors

The development of a national roadsafety strategy with precise targetsand funding for implementation is akey element of sustained road trafcinjury prevention efforts. Each countryshould have a road safety strategythat is multisectoral involvingagencies concerned with transport,health, law enforcement, educationand other relevant sectors andalso multidisciplinary, involving bothgovernment and nongovernmentstakeholders. Currently, 139 countrieshave a single or multiple nationalstrategies on road safety. Governments

also need to ensure sufcient resourcesto effectively develop, implement andmonitor activities included in theirnational strategies: of 139 countries withnational strategies, 119 are partially orfully funded.

Setting targets to improve and assessroad safety performance has becomeincreasingly important in a number ofhigh-income countries(39) . Targets thatare realistic, attainable and time-boundcan motivate stakeholders and hold roadsafety leaders accountable for achievingdened results(40) . While 112 countries(62%) include fatality targets in theirnational strategies, only 62 countries (34%)include targets on non-fatal injuries inpart due to the difculty in dening andcounting non-fatal injuries (see Section 1,page 7). Governments should also includetargets on intermediate outcomes in theirstrategies (e.g. increases in helmet wearing,reductions in drinkdriving)(40, 41) : only athird of countries have data on all ve keyrisk factors. Setting interim targets can bevery helpful in obtaining and sustaining

community and political support forlonger-term road safety measures as wellas in identifying emerging issues (seeBox 7), but requires that countries haveand can continue to collect data on theinterim measures.

LEAD AGENCIES ARE VITAL TO DEVELOPINGA NATIONAL ROAD SAFETY STRATEGY

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public understanding of and support forlegislative measures.

Reducing road trafc deathsrequires more consideration of theneeds of pedestrians, cyclists, andmotorcyclistsReducing the total number ofglobal road trafc deaths requiresthat increased attention be paid toimproving the safety of pedestrians,cyclists and motorcyclists. Half of allroad trafc deaths occur among theseroad users, and yet less than onethird of all countries have put in placemeasures to promote forms of non-motorized transport that will be safe forthose using them. Governments mustactively address the safety and mobilityneeds of these more vulnerable roadusers, and consider how non-motorizedforms of transport can be safely

integrated into more sustainable andsafer transport systems.

In addition, there are a number of otherareas that governments need to address toensure the implementation of theGlobal plan of Action for the Decade of Action forRoad Safety. These include making roadinfrastructure safer, intensifying work toimprove the proportion of vehicle eetsthat meet international crash testingstandards, and improving post-crashcare. The recommendations outlined intheGlobal plan of Action could serve asa basis for discussion and agreement onofcially endorsed targets and indicatorson these areas, which will assist with bothimplementation and future monitoring.The report has also highlighted the needfor continued efforts to be made towardimproving the quality of data on road

trafc deaths, injuries, and on interimindicators. Coordination of these multipleefforts by a well-resourced lead agencyis recommended, such that activitiesare detailed in a multisectoral nationalstrategy that includes specic targets toallow accurate monitoring and evaluationof outcomes and outputs.

The decision to proclaim a Decade ofAction for Road Safety was adoptedunanimously at the UN General Assemblyin 2010. While much progress has beenmade in improving road safety in a numberof countries, considerable work will beneeded for the goals and objectives ofthe Decade of Action to be realized.There is a strong evidence base onwhat interventions work governmentaction is now the key to ensure theirimplementation.

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EXPLANATORY NOTE2

COUNTRY PROFILE EXPLANATIONS

The country proles shown on pages 53 to 236 to y present a selection of core information about road safety, as reported by 182 participating countries/areas. The country proles are presented in alphabetical order. Additional national data can also bthe Tables of the Statistical Annex (Tables A2A10).

Data reported for population were extracted from the United Nations Population Division database(1) , while gross national income (GNI)per capita for the year 2010 came from World Bank estimates(2) . Where no data were available for 2010, published data for the latestyear were used. The World Bank Atlas method was used to categorize GNI into bands thus: low-income = US$ 1005 or less middle-income = US$ 1006 to US$ 12 275 high-income = US$ 12 276 or more.

Flags were obtained from the World Flag Database (http://www.ags.net). Flags as of 31 December 2010 were used (to correthe year of data collection).

The sections below reect the way information is structured in each of the Country Proles. They include details on how datvariables are presented and should be interpreted. Variables were coded as if the information was unavailable or non-apif respondents had ticked a Dont know response.

Institutional framework

Information on the existence of a national road safety strategy is indicated as Yes or No: countries where national strategdevelopment is underway but has not yet been approved or endorsed by government are indicated as No.

Where countries indicated that they have a fatality reduction target, information on this target is included. Specic fatality taindicated either as absolute numbers of deaths, or as a rate per 100 000 population.

Safer roads and mobility Information on road safety audits of new road infrastructure projects is reported as Yes or No. Information on road safety audits on existing road infrastructure projects is reported as Yes, Parts of road network, or No.

Safer vehicles Information about the total number of vehicles in the country includes only registered vehicles, and various categories of such

vehicles. In a few countries the number of vehicles in subcategories did not add up to the total number provided. In some respondents noted that a substantial proportion of the vehicle eet may not be registered.

Data Only reported numbers of road trafc deaths are included in the Country Proles. Footnotes indicate what the source of data is and

what denition was used. Due to footnote space constraints, the data source has been summarized as Police, Transport, Health or Vital registration records, or

Combined sources. Data from different countries are not necessarily comparable, as different denitions and timeframes have been used (these arenoted in the footnotes). For more comparable data please see Table A2 in the Statistical Annex.

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footnotes. Note that the information provided for front seat and rear seat occupants does not necessarily represent the samcome from the same source, as indicated in the corresponding footnotes.

Only the presence of a national child restraint law is noted and what the enforcement level of this law is estimated to be. Information about laws on mobile phone use while driving is included for therst time. Only information on whether the law bans

hand-held and/or hands-free is included.

Post-crash care The section on post-crash care indicates whether or not a vital registration system was functional in the country. The variable does

not indicate coverage or completeness of this system. The emergency-room based injury surveillance system variable only indicates whether there was a system in place and not whether it

was national or sentinel in nature. Emergency access telephone numbers are given only if ONE national number was provided. If countries reported multiple national

numbers then multiple numbers is noted in the corresponding eld but the actual numbers are not provided. The proportion of those transported by ambulance was based on expert opinion. The proportion of those disabled as a result of a road trafc crash is only included if a robust source of information was available,

however, this was not necessarily national. The variables on emergency medicine training refer to a formal, recognized training for doctors and a formal post-graduate training for

nurses. Other non-formalized trainings may exist, but are not captured in the information presented here.

References1. Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat.World population Prospects:

The 2010 Revision, Highlights . New York, United Nations, 2011.2. World Development Indicators database, World Bank, November 2012 [website], http://data.worldbank.org/indicator/NY

CD/countries.

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where N is the total road trafc deaths (for a country-year), C is a constant term, X1 are a set of explanatory covariates, Pop is thepopulation for the country-year, and is the negative binomial error term. Population was used as exposure, making it possible tointerpret the coefcients (1) for the independent variables as effects on rates rather than a count. In a previous study, this type ofmodel was used to represent accident proneness(9) . Other authors have also found a negative binomial regression model to be theappropriate for count data such as road trafc fatalities(10) .

The parameters1, 2 n (in the equation above) were estimated by tting the negative binomial regression model to estimated toroad trafc deaths from death registration data for all country-years in the range 1950-2010 meeting the completeness criteria (G

Three models (Models A, B and C) were chosen that had good in-sample and out-of-sample t, and for which all the covariatesstatistically signicant and for which overall estimation is the average of the prediction of these three best models (see Table E2these countries a 95% condence interval was given by using the negative binomial regression in the statistical package STATA

Independent variables Description Source of informationIncluded inmodels

ln (GDP)WHO estimates of Gross DomesticProduct (GDP) per capita(international dollars or purchasingpower parity dollars, 2005 base)

WHO database Models A, B, C

ln (vehicles per capita) Total vehicles per 1000 personsGSRRS surveys and WHOdatabase Models A, B, C

Road density Total roads (km) per 1000 hectaresInternational Futuresdatabase(11) Models A, B, C

National speed limits on ruralroads

The maximum national speed limits

on rural roads (km/h) from WHOquestionnaire GSRRS survey Models A, B, CNational speed limits on urbanroads

The maximum national speed limitson urban roads (km/h) from WHOquestionnaire

GSRRS survey Models A, B, C

Health system accessHealth system access variable(principal component score basedon a set of coverage indicators foreach country)

Institute for Health Metricsand Evaluation dataset(12) Models A, B, C

Alcohol apparentconsumption

Litres of alcohol (recorded plusunrecorded) per adult aged 15+ WHO database Models A, B, C

Population working Proportion of population aged 1516yearsWorld Population Prospects2010 revision (UNDESA) Models A, B, C

Percentage motorbikes Percentage of total vehicles that aremotorbikes GSRRS survey Model B

Corruption indexControl of corruption index (unitsrange from about 2.5 to +2.5 withhigher values corresponding tobetter control of corruption

World Bank(13) , InternationalFutures database(11) Model B

National policies for walking /cycling

Existence of national policies thatencourage walking and/or cyclingGSRRS survey Model C

Population Total population (used as offset innegative binomial regression)World Population Prospects2010 revision(5) Models A, B, C

Table E2

Covariates used in the model

Following the computation of estimates of road trafc deaths for 2010, a country consultation process was undertaken. Each coprovided with an opportunity to comment on both the methodology which had been employed to compute the estimate, as well

actual estimate received. As a result of this process, seven countries (Canada, Chile, China(14),Costa Rica, India(15) , Iran and the USA)provided WHO with more up to date data which was used to improve estimates.

Table E3 provides an overview of the method used for each of the 182 countries that participated in the survey.

ln N = C + 1 X 1 + 2 X 2 + .... + n X n + ln Pop +

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Group 1 Group 2 Group 3 Group 4

Countries with good deathregistration data

Countries with other sourcesof cause of death information

Countries with populationsless than 150 000

Countries without eligibledeath registration data

Argentina, Australia, Austria,Azerbaijan, Bahamas,Bahrain, Barbados, Belarus,Belgium, Belize, Brazil, BruneiDarussalam, Bulgaria, Canada,Chile, China, Colombia, CostaRica, Croatia, Cuba, Cyprus,Czech Republic, Denmark,Ecuador, Egypt, El Salvador,Estonia, Fiji, Finland, France,Georgia, Germany, Greece,Guatemala, Guyana, Hungary,Iceland, Ireland, Israel, Italy,Jamaica, Japan, Kazakhstan,Kuwait, Kyrgyzstan, Latvia,Lithuania, Luxembourg,Maldives, Malta, Mauritius,Mexico, Montenegro,Netherlands, New Zealand,Norway, Oman, Panama,Paraguay, Philippines, Poland,Portugal, Qatar, Republic ofKorea, Republic of Moldova,Romania, Russian Federation,Saint Lucia, Serbia, Singapore,Slovakia, Slovenia, SouthAfrica, Spain, Suriname,Sweden, Switzerland, TheFYR of Macedonia, Trinidadand Tobago, Ukraine, UnitedKingdom, United States ofAmerica, Uruguay, Uzbekistan,Venezuela, West Bank andGaza Strip, Zimbabwe

India, Iran, Thailand, Viet Nam Andorra, Cook Islands,Dominica, Kiribati, MarshallIslands, Micronesia, Niue,Palau, Saint Kitts and Nevis,Saint Vincent and theGrenadines, San Marino,Seychelles, Tonga

Afghanistan, Albania, Angola,Armenia, Bangladesh, Benin,Bhutan, Bolivia, Bosnia andHerzegovina, Botswana,Burkina Faso, Burundi,Cambodia, Cameroon, CapeVerde, Central AfricanRepublic, Chad, Comoros,Congo, Cte dIvoire, DPRKorea, DR Congo, DominicanRepublic, Equatorial Guinea,Ethiopia, Gabon, Gambia,Ghana, Guinea, Guinea-Bissau, Honduras, Indonesia,Iraq, Jordan, Kenya, LaoPDR, Lebanon, Lesotho,Liberia, Madagascar, Malawi,Malaysia, Mali, Mauritania,Mongolia, Morocco,Mozambique, Myanmar,Namibia, Nepal, Nicaragua,Niger, Nigeria, Pakistan,Papua New Guinea, Peru,Rwanda, Samoa, Sao Tomeand Principe, Saudi Arabia,Senegal, Sierra Leone,Solomon Islands, Sri Lanka,Sudan, Swaziland, Syrian ArabRepublic, Tajikistan, Timor-Leste, Togo, Tunisia, Turkey,Uganda, United Arab Emirates,United Republic of Tanzania,Vanuatu, Yemen, Zambia

For specic methods used for each country, see web appendix, at http://who.int/violence_injury_prevention/road_safety_status/2013/methodology/en/index.html

Table E3Overview of methods used to obtain comparable country estimates

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59

Further data on each country can be found in the statistical annex.

ARGENTINA

INSTITUTIONAL FRAMEWORKLead agency National Road Safety Agency (ANSV)

Funded in national budget YesNational road safety strategy YesFunding to implement strategy Yes, fully fundedFatality reduction targets set Yes (20082012)Fatality reduction target 50%

Population: 40 412 376Income group: MiddleGross national income per capita: US$ 8 620

SAFER ROADS AND MOBILITYFormal audits required for new road construction YesRegular inspections of existing road infrastructure YesPolicies to promote walking or cycling SubnationalPolicies to encourage investment in public transport YesPolicies to separate road users to protect VRUs Subnational

SAFER VEHICLESTotal registered vehicles (2010) 14 163 125

Cars and 4-wheeled light vehicles Motorized 2- and 3-wheelers Heavy trucks Buses Other

Vehicle standards appliedUN World forum on harmonization of vehicles standards YesNew car assessment programme No

Vehicle regulationsFront and rear seat-belts required in all new cars Yes

Front and rear seat-belts required all imported cars No POST-CRASH CAREVital registration system YesEmergency Room based injury surveillance system YesEmergency access telephone number(s) 107Seriously injured transported by ambulance 75%Permanently disabled due to road trafc crash Emergency medicine training for doctors YesEmergency medicine training for nurses Yes

SAFER ROAD USERSPenalty/demerit point system in place Yes

National speed limits YesLocal authorities can set lower limits NoMaximum limit urban roads 4060 km/hEnforcement 0 1 2 3 4 5 68 9 10

National drinkdriving law YesBAC limit general population 0.05 g/dlBAC limit young or novice drivers 0.05 g/dlBAC limit professional/commercial drivers 0 g/dlRandom breath testing and/or police checkpoints YesEnforcement 0 1 2 3 4 57 8 9 10% road trafc deaths involving alcohol 33%b

National motorcycle helmet law YesApplies to drivers and passengers YesHelmet standard mandated YesEnforcement 0 1 2 3 4 57 8 9 10Helmet wearing rate 46% Driversc

24% PassengerscNational seat-belt law Yes

Applies to front and rear seat occupants YesEnforcement 0 1 2 3 46 7 8 9 10Seat-belt wearing rate 29% Front seatsc

11% Rear seatscNational child restraint law Yes

Enforcement 0 1 2 35 6 7 8 9 10National law on mobile phones while driving Yes

Law prohibits hand-held mobile phone use YesLaw also applies to hands-free mobile phones Yes

b 2009, National Road Safety Agency.c 2011, National Survey Study of helmet, seat-belt use and distracting factors.

DATAReported road trafc fatalities (2010) 5 094a, 80%M, 20%FEstimated GDP lost due to road trafc crashes a Police records. Dened as died within 30 days of crash.

TRENDS IN ROAD TRAFFIC DEATHS

Source: 2004/2008, RENAT (National Registry of Trafc Record)2008/2010, National Directorate of Road Trafc Observaroty, ANSV.

D e a t h s p e r 1 0 0 0 0 0 p o p u l a t i o n

02468

10121416

2004 2005 2006 2007 2008 2009 2010

D a t a c o l l e c t e d b y m u l t i s e c t o r a l c o n s e n s u s m e e t i n g a n d c l e a r e d b y N a t i o n a l R o a d S a f e t y A g e n c y .

Source: 2010, National Directorate of Road Trafc Observaroty, ANSV.

DEATHS BY ROAD USER CATEGORY

Drivers(all vehicles)(44%)

Pedestrians (15%)

Passengers (allvehicles) (25%)

Other (6%)

Riders motorized2- or 3-wheelers

(10%)


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AUSTRALIA

INSTITUTIONAL FRAMEWORKLead agency Department of Infrastructure and Transport

Funded in national budget YesNational road safety strategy YesFunding to implement strategy Not fundedFatality reduction targets set Yes (20112020)Fatality reduction target At least 30% annually (number of deaths)

Population: 22 268 384Income group: HighGross national income per capita: US$ 46 200

SAFER ROADS AND MOBILITYFormal audits required for new road construction YesRegular inspections of existing road infrastructure Parts of networkPolicies to promote walking or cycling YesPolicies to encourage investment in public transport YesPolicies to separate road users to protect VRUs Yes

SAFER VEHICLESTotal registered vehicles (2010) 16 061 098

Cars and 4-wheeled light vehicles 14 729 873Motorized 2- and 3-wheelers 660 107Heavy trucks 397 871Buses 86 367Other 186 880

Vehicle standards appliedUN World forum on harmonization of vehicles standards YesNew car assessment programme Yes

Vehicle regulationsFront and rear seat-belts required in all new cars YesFront and rear seat-belts required all imported cars No

POST-CRASH CAREVital registration system YesEmergency Room based injury surveillance system YesEmergency access telephone number(s) 000Seriously injured transported by ambulance 75%Permanently disabled due to road trafc crash Emergency medicine training for doctors YesEmergency medicine training for nurses Yes

SAFER ROAD USERSPenalty/demerit point system in place Yes

National speed limits SubnationalLocal authorities can set lower limits YesMaximum limit urban roads 50 km/hcEnforcement 0 1 2 3 4 5 6 79 10

National drinkdriving law SubnationalBAC limit general population 0.05 g/dldBAC limit young or novice drivers 0 g/dleBAC limit professional/commercial drivers 0 g/dleRandom breath testing and/or police checkpoints YesEnforcement 0 1 2 3 4 5 6 79 10% road trafc deaths involving alcohol 30%f

National motorcycle helmet law SubnationalApplies to drivers and passengers YesgHelmet standard mandated YesgEnforcement 0 1 2 3 4 5 6 79 10Helmet wearing rate 99% Driversh

National seat-belt law SubnationalApplies to front and rear seat occupants YesEnforcement 0 1 2 3 4 5 68 9 10Seat-belt wearing rate 97% Front seatsi

92% Rear seatsiNational child restraint law Subnational

Enforcement 0 1 2 3 4 57 8 9 10National law on mobile phones while driving Subnational

Law prohibits hand-held mobile phone use YesLaw also applies to hands-free mobile phones No

c All states and territories have a default speed limit of 50 km/h in built-up areas. All except WesteAustralia and the Northern Territory have a default speed limit of 100 km/h on other roads. Thesdefault speed limits apply unless signs specify a different limit.

d All states and territories have a consistent BAC limit of 0.05 g/dl for the general population.e All states and territories have zero BAC requirements for young, novice and professional driversf 20022006, Department of Infrastructure and Transport.g Motorcycle helmets are required in all jurisdictions, for drivers and adult and child passengers, o

all roads and road related areas and with all engine types. Motorcycle helmets must comply witAustralian Standard 1698.h 1997, Haworth, N, et al. Case-Control Study of Motorcycle Crashes, CR174.i 2009, Petroulias, T. Community Attitudes to Road Safety: 2009 Survey report.

DATAReported road trafc fatalities (2010) 1 363a, 72% M, 28% FEstimated GDP lost due to road trafc crashes 1.7%ba Police records. Died within 30 days of crash.b 2009, Dept of Infrastructure and Transport and Regional Economics (BITRE).


Source: Department of Infrastructure and Transport and Regional Economics (BITRE).

D e a t h s p e r 1 0 0 0 0 0 p o p u l a t i o n

0123456789

10

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

D a t a c o l l e c t e d b y N a t i o n a l D a t a C o o r d i n a t o r a n d c l e a r e d b y D e p a r t m e n t o f I n f r a s t r u c t u r e a n d T r a n s p o r t .

Source: 2010, Department of Infrastructure and Transport,Australian Road Deaths Database.


Pedestrians (13%)

Other (


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COMOROS

INSTITUTIONAL FRAMEWORKLead agency Directorate for Road Safety, Circulation and

RegulationFunded in national budget No

National road safety strategy NoFunding to implement strategy Fatality reduction targets set Fatality reduction target

Population: 734 750Income group: LowGross national income per capita: US$ 750

SAFER ROADS AND MOBILITYFormal audits required for new road construction NoRegular inspections of existing road infrastructure NoPolicies to promote walking or cycling NoPolicies to encourage investment in public transport NoPolicies to separate road users to protect VRUs No

SAFER VEHICLESTotal registered vehicles (2010) 29 970

Cars and 4-wheeled light vehicles 23 942Motorized 2- and 3-wheelers 5 146Heavy trucks 772Buses 110Other 0

Vehicle standards appliedUN World forum on harmonization of vehicles standards NoNew car assessment programme No

Vehicle regulationsFront and rear seat-belts required in all new cars a

Front and rear seat-belts required all imported cars Noa No car manufacturers/assemblers. POST-CRASH CAREVital registration system NoEmergency Room based injury surveillance system Emergency access telephone number(s) SubnationalSeriously injured transported by ambulance 10%Permanently disabled due to road trafc crash Emergency medicine training for doctors YesEmergency medicine training for nurses No

SAFER ROAD USERSPenalty/demerit point system in place No

National speed limits SubnationalLocal authorities can set lower limits NoMaximum limit urban roads 30 km/hEnforcement 0 1 24 5 6 7 8 9 10

National drinkdriving law Yesc,dBAC limit general population BAC limit young or novice drivers BAC limit professional/commercial drivers Random breath testing and/or police checkpoints NoeEnforcement 0 13 4 5 6 7 8 9 10% road trafc deaths involving alcohol

National motorcycle helmet law YesApplies to drivers and passengers YesHelmet standard mandated NoEnforcement 0 13 4 5 6 7 8 9 10Helmet wearing rate

National seat-belt law NoApplies to front and rear seat occupants Enforcement Seat-belt wearing rate

National child restraint law NoEnforcement

National law on mobile phones while driving NoLaw prohibits hand-held mobile phone use Law also applies to hands-free mobile phones

c Alcohol consumption legally prohibited.d Not based on BAC.e Cases suspected of drink-driving are further investigated.

DATAReported road trafc fatalities (2010) 11b, 73%M, 27%FEstimated GDP lost due to road trafc crashes b Police records. Dened as died within 24 hours of crash.

D a t a c o l l e c t e d b y m u l t i s e c t o r a l c o n s e n s u s m e e t i n g a n d c l e a r e d b y M i n i s t r y o f H e a l t h

, S o l i d a r i t y

, S o c i a l C o h e s i o n a n d t h e P r o m o t i o n o f G e n d e r E q u a l i t y

.


N u m b e r o f r o a d t r a f c d e a t h s

0

2

46

810

1214

2003 2004 2005 2006 2007 2008 2009 2010

Source: National Trafc Police.

Source: 2011, National Trafc Police.


Drivers 4-wheeledcars and lightvehicles (18%)

Passengers 4-wheeledcars and light vehicles(9%)

Riders motorized2- or 3-wheelers(27%)

Pedestrians (46%)


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DEMOCRATIC REPUBLIC OF THE CONGO

INSTITUTIONAL FRAMEWORKLead agency National Program for Road Safety (CNPR)

Funded in national budget YesNational road safety strategy NoFunding to implement strategy Fatality reduction targets set Fatality reduction target

Population: 65 965 796Income group: LowGross national income per capita: US$ 180

SAFER ROADS AND MOBILITYFormal audits required for new road construction YesRegular inspections of existing road infrastructure Parts of networkPolicies to promote walking or cycling NoPolicies to encourage investment in public transport NoPolicies to separate road users to protect VRUs No

SAFER VEHICLESTotal registered vehicles (2010) 350 000

Cars and 4-wheeled light vehicles Motorized 2- and 3-wheelers Heavy trucks Buses Other

Vehicle standards appliedUN World forum on harmonization of vehicles standards NoNew car assessment programme No

Vehicle regulationsFront and rear seat-belts required in all new cars aFront and rear seat-belts required all imported cars Yes

a

No car manufacturers/assemblers.

POST-CRASH CAREVital registration system YesEmergency Room based injury surveillance system NoEmergency access telephone number(s) NoneSeriously injured transported by ambulance cPermanently disabled due to road trafc crash Emergency medicine training for doctors Emergency medicine training for nurses Noc No ambulance services in country.

SAFER ROAD USERSPenalty/demerit point system in place No

National speed limits YesLocal authorities can set lower limits NoMaximum limit urban roads 60 km/hEnforcement 0 1 2 3 46 7 8 9 10

National drinkdriving law YesBAC limit general population 0.01 g/dlBAC limit young or novice drivers 0.01 g/dlBAC limit professional/commercial drivers 0.01 g/dlRandom breath testing and/or police checkpoints YesEnforcement 0 1 2 35 6 7 8 9 10% road trafc deaths involving alcohol

National motorcycle helmet law YesApplies to drivers and passengers YesHelmet standard mandated NoEnforcement 0 13 4 5 6 7 8 9 10Helmet wearing rate

Nati

oms accidentes viales

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