Progress in reducing road-traffic injuries in the WHO European region
Authors: Jonathon Passmore, Yongjie Yon, Bente Mikkelsen
Journal: The Lancet Public Health (2019)

Worldwide, someone is killed on the roads every 23 s and millions more are non-fatally injured according to WHO's latest monitoring report on road safety, the fourth Global Status Report on Road Safety.1WHOGlobal status report on road safety. World Health Organization, Geneva2018https://www.who.int/violence_injury_prevention/road_safety_status/2018/enDate accessed: April 28, 2019Google Scholar With 1·35 million people killed each year, road-traffic injuries are now the eighth leading cause of death overall and the leading cause of death for those aged 5–29 years. The grief and suffering caused by this human-made epidemic is perhaps exacerbated by all that is known—but in many cases not fully implemented—about prevention. Despite the magnitude of death and injury, and of financial burden and slowed economic growth, some progress is being made in preventing death and injury on our roads. Decreasing by 13% between 2010 and 2016, WHO's European region (along with the western Pacific region) are the only WHO regions to show reductions in road-traffic mortality since the global community adopted the visionary but ambitious UN Sustainable Development Goal (SDG) 3.6, to halve the number of road-traffic deaths and injuries by 2020.2UNTransforming our world: the 2030 agenda for sustainable development. United Nations, New York, NY2015https://sustainabledevelopment.un.org/post2015/transformingourworldDate accessed: April 28, 2019Google Scholar Reductions in mortality have been achieved despite a 14% growth in the number of registered vehicles. Further highlighting that increasing motorisation is not sufficient cause for a higher number of road-traffic deaths, Azerbaijan and Kazakhstan have seen a 5% increase in deaths despite a 30% increase in vehicles. The European status report on road safety documents national road safety efforts in 51 of the 53 regional countries. In the European region, over 85 000 people were killed in 2016, making road-traffic injuries a leading cause of death for those aged 5–14 years. An estimated 235 people were killed each day and over 70% of this burden occurred in low-income and middle-income countries in the region. Four people in every ten who are killed are vulnerable road users, including pedestrians, cyclists, and motorcyclists. Although the region has the lowest road-traffic mortality rate of any WHO regions (9·3 deaths per 100 000 population compared with 18·2 per 100 000 globally), wide differences continue to persist, with a seven-times difference between countries with the highest (Tajikistan) and lowest (Switzerland and Norway) rates of road-traffic mortality. If every country achieved a similar level of road safety to those of Switzerland and Norway, more than 60 000 lives would be saved every year. Compared with 2010, 40 countries have made progress in reducing the number of road-crash deaths, a highly commendable outcome. Regarding intermediary actions that support the achievement of road-safety outcomes, 46 countries have adopted road-safety strategies (40 with lead agencies to coordinate their implementation); however, the implementation of these strategies is only funded in nine. Only five countries (France, Hungary, Italy, Luxembourg, and Sweden) have good practice legislation for the prevention of road-traffic injuries due to speed, drink driving, and the non-use of motorcycle helmets, seatbelts, and child restraints. Despite legislation in place, police in even these countries identified important opportunities to increase the enforcement of such legislation. The enforcement challenges are magnified even further in countries where comprehensive enforceable legislation does not exist to begin with. Reflecting the progress in vehicle and infrastructure safety, as of the end of 2017, 35 countries, including more than 745 million people, have implemented at least seven of the eight priority UN vehicle safety standards.3UNVehicle regulations. United Nations Economic Commission for Europe, Geneva2018https://www.unece.org/trans/main/welcwp29.htmlDate accessed: April 28, 2019Google Scholar 49 countries require full or partial safety reviews for the design and planning of new road infrastructure and 51 countries inspect existing infrastructure for safety on a regular basis. Access to timely emergency care can save lives and reduce the risk for disability once a crash occurs. In the European region, all countries have a universal nationwide emergency number. With road safety already identified as a priority by national governments and multilateral bodies, the focus must move beyond convincing decision makers of the need to act. The key to achieving the goals of the Global Plan for the Decade of Action for Road Safety 2011–20204WHOGlobal plan for the decade of action for road safety, 2011–2020. World Health Organization, Geneva2011https://www.who.int/roadsafety/decade_of_action/plan/enDate accessed: April 28, 2019Google Scholar and the SDGs2UNTransforming our world: the 2030 agenda for sustainable development. United Nations, New York, NY2015https://sustainabledevelopment.un.org/post2015/transformingourworldDate accessed: April 28, 2019Google Scholar is the implementation by the governments of data-driven and evidence-based strategies that have been shown to prevent road-traffic injuries and deaths. More than just token words, what is needed is the political and technical commitment to implement the principles and practices of a safe systems approach to road safety, which recognises that the human body is highly susceptible to injury and that humans make mistakes, but that a set of complementary interventions, to create safer roads, safer vehicles, safer speeds, and safer behaviour of road users, must work together to accommodate error.5International Transport ForumZero road deaths and serious injuries: leading a paradigm shift to a safe system. Organisation for Economic Co-operation and Development, Paris2016Crossref Google Scholar Under WHO's mandate, conferred by the UN General Assembly,6UNImproving global road safety. United Nations General Assembly Resolutions, New York, NY2010https://www.who.int/roadsafety/about/resolutions/download/enDate accessed: April 28, 2019Google Scholar, 7WHOAddressing the challenges of the United Nations Decade of Action for Road Safety: outcome of the second Global High-level Conference on Road Safety—time for results. World Health Assembly, Geneva2016https://www.who.int/roadsafety/about/resolutions/download/enDate accessed: April 28, 2019Google Scholar to lead (in collaboration with the regional commissions) road safety efforts within the UN System, WHO stands ready to support intersectoral counterparts in all regional member states in the implementation of evidence-based recommendations such as the Save LIVES technical package.8WHOSave LIVES: a road safety technical package. World Health Organization, Geneva2017https://www.who.int/violence_injury_prevention/publications/road_traffic/save-lives-package/enDate accessed: April 28, 2019Google Scholar With the European region also home to some of the best performing countries in the OECD (such as France, the Netherlands, Norway, Sweden, and the UK), a crucial component of WHO's engagement is facilitating the sharing of experiences and outcomes of leadership and expertise. In that regard, the upcoming WHO European Status Report on Road Safety, to be published in September 2019, will serve as a crucial reference. We declare no competing interests. The views expressed in this Comment are those of the authors and do not necessarily represent the stated policy of WHO.