Print version ISSN 0042-9686
Bull World Health Organ vol.81 n.12 Genebra Dec. 2003
UN calls for international debate on road safety crisis
Sarah Jane Marshall
A UN General Assembly resolution adopted on 5 November has called for a debate among governments, UN agencies, WHO and the World Bank, on the global road safety crisis. A plenary meeting of the 191-member Assembly devoted solely to road safety, planned for April 2004, will coincide with World Health Day and the launch of the first ever World Report on Road Traffic Injury Prevention.
The meeting next April is intended to increase awareness at a high level of the magnitude of the road traffic injury problem. The UN's involvement in the problem in such a major way began earlier in the year with the first ever General Assembly resolution on road safety. Adopted in May and sponsored by 56 countries, it called for a report on the crisis by the UN Secretary-General, Kofi Annan.
Annan's report, presented in August, drew attention to the seriousness of the problem which sees over 1.2 million deaths annually resulting from road traffic crashes the vast majority of which occur in low- and middle-income countries and called for urgent action. "To date, road safety has received insufficient attention at the international and national levels," Annan told the Assembly. "This has resulted in part from a lack of information on the magnitude of the problem and its preventability, a fatalistic approach to road crashes and a lack of political responsibility."
Annan's message and the involvement of the UN in road safety has received strong international support. The European Union, addressing a plenary meeting of the 58th General Assembly on 22 October, said that it "believes that saving human lives through an effective road safety policy is a difficult challenge but also a moral obligation for all member states." In the European Union alone, more than 50 000 people are killed each year and more than 150 000 are disabled for life.
In response to the UN Secretary-General's report, the latest resolution calls for a plenary meeting of the Assembly on 14 April and also invites governments, the President of the General Assembly, the UN Secretary-General, the Director-General of WHO, the President of the World Bank, the Executive Director of the UN Children's Fund and the Administrator of the UN Development Programme to address the Assembly on the issue. The only other health topics to have been discussed in the General Assembly plenary are HIV/AIDS and malaria.
"The plenary discussion called for in this latest General Assembly resolution will be a historical event," said Dr Etienne Krug, Director of WHO's Department of Injuries and Violence. "It offers a unique opportunity to create the political will needed to address this major public health crisis at a global level."
The discussion has been planned in connection both with World Health Day on 7 April 2004, whose theme is road safety, and with the release of the World Report on Road Traffic Injury Prevention. The report, a joint project of WHO and the World Bank, is expected to be launched in Paris on World Health Day. It aims to raise awareness about the health and societal impact of a problem which costs developing countries US$ 100 billion a year twice the annual amount of development assistance received by those countries. The report will present comprehensive documentation of what is known about the magnitude and determinants of road traffic injuries and offer evidence-based solutions to address the problem.
The resolution also asks the UN to make recommendations for traffic safety and requests Annan to submit a second report in time for the 2005 General Assembly session. In addition, it calls for the UN Department of Public Information to organize a meeting of experts, the private sector, relevant nongovernmental organizations and other interested parties on 15 April 2004 to raise awareness and exchange information.
WHO predicts that road traffic injuries will join the top 3 causes of worldwide mortality and disability, ahead of tuberculosis, HIV/AIDS and malaria. Whilst it is a global problem affecting all sectors of society, 90% of global mortality resulting from road traffic injuries is carried by low- and middle-income countries.
"Most high-income countries have seen dramatic reductions in road traffic fatality rates whilst most low-and middle-income countries have witnessed the opposite," said Krug. According to WHO, the US has seen the numbers of deaths due to road traffic crashes fall from 26 per 100 000 in 1996 to 15 per 100 000 in 2000. In Finland, the number of fatalities has been halved in the last 30 years despite a tripling in the volume of road traffic. This has been mainly due to effective government road safety policies.
The story in the developing world is very different. India, for example, has witnessed a mortality rate of 30 per 100 000 in the early 1970s rocket to more than 50. "This is a typical trend in most developing countries," said Krug. He also said that in developing countries it is often cyclists and pedestrians who are dying, whereas in developed countries most victims are in the car.
A new World Health Assembly resolution on road safety is also likely to be adopted in 2004. This will replace the previous resolution adopted in 1974. Currently under preparation by experts at WHO, it is expected to support Annan's call for a "systems approach" in order to identify all the risk factors that contribute to road crashes before trying to reduce their consequences. Pending approval by WHO's Executive Board in January, the final version is expected to be presented in May 2004.