If there was a disease that killed three times more people than malaria, nearly all of them in developing countries, and yet a cure was readily available, don’t you think the aid agencies would be falling over themselves to do something? So why is road traffic in some different category? Kudos to the Economist for regularly drawing attention to the issue of road safety in developing countries. Some extracts from its latest overview.
‘Globally, road accidents kill more people every year than malaria or HIV/AIDS. Spencer James and other researchers at the Institute for Health Metrics and Evaluation (IHME) in America put the death toll in 2017 at 1.24m. According to IHME, the overall number of deaths has been more or less static since the turn of the century. But that disguises a lot of movement up and down in individual countries.
In many poor countries, especially African ones, road accidents are killing more people (see chart). Those countries have swelling, young populations, a fast-growing fleet of cars and motorbikes, and a limited supply of trauma surgeons. It is impossible to know for sure because official statistics are so inadequate, but deaths are thought to have risen by 40% since 1990 in countries that the World Bank defines as low-income, such as Afghanistan. In many rich countries, by contrast, roads that were pretty safe are becoming even safer. In Estonia and Ireland, the number of deaths has fallen by about two-thirds since the late 1990s.
The most important and intriguing changes are taking place in middle-income countries, such as Thailand. These contain most of the world’s people and have some of the most dangerous roads. They also tend to be close to an inflection point. In China and South Africa deaths have been falling since about 2000, according to IHME—though crashes still claim about a quarter of a million Chinese lives each year. In India deaths peaked in 2012. It is possible that the Philippines reached a peak four years ago. In Kenya and Nigeria deaths are still rising.
Rob McInerney, head of the International Road Assessment Programme, a charity, says that countries tend to go through three phases. They begin with poor, slow roads. As they grow wealthier, they pave the roads. Traffic moves faster, which pushes up the death rate (from Australia to Zambia, the physical law is the same: to calculate an object’s kinetic energy, you multiply half its mass by the square of its speed). In the third phase, countries act to make their roads safer. The trick is to reach the third stage sooner, by focusing earlier and more closely on fatal accidents.
How to do that? The answer is probably not education and training, says Soames Job of the World Bank. Some studies suggest that training drivers makes them more dangerous; perhaps they become cockier. Besides, routinely wearing helmets and seat-belts, obeying speed limits and avoiding drink-driving—all things that save lives—are not advanced skills. They are practices which people know they should follow but often don’t. Dangerous driving is not a fixed cultural trait, as some imagine. People respond to incentives, such as traffic laws that are actually enforced.
Countries can make their roads safer even if they are unable or unwilling to make drivers behave better. Many poor and middle-income countries have built concrete medians, especially in and around cities. These prevent head-on crashes—generally the most lethal kind—and give pedestrians a small safe zone halfway across a road. Development banks and groups such as the Millennium Challenge Corporation now insist that the roads they pay for are built to high safety standards.
Roundabouts, chicanes and road humps all reduce speeds and save lives. One study, by academics at the University of KwaZulu-Natal in South Africa, found that the number of pedestrian injuries in two districts of Durban fell from 659 in the two years before speed bumps were built to 519 in the two years after. The number of deaths fell more sharply, from 24 to eight. Mr McInerney points out that fast four-lane roads are still being built through villages in many countries. But in Peru and elsewhere, local people have responded by building illegal speed bumps.’
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