The authors say these new data are important for stimulating the next major efforts in global road safety – ensuring that evidence-based interventions are successfully implemented on a global scale.
Road traffic accidents kill more than 1.35 million people each year, with over 90% of deaths occurring in low- and middle-income countries (LMICs). Yet despite global efforts to prioritize road safety over the past decade and a growing body of evidence to support proven interventions, many national governments have not prioritized road safety and do not have sufficient funding available for implementation in LMICs. is happening, leaving a gap between. Evidence and action.
The Lancet series on road safety, published ahead of the United Nations’ first high-level meeting on road safety, calls for increased political and financial commitments and the inclusion of road safety in mainstream development policies, arguing that it should necessary to obtain. Sustainable Development Goals (SDGs), which include a target to halve road traffic accident deaths and injuries by 2030.
“Most road traffic deaths are preventable, but sadly, mortality rates continue to rise in low-income countries, while progress in high-income countries has slowed over the past decade”, George Washington University, Professor Adnan Haider, USA’s series coordinator, says. , “As the Second United Nations Decade of Action for Road Safety (2021-2030) is underway, our work for this series clearly shows that proven road safety measures can save lives in all countries, rich and poor. In a first For one, we provide in one place evidence to decision makers and donors on the value of implementing specific interventions in every country around the world.”
40% road deaths can be prevented by adopting proven road safety measures
An analysis of data from 74 studies in 185 countries, targeting the four major risk factors for road injuries and deaths (speeding, drunkenness, and not using crash helmets and seatbelts) estimated that between 25% are preventable (assuming complete overlap between interventions) and account for 40% of all fatal road injuries worldwide each year (interventions were fully implemented in 2018 with no overlap between deaths).
For example, infrastructure changes and electronic speed controls such as speed reduction could save an estimated 347,258 lives globally each year, while measures to combat drunk driving such as better drink driving enforcement could save 16,304. People’s lives can be saved. In addition, an estimated 121,083 and 51,698 lives could be saved by passing and enforcing regulations on wearing seatbelts and motorcycle helmets.
All countries will benefit from increasing road safety measures to varying degrees (see Appendix Table 4). For example, improving seatbelt use would have a particularly big impact on reducing road deaths in the United States (saving an estimated 14,121 lives each year) and China (13,228). The benefits of wearing a motorcycle helmet will be greatest in China (saving 13,703 lives a year), Brazil (5,802) and India (5,683), where motorcyclists have a higher incidence of injuries. Dealing with speed will be the most effective way to reduce road accidents in most countries, preventing an estimated 88,374 deaths in China, 1,027 in Spain and 815 in the UK.
“We hope that these new estimates provide a solid impetus for the global road safety community to focus on implementing evidence-based interventions, particularly in low- and middle-income countries”, series co-authors, Dr. Andres Vacino-Ortiz of Johns Hopkins says. Bloomberg School of Public Health, USA. “These estimates can be used by policy makers to conduct their priority setting analysis to reduce road accidents.”
Improving post-accident care could save 200,000 lives a year
There is also a strong case for strengthening trauma care in LMICs. Modeling for the series estimated that effective trauma systems capable of treating all road traffic victims as needed could save more than 200,000 lives in LMICs a year, a 17% reduction in deaths. Is equal to. A more realistic scenario of 50% coverage could save more than 100,000 lives a year, which equates to an 8% lower mortality rate.
For typical clinical trauma interventions, a focus on damage control resuscitation (ie, strategies to control bleeding and early resuscitation) is most likely to save lives (up to 35,000 a year at 50% coverage) more lives), followed by interventional radiology to control bleeding (more than 29,000), tranexamic acid (10,000), and pre-hospital tourniquet (more than 5,700) for suspected bleeding.
Dr Junaid Razzak, co-author from Weill Cornell Medical Center, says, “While prevention remains the cornerstone of reducing road traffic deaths, knowing which trauma interventions have the greatest impact on saving lives.” likely to help make the best use of limited health resources.” USA and Aga Khan University College of Medicine, Pakistan. “While strengthening trauma systems is the ultimate goal, clinical and simple health system interventions are a practical starting point for saving lives as quickly as possible.”
Road accidents among teenagers on the rise
A separate new analysis examining transportation injuries for adolescents in 204 countries from the Global Burden of Disease (GBD) 2019 study by the Institute for Health Metrics and Evaluation at the University of Washington’s School of Medicine is published in The Lancet Public Health. These injuries include pedestrians, cyclists, motorcyclists, motor vehicles and other incidents related to transportation.
The findings show that although the death rate among 10-24-year-olds fell by a third between 1990 and 2019 (17.5 to 11.5 per 100,000), low- and low-middle socio-demographic indices (SDIs) Death Ratio ) Country  Nearly doubling from about 28% (74,713 out of 271,772) in 1990 to about 47% in 2019 (100,102 out of 214,337), persons aged 20-24 years were most affected.
The largest increases in transport injury mortality occurred in Paraguay (+97%), Djibouti (+69%), Lesotho (+50%), and Seychelles (+41%).
The new GBD analysis shows a slowing rate of decline in transport injury deaths in high-SDI countries in the recent decade, with a decline of only 1.7% per year between 2010 and 2019 to 2.4% per year between 1990. and 2010 compared to the fall.
“These new estimates reflect neglect and chronic underinvestment by the global health community to prevent injury-related harm in adolescents,” says author Dr Amy Peden, from the University of New South Wales, Australia. “Unlike many other public health epidemics, there are simple, economical and proven interventions to reduce road traffic injuries that are not being implemented or implemented. Progress has stalled in high-SDI countries and in low and medium The growing burden of transportation injuries-SDI countries demand focused action, including global donor, government and industry investment in injury prevention.”
A sustainable approach to road safety
The authors of the series outline ten challenges that must be addressed to achieve the ambitious goal of preventing at least 50% of road traffic deaths and injuries by 2030. These include building a strong global movement on road safety that includes other health and environmental impacts. As well as generating more and better data on what works in different LMICs, and the need for adequate household and donor funding, as well as solutions (eg, air pollution, sedentary lifestyles). Road safety should also be integrated as a core component of global movements towards universal health coverage, maternal, newborn, child and adolescent health, and healthy aging.
“There have been many successes on road safety globally, including joining the Sustainable Development Goals – but the rhetoric has yet to produce results on the ground,” says co-author Dr Margie Peden of the George Institute for Global Health. , Britain. “The global road safety community must re-evaluate its strategy for this second decade of action – a real, sustained decline in global road traffic injuries and deaths will only occur if there is a focus on effective intervention and the implementation of concrete country action.”
A Lancet editorial that accompanies the series stated that, “Road traffic injuries cannot be understood as an isolated issue. Health systems, sustainable urban development, local and global leadership, governance and the future of cities are one.” There are all aspects of movement that need to be galvanized to rectify the unnecessary burden of these injuries. But, as the series shows, with a coordinated, multi-sectoral approach, road traffic injuries are both treatable and preventable. “