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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Workshop Summary

Introduction: Workshop Objectives and Program

The National Academies held a workshop in Washington, D.C., on January 26–27, 2006, entitled “Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement.” The participants were from U.S. government agencies, nongovernmental organizations, international organizations, and academic research institutions. The workshop discussions focused on defining U.S. interests in the problem of road safety in developing countries, identifying current U.S. government activities aimed at addressing the problem, and determining which U.S. capabilities could contribute to efforts of developing countries to reduce traffic casualties. The National Highway Traffic Safety Administration (NHTSA) of the U.S. Department of Transportation (USDOT) and the Centers for Disease Control and Prevention (CDC) provided funding for the workshop.

The workshop represented a continuation of the National Academies’ activities on this topic. An informal preliminary meeting held in May 2005 included representatives of the U.S. Departments of Transportation, State, Defense, Health and Human Services, and Commerce; the U.S. Agency for International Development; the U.S. Peace Corps; the U.S. Trade and

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

Development Agency; and the World Bank. Participants in this meeting identified a need for their respective government organizations to seek opportunities to increase awareness within the U.S. government and in other sectors about the magnitude of the problem and to seek opportunities for the United States to offer assistance that would improve traffic safety globally.

The workshop planning committee, appointed by the National Academies, arranged the agenda and identified participants. (See Box 1 for the statement of task defining the scope of the committee’s activities, Appendix A for the workshop program, and Appendix B for the list of participants.) In preparation for the workshop, representatives of selected U.S. government agencies were interviewed, and their responses were used to compile an inventory of federal agencies’ activities and interests related to road safety in developing countries. Results of the inventory were presented and discussed at the workshop and are summarized below.

The goal of the workshop was to gain a more complete view than previously available of the diversity of U.S. interests affected by the problem of road traffic deaths and injuries in developing countries, the scope of activities of U.S. agencies addressing the problem, and opportunities for further U.S. engagement. This overview was to be derived from the agency interviews and from the discussions at the workshop among representatives of

Box 1

Planning Committee for a Workshop on Traffic Safety in Developing Nations: Statement of Task

The committee will develop the agenda and identify participants for a 2-day workshop on road traffic safety in developing countries. The workshop will frame (1) the U.S. interest in reducing the frequency of injuries and deaths resulting from road traffic accidents in developing countries and (2) U.S. capabilities that could be brought to bear in reducing these losses. An inventory of U.S. federal agency activities and expenditures (along with those of U.S.-based nongovernmental organizations to the extent possible) will be presented and discussed, and current activities and expenditures will be compared with U.S. interests and capabilities. The workshop will involve approximately 50 participants drawn mainly from the U.S. government, industry, trade, international tourism, academic, and nongovernmental communities.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

federal agencies and international organizations, as well as experts and practitioners from U.S. nongovernmental organizations and other countries. The workshop was intended to help the responsible government agencies gauge whether the U.S. response is proportional to the national interests affected by the problem and to identify next steps toward developing a more effective response.

The four sections of this summary correspond to the sessions of the workshop program, which addressed the following topics:

  • The scope and character of the global road safety problem and an overview of major international initiatives;

  • U.S. activities in global road safety;

  • Cooperation between high-income and developing countries: opportunities and obstacles; and

  • General discussions and summary.

Scope of the Road Safety Problem and International Initiatives

John Flaherty, chief of staff, USDOT, opened the workshop by describing the high priority his agency places on the international traffic safety problem. He assured participants that the agency would receive the results of the workshop with great interest and stated that he expected the workshop would contribute to building the kind of durable coalition necessary to respond to the problem of global road traffic safety. He noted that Secretary of Transportation Norman Mineta, recognizing the significance of the problem, has in his international contacts frequently emphasized the mutual interests of the United States and the developing world in reducing the burden of road traffic injuries. He observed that the globalization phenomenon is compelling nations to acknowledge the linkage between their interests and well-being and global events. In transportation, this linkage has led to cooperation on security and economic issues; however, recognition of and action on this linkage in the area of road safety have been slower to occur. The challenge facing advocates of international action on road safety is to build on the dynamic that is driving international cooperation in security and economic matters. Mr. Flaherty’s remarks concerning specific U.S. interests and government activities related to global road safety have been incorporated in the summaries below devoted to these topics.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

John Flaherty, Chief of Staff, U.S. Department of Transportation, noted in his opening remarks that road safety was an important issue for Secretary Norman Y. Mineta. He also described the challenges of increasing the awareness of and the attention to the road safety problems experienced by developing countries. (Photo by Pam Risdon.)

Two speakers then described the scope and character of the global road safety problem. David Bishai, the Johns Hopkins University, reviewed the economic and human costs of road crashes and the resulting deaths and injuries, while Anthony Bliss, the World Bank, outlined institutional and social obstacles that must be overcome to mount an effective global response. Dr. Bishai’s remarks are summarized in this section; those of Mr. Bliss are summarized in the section below on cooperation between high-income and developing countries.

The Road Traffic Injury Problem and Its Economic, Social, and Human Costs

David Bishai reviewed the established facts about the magnitude of the road traffic safety crisis in the developing world. The World Health Organization (WHO) estimates that 1.2 million people die each year from road traffic crashes—130,000 in high-income countries and 1.07 million in low- and middle-income countries. In addition, WHO estimates that on the order of 20 million people suffer serious injuries in road crashes annually. The death rate from road crashes is higher in low- and middle-income countries

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

(20 deaths annually per 100,000 persons) than in high-income countries (13 deaths annually per 100,000 persons)—this despite much lower usage of motor vehicles in the former countries (see Figure 1). Road traffic injuries are the second-leading cause of death, after HIV/AIDS, among 15- to 29-year-olds in low- and middle-income countries, and the second-leading cause, after the childhood cluster diseases (diphtheria, tetanus, pertussis, polio, and measles), for 5- to 14-year-olds. WHO projects that in 2030, road traffic injuries will rank seventh among major disease and injury categories (up from eighth rank in 2002) in their contribution to the global burden of disease and injury, as measured by disability-adjusted life years (DALYs) lost. By this measure, the impact of road traffic injuries is comparable with that of cerebrovascular disease or heart disease (Mathers and Loncar 2005).

The characteristics and consequences of road crashes resulting in deaths and injuries in developing countries differ from those in high-income countries. In the United States, 80 percent of those killed in road crashes are occupants of four-wheeled motor vehicles; in low- and middle-income countries, most fatalities are among pedestrians or cyclists. The fraction of

FIGURE 1 Global mortality due to road traffic crashes (HIC = high-income countries; LMIC = low- and middle-income countries). (Source: Peden et al. 2002; used with permission of the World Health Organization.)

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

crashes that result in deaths is much higher in low- and middle-income countries, and the population groups with the lowest incomes are particularly vulnerable. The family burden of a road injury can be catastrophic. For example, a survey found that when a member of a rural household in Ghana was injured in a road crash, average household income and consumption declined sharply, to the point that 28 percent of households were forced to reduce food consumption. According to one published estimate, the annual cost of road injuries worldwide is 1 percent of gross domestic product in low-income countries and 1.5 percent in middle-income countries.

The frequency of road fatalities is declining in high-income countries today, despite traffic growth, because of improvements in vehicles, roads, traffic management, law enforcement, education, emergency services, and medical treatment. However, fatalities are rising in the developing world, especially where motor vehicle use is growing rapidly. World Bank projections suggest that if present patterns persist, by 2020 annual road fatalities will increase by 80 percent compared with 2000 levels in low- and middle-income countries and will decline by 30 percent in high-income countries.

When fatality data are examined across countries and over time, a rough pattern emerges: as a country’s income rises, road traffic fatalities initially increase with growing use of motor vehicles; then, at higher incomes, the frequency of fatalities begins to fall (Kopits and Cropper 2005). Three factors presumably account for most of the decline: as motor vehicles become the dominant mode of transport, conflicts between motor vehicles and pedestrians and cyclists decrease; higher incomes lead to adoption of practices that reduce risk, such as better road designs, safer vehicles, and better traffic control; and travelers learn from experience over time how to reduce their risks.

This pattern might appear to suggest that the rise in fatalities in developing countries is inevitable and ultimately will be self-correcting. However, such a view is unnecessarily fatalistic. The diversity of experience among countries shows that development alone will not necessarily solve the problem, and there is evidence that appropriate measures can be taken to reduce injuries and fatalities in countries at all stages of development. Estimates comparing the cost-effectiveness of injury prevention measures indicate that improved traffic law enforcement in low- and middle-income countries could save 1 DALY for every $5 spent and that installing speed bumps to slow vehicles at the most dangerous intersections could save 1 DALY for every $9 spent. In contrast, treating AIDS patients in Africa with the simplest regimen of active therapy costs $600 per DALY saved. In one example of an effective intervention, a speed enforcement program begun in 2004 in

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

Uganda on main roads out of the capital has reduced deaths by more than 200 per year. The annual cost is $70,000, which was more than covered in the first year by the $400,000 in fines collected.

Despite the availability of effective measures, almost nothing is spent on road safety in many developing countries. Annual government spending on activities aimed at improving traffic safety is estimated to be $0.07 per capita in Pakistan and $0.09 in Uganda, about 1 percent as much as health spending or 0.2 percent as much as military spending.

Major International Initiatives

Four presentations reviewed road safety initiatives of major international organizations: the WHO/World Bank World Report on Road Traffic Injury Prevention (Peden et al. 2004) and regional road safety efforts in the Americas the World Bank), and the United Nations (UN) Global Road Safety Collaboration (Maria Vegega, NHTSA).

International organizations are leading efforts to marshal action to reduce road traffic deaths and injuries. In 2003, the UN General Assembly recognized road deaths and injuries as a global epidemic, and in May 2004 a special session of the General Assembly was dedicated to the road safety crisis. World Health Day, organized annually by WHO, focused for the first time in 2004 on road safety. However, growing international recognition of the problem has not yet been matched by growth in the resources devoted to assisting low- and middle-income countries to address the problem.

The World Report on Road Traffic Injury Prevention, produced jointly by WHO and the World Bank and released on the occasion of World Health Day in 2004, is a comprehensive review of knowledge about road traffic injuries worldwide. It includes information on frequency and trends in crashes, injuries, and deaths; costs and social impacts; factors affecting risk; and effective interventions. The report’s recommendations (see Box 2) emphasize the need to build institutional capacity, particularly in developing countries, to manage road transportation systems safely. PAHO is promoting adoption of these recommendations in the countries of the Americas, where each year 130,000 deaths and 1.2 million injuries result from road crashes. The documents have been translated into Spanish and disseminated in each country. Mexico and Honduras have adopted the recommended measures as the basis for national planning, and other counthe World Bank’s Global Road Safety Facility (Maryvonne Plessis-Fraissard, [Alberto Concha-Eastman, Pan American Health Organization (PAHO)],

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

Box 2

Recommendations of the World Repor t on Road Traffic Injury Prevention

The World Report on Road Traffic Injury Prevention (Peden et al. 2004) recommends that governments take six actions to reduce road traffic injuries:

  • Identify a lead agency in government to guide the national road traffic safety effort.

  • Assess the problems, policies, and institutional settings relating to road traffic injury and the capacity for road traffic injury prevention in each country.

  • Prepare a national road safety strategy and plan of action.

  • Allocate financial and human resources to address the problem.

  • Implement specific actions to prevent road traffic crashes, minimize injuries and their consequences, and evaluate the impact of these actions.

  • Support the development of national capacity and international cooperation.

The report notes (p. 160) that “in certain low-income and middle-income countries with limited human and financial resources, it may be difficult for governments to apply some of these recommendations on their own. In these circumstances, it is suggested that countries work with international or nongovernmental organizations or other partners to implement the recommendations.”

tries have formed national committees to address the problem. PAHO has organized three international meetings in Latin America to disseminate the recommendations of the World Report and to discuss the need to strengthen the ability of the health sector to respond to the road safety crisis.

The Global Road Safety Facility is the World Bank’s program to implement the recommendations of the World Report. About 15 percent of all World Bank–funded investment is in roads, but a small share of funds has been devoted specifically to road safety improvement. The Global Road Safety Facility will provide seed funding for projects through a multidonor trust fund. Present donors are the Netherlands, the FIA Foundation, and

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

the World Bank. Seed funding of $12 million per year is expected to leverage much larger investments from the main development programs of the World Bank and others. The facility will support activities at the global level (including coordination, advocacy, and research) and at the regional and national levels. At the national level, an objective of the facility is to promote one “second-generation” road safety project annually in each of six world regions over the initial 5 years of the program. These projects (see Box 3 for one example) will reflect the multisector capacity-building approach recommended in the World Report. The World Bank believes that a reasonable goal for the program is to reduce the death rate from road traffic crashes by 30 percent and thereby avoid 2.5 million deaths in the next 15 years. No other World Bank program can claim a comparable potential health benefit.

The UN Road Safety Collaboration is an association of national government agencies, international organizations, and private entities concerned with road safety. The transportation, health, and public safety sectors are represented. The collaboration was created in response to a May 2004 resolution of the UN General Assembly, which called on WHO to act as a coordinator on road safety issues within the UN systems. Participating international organizations include WHO, the World Bank, and UN commissions. NHTSA and CDC represent the United States. The collaboration’s periodic meetings are organized by WHO and are an opportunity to exchange information and to plan cooperative activities for all participants in the global initiative to improve road safety. The collaboration is organizing the production of a series of best-practice manuals and other tools to help public agencies develop effective interventions, including promotion of seat belt use and reduction of speeding and impaired driving.

U.S.Activities in Global Road Safety

Susan Gallagher of the Education Development Center, a consultant to the National Academies, had been engaged in preparing an inventory of activities and interests of U.S. government agencies related to road safety in developing countries and presented her preliminary findings at the workshop. This information was collected from interviews with the staff of 27 offices in seven cabinet departments and independent agencies. It was supplemented during the workshop by representatives of U.S. government agencies and nongovernmental organizations; the workshop program lists those who commented on the inventory and on their organizations’ activities. The information presented included the interests that motivate each agency’s activities (that is,

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

how the activity is related to fulfilling the agency’s responsibilities). The goals of the inventory were to help government policy makers form a comprehensive picture of U.S. government interests related to road traffic safety in other countries, to aid in comparing the magnitude of these interests with the scope of current efforts directed at the problem, and to help agencies coordinate their efforts so as to allow a more effective governmentwide response.

Because of the considerable scope of international involvement of U.S. government agencies, the interviews did not encompass every government

Box 3

World Bank Iran Road Safety Project

The World Bank is preparing a road safety project with the government of Iran that the bank regards as an innovative and experimental approach to the problem, building on the experience of past, generally less ambitious, projects. The project was designed in accordance with the recommendations of the World Report (see Box 2). The World Bank states the philosophy guiding the project as follows (World Bank 2006):

Road accidents are due to a number of factors that are deeply rooted and reinforce each other, including, especially, drivers’ attitude and behavior, insufficient enforcement of traffic and transport regulations, physical inadequacies in the urban and interurban road networks, shortcomings in road safety information and education, inadequate driver training and testing, insufficient control of vehicles’ roadworthiness, weaknesses in the rescue and emergency service, underdevelopment of monitoring and evaluation systems, and a fragmented institutional setup. All these factors need to be addressed in a coherent and integrated way in order to bring about a sustained decrease in road accidents.

The objectives of the project are to reduce crashes and related deaths and injuries in selected pilot interurban corridors and urban areas and, through the experience gained in the pilot projects, to permanently strengthen the institutional capabilities of all the sectors with main responsibility for road safety, including the roads agency, as well as police, health care, and general public administration. The budget is $105 million. The project has seven components:

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

agency with potentially relevant programs. The agencies contacted were those with responsibilities most closely related to traffic safety and public health and to U.S. external relations. The list of agencies to be interviewed was based on the knowledge of the consultant and of the staff of the National Academies and the sponsors, as well as on information provided by interviewees.

Appendix C presents the guide used for the interviews. The key questions were as follows:

  • Safer road users (enforcement programs and training, driver training, and public information);

  • Safer vehicles (including development of regulations for commercial vehicles);

  • Safer roads (low-cost civil works in the pilot corridors and cities, such as signs, markings, and crash barriers, and development of procedures for conducting safety audits of roads)—the component receiving the majority of funding;

  • Road safety monitoring and evaluation systems (establishment of both systems to evaluate the effectiveness of road safety activities and a national road crash data system);

  • Improvements to postcrash rescue and relief and emergency medical services;

  • Institutional development and support (including development of improved road safety legislation, guidelines for allocating funds to road safety, and safety planning); and

  • Transport technical assistance (advice on improving the efficiency of operations of the road, rail, port, and transit systems).

The project targets corridors and areas where the concentration of deaths and injuries is high and aims to bring all the relevant actors together to develop an appropriate response. The goal is to replicate the elements of good practice that are observed in countries with effective safety programs. The experience in the target areas will provide a model for the application of the same techniques throughout the country.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Harvey Fineberg, President of the Institute of Medicine, and Michael McGinnis, Executive Director and Senior Scholar at the institute, meet with Maryvonne Plessis-Fraissard, World Bank, between sessions. (Photo by Mark Rosenberg.)

  • Does the agency have an interest in traffic safety in developing countries? (In other words, is global road safety related to the mission of the agency?)

  • Does the agency have activities or programs related to traffic safety in developing countries, and if so, what are their character, objectives, budget, and staffing?

  • What is the respondent’s assessment of the agency’s activities related to traffic safety in developing countries? (Respondents were asked to comment on their programs’ strengths and weaknesses relative to the agency’s responsibilities in the area.)

  • What events or actions would be required to advance the priority of the issue of traffic safety in developing countries on the agency’s agenda?

  • Does the agency have experience with related or analogous aid or cooperative programs that might be applicable to efforts to assist developing countries in reducing traffic casualties?

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

Appendix D lists the agencies interviewed and briefly describes the involvement of each in international traffic safety activities. The responses can be grouped according to the predominant interest motivating each agency’s activities:

  • Protection of U.S. travelers and government employees abroad from involvement in road crashes: U.S. government agency activities aimed at avoiding injuries to U.S. personnel or citizens are narrowly focused and may have little direct benefit for the residents of other countries. However, the problem of road injuries to U.S. citizens raises awareness of the general road safety problem within the affected agencies and among the public and provides a stimulus for action.

  • Commercial interests of U.S. businesses that may be affected by road safety conditions and safety regulations in other countries: Activities related to commercial interests may have benefits for the residents of other countries even if those benefits were not the primary motivation for the U.S. engagement. For example, activities to harmonize international vehicle standards may lead to safer vehicles or operating practices.

  • Recognition of an indirect U.S. benefit from improved general welfare in developing countries: Enlightened self-interest in economic development and welfare in other countries has involved U.S. government agencies in activities aimed directly at reducing the overall rate of road traffic deaths and injuries in developing countries.

Activities related to each of these motivations, as well as those of nongovernmental organizations, are detailed below.

Activities Related to the Safety of U.S. Travelers and Employees

Offices in three of the departments and agencies that participated in the interviews—all of which have extensive foreign operations—are responsible for programs intended solely to protect foreign-based personnel:

  • Department of Defense (Office of the Secretary of Defense: Safety, Health, and Fire Protection; and Uniformed Services University of the Health Sciences, Department of Preventive Medicine),

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
  • Department of State (Undersecretary of Global Affairs, Overseas Motor Vehicle Safety Management Program), and

  • U.S. Peace Corps (Office of Safety and Security).

These offices engage in similar activities, which may include establishing rules for safety practices for employees using vehicles in other countries, providing safety training for employees, setting safety requirements for vehicles used for employees, providing for emergency medical services and evacuation, investigating road crashes involving employees, analyzing the special risks of specific countries or regions, and maintaining data on the frequency and circumstances of crashes and injuries involving employees.

In addition, a program of the State Department’s Bureau of Consular Affairs promotes awareness of the risks of road travel among U.S. private citizens abroad. The department publishes information sheets for 200 countries containing facts about road and traffic conditions and produces regular reports tabulating deaths from nonnatural causes among Americans abroad. This program may serve to increase the American public’s awareness of the magnitude of the road safety problem in other countries. The agency staff interviewed noted that they lack satisfactory means to assess the

Nancy Carter-Foster, U.S. Department of State, indicated that her office was willing to work with other organizations on ways to focus appropriate attention on road safety. (Photo by Mark Rosenberg.)

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

impact of the material they prepare or to determine what methods would be most effective in helping Americans abroad avoid road traffic injuries.

In the discussion following the presentation of the inventory, a representative of the State Department confirmed that the department’s current efforts are aimed principally at protection of personnel and U.S. citizens. Certain international health programs, such as those dealing with HIV/AIDS, avian influenza, and malaria and tuberculosis eradication, have been recognized within the department as addressing issues important to U.S. foreign relations. Road traffic safety has not attained the same status; however, the department would welcome discussions with other organizations on how the problem can receive appropriate attention and would be glad to cooperate in road safety activities.

Activities Related to U.S. Commercial Interests

Offices in three of the departments and agencies that participated in the interviews are responsible for programs that promote international trade and efficient international freight movement and that have implications for road traffic safety in developing countries.

The U.S. Trade and Development Agency (USTDA) promotes economic growth in developing and middle-income countries while at the same time helping American businesses export their products and services. The agency funds technical assistance, feasibility studies, training, visits, and workshops that support infrastructure development and a fair and open trading environment. Assistance involves building partnerships between U.S. companies and overseas project sponsors. USTDA projects intended to create market opportunities in transportation for U.S. companies may have traffic safety implications. For example, USTDA projects aided procurement of buses and traffic signals by the city of Beijing in preparation for the 2008 Olympics and funded a trade mission of Czech officials evaluating traffic management systems.

With regard to obstacles to greater involvement in road safety, USTDA staff noted that the nature of the projects in which the agency is engaged depends on the interests of the sponsoring country. Improving traffic safety often is not among the other countries’ development priorities.

The Federal Motor Carrier Safety Administration (FMCSA) of USDOT has responsibilities for implementation of the 1994 North American Free Trade Agreement (NAFTA) concerning international truck traffic. NAFTA requires the United States, Canada, and Mexico to harmonize regulatory

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

standards in order to allow free operation of transportation companies across their borders. Progress toward implementing these provisions has been slow, however, and cross-border trucking is still restricted. FMCSA’s NAFTA activities include working with the governments of Canada and Mexico to develop compatible commercial trucking safety requirements; providing training for Mexican law enforcement officials (in association with the International Association of Chiefs of Police) and for Mexican vehicle safety inspection instructors; providing Spanish-language educational materials for use in teaching truck drivers about U.S. safety regulations; and assisting Mexico in the development of a database of commercial carriers, vehicles, and drivers. FMCSA, through its participation in a program of the Organisation for Economic Co-operation and Development (OECD), has also provided technical advice on traffic safety in other regions. FMCSA staff noted that in carrying out its NAFTA activities, the agency has the capacity to offer non-U.S. carriers greater opportunities for education and exchange but is hindered by difficulties in establishing the necessary contacts.

Finally, NHTSA’s Division of International Policy and Harmonization participates in international activities aimed at harmonization of motor vehicle standards related to safety. NHTSA represents the United States in the World Forum for the Harmonization of Vehicle Regulations (UN Economic Commission for Europe Working Party 29), which works, under the terms of a 1998 international agreement, to establish international technical regulations for motor vehicle safety. NHTSA also participates in North American standards harmonization activities under the terms of NAFTA. These standards harmonization efforts are undertaken primarily to avoid obstacles to international trade in motor vehicles and transportation services; however, they also yield general safety benefits for the participating countries through the dissemination of technological innovations and information about best practices.

Activities Based on Recognition of the Benefit to the United States of Improved General Welfare in Other Countries

Both the Department of Health and Human Services (DHHS) and USDOT conduct activities that have the primary objective of improving road safety and reducing deaths and injuries due to road crashes in low- and middle-income countries. Likewise, road construction projects of the U.S. Agency for International Development (USAID) and the U.S. government’s

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

A crowded bus negotiates a street in Usulutan, El Salvador. (Photo by Susan Gallagher.)

Millennium Challenge Corporation in developing countries are intended to enhance road safety and offer opportunities to transfer technology and expertise. These activities are carried out as a demonstration of good will, for the sake of the benefits the United States derives from economic progress in other countries, and in recognition of an ethical obligation to improve health and economic standards in low- and middle-income countries.

Within DHHS, significant activities include the following:

  • The Fogarty International Center, National Institutes of Health, offers collaborative research and training grants that fund U.S. institutions to work with developing countries to build institutional capacity for research and address health problems. The center’s new Trauma and Injury Research Training Program has funding commitments of $7 million over 5 years. Currently, five grants to U.S. universities are funding activities related to road safety issues in partnership with institutions in Egypt, Pakistan, Ghana, Croatia, and Mozambique. These activities involve training researchers in the developing countries through study in the United States and the conduct of locally relevant research projects addressing injury control. Another Fogarty program provides grants directly to researchers from developing countries, although the projects funded by these grants have not addressed road traffic safety.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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  • CDC’s National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention, monitors U.S. injury trends and conducts research on injury risks and prevention methods. Road traffic injuries are within the scope of the program. The division coordinated the participation of DHHS in the 2004 WHO World Health Day, which as noted was dedicated to global road safety. Division staff were coeditors of the World Report on Road Traffic Injury Prevention. The division has worked to demonstrate within DHHS that the department can make contributions to health improvements abroad and to global road safety that are consistent with its responsibilities. The division has also provided technical assistance to health agencies in several Latin American countries, sometimes in support of PAHO, for the development of injury data systems and injury prevention programs, and it hosts fellows and guest researchers from other countries working on road safety research and surveillance. These activities are aimed at reducing all unintentional injuries, including those due to road traffic crashes. In addition, the division has participated with the United Nations Children’s Fund in the development of an injury prevention program in Vietnam and is beginning a similar project in Bangladesh.

Other offices in DHHS that were contacted participate in various international forums, working groups, and other arrangements for the exchange of information relevant to road safety. These include the Office of Global Health Affairs, the National Center for Health Statistics (which participates in the International Collaborative Effort on Injury Statistics), and the National Institute for Occupational Safety and Health (which chairs the Global Network of Occupational Health Centers).

Programs and activities within USDOT that reflect recognition of the indirect benefit to the United States of improved general welfare in other countries include the following:

  • NHTSA’s National Center for Statistics and Analysis (whose main responsibilities are maintaining U.S. national databases concerning highway safety and conducting research and evaluations) is engaged in a number of projects that involve assisting other countries to develop road safety data systems. Some projects are conducted through Asia Pacific Economic Cooperation, an international economic forum with 21 member states, including the United States. In India, the center is working with the automobile insurance industry to establish an organization similar to the U.S. industry’s Insurance Institute for Highway Safety. The center also participates in an OECD program on standardizing road traffic data inter-

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

nationally. Annual expenditures for the center’s international activities are on the order of $100,000 to $200,000. Among the challenges the center encounters in its international activities are maintaining continuity as U.S. administrations and priorities change and demonstrating that the U.S. benefits derived from improved safety in developing countries justify the funding provided for the purpose.

  • NHTSA’s Office of Traffic Injury Control Program Development and Delivery administers domestic traffic safety programs concerning impaired driving, occupant protection, enforcement, speed control, pedestrian and bicycle safety, and other areas. The office has responsibilities for NHTSA planning with regard to international activities and for the agency’s participation in UN, WHO, and World Bank global road safety forums, including the UN Economic Commission for Europe Working Party 1 on Road Traffic Safety.

  • The Federal Highway Administration (FHWA) (whose primary responsibilities are administering the domestic federal-aid highway program and sponsoring research and technology diffusion within the U.S. highway industry) supports technology transfer centers in 22 countries. The centers’ programs include training workshops and personnel exchanges. The centers are justified as promoting trade, improving safety for U.S. travelers abroad, and providing U.S. access to foreign innovations. Centers organize partnerships between U.S. state transportation departments and transportation agencies of other countries for technical and personnel exchanges. FHWA also represents the United States in international highway organizations and operates an international visitors program that hosts several hundred technical experts annually. In addition, FHWA is providing technical support to the government

Family excursion on a scooter.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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of China on road safety and environmental standards under a bilateral agreement between the two countries; a similar agreement is being developed with India.

USAID supports projects in developing countries in the health sector and in infrastructure development. Activities in both areas could potentially have important influences on road deaths and injuries in the countries receiving aid:

  • Offices within USAID’s Bureau of Global Health offer grants supporting projects aimed at providing health services and building capacity in the health care sectors of developing countries. Injury prevention programs are among the types of activities funded. These activities probably contribute to reducing deaths and injuries resulting from road traffic crashes, but this is rarely their primary objective.

  • The Bureau for Economic Growth provides grants for road building and rehabilitation. Road projects with USAID participation are under way in Pakistan, Afghanistan, Gaza and the West Bank, and elsewhere. Projects whose primary purpose is improving road safety are not funded, but U.S. standards, including those intended to ensure road safety, normally are adhered to in the design of projects. Technical and institutional capacity building through training and employment of local residents is required in all projects. Planning involves interactions with the host government, communities, and nongovernmental organizations. The U.S. Millennium Challenge Corporation, an independent U.S. development grant program that coordinates its activities with USAID, also is funding road projects in several countries.

  • USAID’s Global Development Alliance program forms partnerships with nongovernmental organizations to pool funds and other resources needed to carry out development projects. None of these projects specifically focus on road safety, although the program’s administrators have discussed the possibility of such projects with nongovernmental road safety organizations.

Those interviewed identified as a key obstacle to greater USAID activity in road safety the lack of awareness of or the low priority assigned to the problem by the agency’s U.S. partners and grant recipients, as well as

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

by the developing countries receiving aid. In child health programs in particular, road injuries are not recognized as among the highest priorities compared with other threats in developing countries. Another obstacle to greater engagement noted by USAID interviewees is a lack of awareness among the agency’s own staff of the significance to development of the road safety problem. Indeed, this was a theme in interviews at other agencies as well—that agency staff often do not appreciate the magnitude of the road safety problem or how it relates to the agency’s objectives and programs.

Involvement of U.S. Nongovernmental Organizations

The interviews conducted in preparation for the workshop involved only U.S. government agencies. However, U.S. nongovernmental entities, including nonprofit organizations and businesses, are also important contributors to overall U.S. international assistance and cooperation. Representatives of three U.S.-based nonprofit organizations—Peter Kissinger, AAA Foundation for

Open-bed trucks are typical modes of transport in El Salvador. (Photo by Susan Gallagher.)

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Traffic Safety; Rochelle Sobel, Association for Safe International Road Transport; and Thomas Brahms, Institute of Transportation Engineers— participated in the workshop and described activities of their groups:

  • The AAA Foundation is working with the International Road Assessment Programme to develop pilot road assessment programs in Latin American countries. The concept derives from the European Road Assessment Program developed by European automobile clubs. These programs assess the relative risk of individual road segments in a country on the basis of analyses of crash data and inspection of road design features. The Latin American initiative will also develop technical guidance to aid local authorities in improving road safety after the initial road ratings have been completed. The road ratings are communicated to local and national officials and to the public. One objective of the road assessment programs is to increase public discussion of road safety in order to generate support for investment in safety guided by risk evidence.

  • The Association for Safe International Road Travel (ASIRT) was formed to press the U.S. State Department to collect and publish detailed and up-to-date information on road traffic safety risks to U.S. travelers in other countries. The State Department now publishes such information. ASIRT also supported the formation of a global road safety caucus in the U.S. Congress. The State Department’s injury data have been valuable in illustrating the magnitude of the global road safety problem to policy makers and in demonstrating a direct constituent interest.

  • The Institute of Transportation Engineers is an international professional association with members in 90 countries. It has a safety action plan to promote awareness and application of best practices among transportation professionals in all countries. The institute publishes selected traffic engineering and safety documents and computer-based training programs in both Spanish and English, and it cooperates in international professional exchanges.

A NHTSA representative is a member of the steering committee of the Global Road Safety Partnership, a group initially convened by the World Bank that includes U.S. and international corporate and nonprofit organizations among its membership. The partnership fosters the formation of local cooperative efforts in developing countries that link private firms and

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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nongovernmental organizations together with international and governmental agencies to organize and promote road safety programs.

Summary

Harvey Fineberg, President, the Institute of Medicine, presented a summary of the discussion of U.S. activities and concluding observations. He first reviewed the kinds of U.S. interests encompassed by the activities described above: protection of employees and citizens abroad, commercial interests linked to road safety, the desire to demonstrate that the United States is a global “good neighbor” in order to gain good will, recognition of U.S. benefits from development in other countries, and recognition of a moral obligation to contribute to reducing deaths and injuries in other countries. Dr. Fineberg also noted certain tensions or conflicts between the nature of these interests and the actions necessary to make progress.

First, although activists are motivated by a sense of moral obligation, politicians and the public require that commitment of U.S. resources be justified by demonstration of tangible U.S. benefits. Advocates therefore must strengthen the evidence supporting the argument for enlightened self-interest while at the same time presenting the ethical case for engagement. Second, there is a tension between the need for leadership and the requirement for collaboration across a broad range of governmental and private economic sectors in the United States in order to offer assistance effectively. Finally, increasing appreciation of the gravity of the problem among the public and politicians is necessary, but the agency interviews revealed that the problem does not appear to inspire a high degree of concern. There is no perceived direct threat or sense of urgency since the problem is seen as unfolding slowly over decades.

On the other hand, certain characteristics of the road safety problem may facilitate action. The evidence is strong on the magnitude of the costs involved and on the likelihood that those costs will grow rapidly in the future. Also, action on the problem faces no strong opposition from any social or economic faction.

Dr. Fineberg concluded by observing that while the question of U.S. willingness to devote greater resources to the global road safety problem is under discussion, planning in the U.S. government agencies concerned should address two key questions. First, if no additional funding is provided, but high-level leadership in the government is exerted, what opportunities will there be for further U.S. contributions? Second, if new funds

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Trucks overloaded with cargo and passengers.

are made available, what should be the first steps of a U.S. program? A response to the latter question will be an essential part of the justification of any proposal for new funding.

Cooperation Between High-Income and Developing Countries: Opportunities and Obstacles

Anthony Bliss, the World Bank, spoke during the workshop’s introductory session on the challenges of scaling up knowledge transfer and investments in road safety improvement. In his presentation, he raised issues that were illustrated by particular cases during the afternoon panel discussion of cooperation between high-income and developing countries. Five panelists contributed to a discussion of model traffic safety programs linking high-income countries with developing countries: Adnan Hyder, the Johns Hopkins University; Fred Wegman, the Institute for Road Safety Research of the Netherlands; Mary Lydon, ARRB Group, Australia; Henning Lauridsen, Institute of Transport Economics of Norway; and Avinash Sarna, consultant, formerly at the Central Road Research Institute of India.

Mr. Bliss noted that recent UN and WHO resolutions and publication of the World Report on Road Traffic Injury Prevention have highlighted reduction of losses associated with road traffic crashes in the developing world as a development priority. The challenge now is to scale up knowledge transfer and investment so as to develop effective, sustainable traffic safety programs in developing countries. A substantial effort will be required, and such an effort will confront obstacles arising from weaknesses in safety

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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management capacity in the developing world, as well as in international development assistance organizations.

As the road safety expenditure estimates cited earlier suggest, many developing countries are devoting a paucity of resources to the problem; as a result, their safety management capacity is at the most rudimentary level. There are a number of critical weaknesses: often no national goals or targets are defined, no performance data or measures of results of actions exist, systematic national estimates of the costs of road crashes are lacking, government road and police agencies seldom are held accountable for road safety performance, interventions are fragmented and not based on best practices, enforcement of traffic and safety regulations is ineffective, and legislation needed for effective safety programs is not in place. The road transportation system in general is not well managed or maintained, and safety management in truck and bus companies is poor.

If progress is to be made, this lack of capacity must be recognized. The necessary institutional capacities in high-income countries evolved over a long period of motorization, and the deficiencies in developing countries will take time to redress. Well-intentioned interventions that fail to take institutional capacity weaknesses into account will fail to yield sustainable results. The need to overcome these weaknesses is recognized by the World Report: five of the report’s six recommendations are aimed at creating institutional capacity for road safety management at the national level (see Box 2).

International organizations also have failed to develop the necessary internal institutional capacity for providing effective assistance in traffic safety. They have not committed resources to the problem commensurate with its gravity and have not coordinated their efforts or quantified targets. The new initiatives of the UN, WHO, the World Bank, and regional organizations are first steps in addressing these deficiencies. The World Bank, after experiencing only limited success with smaller, more narrowly conceived projects, is promoting pilot second-generation projects in Vietnam and Iran that take a comprehensive, multisectoral approach. These projects are aimed at implementing the recommendations of the World Report by concentrating on the building of safety management capacity at the national level, thus making it possible to sustain long-term safety improvements. At the same time, the projects focus on achieving quick, measurable road safety results so as to create support for the long-term effort. The World Bank’s Global Road Safety Facility, described above, has as an objective the promotion of one such project annually in each of six global regions.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Model Traffic Safety Programs Linking High-Income and Developing Countries

If the United States decides to become more deeply engaged in the global road safety problem, a valuable preparatory step will be to review the experiences of other governments and organizations to identify possible models for engagement. The panel discussion on model traffic safety programs linking high-income and developing countries provided examples of such models and of the roles of a variety of institutions in international knowledge transfer. The activities described involve universities, government agencies, and private nonprofit and for-profit organizations:

  • The Road Traffic Injuries Research Network, an example of a university-based research collaboration, is an association of traffic safety researchers in high-income and developing countries that facilitates networking and creation of partnerships by connecting researchers in developing countries to the international traffic safety research community. The network has sponsored training, meetings, pilot research projects, a Listserv, and an electronic newsletter. Its objectives are to make investment in traffic safety research a higher priority in developing countries and to strengthen capabilities for conducting safety research. The network has received funds from international organizations and private donors and is governed by a board of sponsors and participating researchers.

  • Government agencies and institutions in the state of Victoria, Australia, have conducted more than 40 road safety projects in the past 10 years in 30 countries, including China, India, and countries of Southeast Asia. Australia, in particular the state of Victoria, is noted for innovation and performance in road safety. Australian participants in the projects have included the state highway agency; the police; a state insurance agency; Monash University; and the ARRB Group, a research and consulting organization set up as a private entity, owned by the governments of the Australian states. The ARRB Group distributes safety technology internationally as a commercial enterprise. It has developed a set of standard products: model regulations, guidelines, and legislation; safety management strategies; evaluation techniques; program reviews; demonstration projects; and educational materials. Projects are funded by the client governments, international organizations, and Australian aid funds. Projects are conceived as partnerships, typically involving an Australian

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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state or national government agency, an Australian university, an international agency, a local contractor, and the host government. The effectiveness of the program depends on preexisting, established relationships among all these parties.

  • The Institute for Road Safety Research of the Netherlands is also a private, government-owned organization, and the Netherlands is, like Australia, a country noted for its success in reducing road crashes. The institute has participated in traffic safety projects in other countries initiated by government-to-government contacts at the ministerial level, including projects in central and eastern Europe emphasizing institutional capacity building. The Netherlands government has provided support for training of central and eastern European engineers and engineer exchanges, and central and eastern European engineers are encouraged to participate in professional organizations and conferences.

  • The Institute of Transport Economics, Norway, a private organization that receives base funding from the government, has participated in about 20 safety projects in Africa and Asia in the past 25 years, often funded jointly though the Nordic Development Fund (the foreign-aid fund of Norway, Sweden, Finland, Denmark, and Iceland). Early, small projects did not achieve sustainability; the host country lacked institutional capacity, and funding ceased once the aid project ended. A new, more ambitious approach now is being tested: a regional aid program with the 14-nation Southern African Development Community, supported by the Nordic Development Fund. The program entails commitments to a 10- to 15-year engagement and emphasizes national road safety programs and regional model legislation. The intent is for the regional structure to reinforce each country’s efforts and provide sustainability. Problems encountered have included lack of cooperation among government agencies in the participating countries, insufficient provision for evaluation of program results, and the uncertainty of ongoing funding among the countries receiving aid. The lessons of the overall experience of the Nordic projects are that a long-term commitment by all parties is required, multisectoral cooperation in the recipient country is essential, and monitoring and evaluation are especially difficult tasks.

The final speaker on the panel, Avinash Sarna, described the status of road safety efforts in India and requirements for establishing successful

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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working relationships between high-income and developing countries. India has suffered a dramatic increase in road crashes and associated deaths and injuries in the past 30 years (see Figure 2); in 2003, 86,000 persons were killed in reported crashes. Road safety is a problem of emerging public and government interest, but political will and financial support to address the problem remain inadequate. Road safety improvements are not guided by overall national or state policies or action plans. Data systems are weak, and there is no capability to evaluate the safety impacts of interventions. Little coordination occurs among government agencies with safety responsibilities. The nation faces a choice with regard to the future trend in road traffic injuries and fatalities. If crash rates are reduced as motorization increases, exponential growth in injuries can be avoided. However, progress in reducing crash rates will require development of a strong national commitment; financial support; and efforts from all relevant sectors within the country, including government bodies, health institutions, the motor vehicle industry, communities, and civic organizations.

Aid programs supported by high-income countries can contribute to effecting the needed changes. Forms of involvement should include participation in a global exchange of ideas and experience; transfer of road safety knowledge through training and professional development programs; support for and participation in joint road safety projects, including research projects, pilot infrastructure projects, and projects involving traffic management and accident investigation; and programs to support the develop-

FIGURE 2 Indian and global road safety trends. (Source: Avinash Sarna, workshop presentation.)

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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ment of road safety policies and plans and to strengthen institutional and legal systems.

Lessons Learned from Other Public Health Challenges

In the concluding presentation, Jim Yong Kim, Harvard School of Public Health, Harvard Medical School, spoke about lessons learned from the global response to the AIDS epidemic that may be applicable to the crisis of road safety in developing countries. A period of years elapsed between recognition of the magnitude of the costs of the AIDS epidemic and the scaling up of global efforts to combat the epidemic to a level at all commensurate with the need. The costs of those efforts could have been greatly reduced if the global reaction had been more rapid. However, global funding for AIDS control, including funding for assistance to developing countries, has increased significantly in recent years. Attaining this level of success required developing evidence, political will, and a social strategy. Any effective movement to generate action on a public health crisis will depend on the same three elements.

Scientific evidence is needed to demonstrate the dimensions and costs of the health crisis and the effectiveness of available interventions. The evidence must become widely recognized. In the case of AIDS, such evidence existed from the 1980s, at least a decade before interventions on a meaningful scale were mobilized, demonstrating that evidence alone is insufficient to spur action. When political action was finally stimulated, one item of evidence turned out to be a critical motivator: the demonstration that AIDS treatment could be effective in Africa. Perhaps treatment programs gained support more readily than prevention efforts because the benefits of the former investments are more visible and their beneficiaries identifiable; in any case, the experience suggests that it is necessary to find ways of presenting evidence to policy makers in terms that are meaningful to them.

Creation of political will to respond to AIDS at the global level was to a great extent the consequence of an activist movement in high-income countries. Activists have a similar role to play in creating political support for the provision of assistance to improve road safety because they can show leaders that action on road safety has political benefits.

Social strategy is defined as a strategy for attaining a social objective, such as control of AIDS or reduction in road traffic deaths and injuries. The strategy must recognize the strengths and weaknesses of institutions and the expectations of stakeholders in a country. In the case of AIDS, the break-

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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through in obtaining funding for treatment in developing countries has led to increased resources for prevention, which is the more cost-effective intervention. In the case of road safety, a comparable social strategy has been adopted in the World Bank’s second-generation road safety projects, described above. In those projects, immediate and visible payoffs in reducing crashes and associated deaths and injuries are sought by concentrating initially on direct interventions (e.g., removing physical hazards and strengthening law enforcement) in locations with high crash frequency. The strategy is that demonstrating short-term successes will build political and public support and momentum for the needed long-term institutional reforms.

General Discussions and Summary

After the invited presentations, workshop chair Mark Rosenberg asked the participants to comment on four questions concerning the goals of the workshop in light of the insights gained from the presentations and related discussions:

  • What is the U.S. interest in reducing the losses from road injuries in developing countries?

  • What forms can U.S. assistance for road safety take, how can it be delivered, and how can the United States ensure accountability and measurable objectives in the projects it supports?

  • How can collaboration on the problem among U.S. government agencies be promoted?

  • How can U.S. organizations identify needs of developing countries?

The workshop ended with a discussion of the next steps viewed by participants as necessary to a more effective U.S. response.

U.S. Interest in the Problem

The workshop presentations and the responses of U.S. government agency interviewees, as summarized above, form a consistent picture of the scope of U.S. interests affected by the problem of road safety in developing countries. Nearly all such interests can be grouped into four categories:

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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  • Protection of U.S. travelers and employees abroad (including civilian and military U.S. government employees and employees of U.S. private organizations) from involvement in road crashes.

  • Commercial interests of U.S. firms that may be affected by road safety conditions and safety regulations in other countries. For example, vehicle manufacturers have an interest in international harmonization of safety standards, and North American trade may be impeded by differences among countries in the safety standards and practices applied to commercial trucks.

  • Indirect U.S. benefits from improved general welfare in low- and middle-income countries. Road injuries and fatalities, like any major public health problem, are an obstacle to economic development. U.S. welfare is enhanced by economic development in other countries: development brings more opportunities for trade and reduces problems arising from emigration and conflicts. Institutional capacity building for the sake of improving road safety (such as strengthening competencies for public administration, infrastructure planning, and law enforcement) probably contributes to development in more general ways as well that may also benefit the United States. (For example, strengthening capabilities for enforcement of traffic laws may help strengthen police capacity to combat international crime and may also decrease corruption, increase public acceptance of the police, and thereby promote democratic stability.) Development aid also serves as an instrument for gaining good will for the United States internationally.

  • Altruism. U.S. government officials and the electorate may decide that contributing to relieving the road safety problem in the developing world is morally imperative.

As the description of U.S. government agency activities showed, these various interests have motivated different forms of U.S. engagement. Concern for protecting U.S. citizens and commercial interests has led to narrowly focused actions, although it has also served to raise awareness of the global road safety problem among U.S. agencies and their constituents. The broader kinds of interests—in promoting economic development for the sake of indirect U.S. benefits or out of a sense of moral responsibility—can be served only through efforts aimed at general improvement in traffic safety in the developing world.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Forms of Assistance, How Assistance Can Be Delivered, and How Accountability and Measurable Objectives Can Be Ensured

The workshop presentations and discussions concerning cooperation between high-income and developing countries, as well as the conclusions of the World Report, clearly indicate the challenges of scaling up knowledge transfer, international cooperation, and assistance. The workshop presentations also provided examples of the objectives, content, and organization of cooperative international road safety programs. Elements of international assistance programs that probably will be critical to success include the following:

  • Programs should take a long-term perspective aimed at institutional capacity building at the national level.

  • Programs must be multisectoral; that is, resources and capabilities will be required not only by road agencies, but also by law enforcement, emergency response and medical services, education and research institutions, and agencies of general public administration responsible for infrastructure planning, data, and evaluation. Attaining the needed cooperation across sectors in developing countries was identified as a serious challenge and a difficulty encountered in most projects.

  • Programs should have specific goals and incorporate monitoring and evaluation.

The World Bank’s second-generation traffic safety projects are the prototype for projects aimed at satisfying these requirements comprehensively. However, participants described activities of more limited scope that are consistent with such a comprehensive framework, including the following:

  • Activities that tie professionals to the international community of practitioners in research, education, engineering, and public administration so as to develop skills and promote awareness of best practices. The Road Traffic Injuries Research Network and activities of the Transportation Research Board that attract substantial international participation are examples.

  • Assistance on data programs that can provide credible quantitative evidence of the economic and human costs of traffic-related deaths and

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

A broken bicycle lies among shattered glass after a collision between a bus and a cyclist in Huangshan, China. Cyclists are among the most vulnerable road users when they must share the roads with cars, trucks, and buses. (Photo by Mark Rosenberg.)

injuries in a country. The workshop presentations made clear that broad dissemination of facts on these costs to the leaders in a country is necessary to build local support for traffic safety initiatives. Creation of a standardized global data infrastructure could provide this information at the country level. Quantitative objectives could be set and progress monitored on both a country-specific and a global basis. Creating such a data infrastructure would require a large, collaborative project.

  • Cooperation to develop the capacity of nongovernmental organizations and civil society in a country as a way to build general public awareness of and support for road safety initiatives. The project of the AAA Foundation and auto clubs of other countries to develop road assessment programs in developing countries as a means of stimulating public dialogue on the problem is an example of such a nongovernmental initiative. The initiative of the National Academies to support the development of African science academies, although not specifically related to road safety, is another illustration of this kind of engagement. That

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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initiative is supporting African academies in building their capacity to provide independent, evidence-based advice to their governments and countries on health-related matters. Strengthening science academies in developing countries, and the scientific community they represent, can inform public policy and increase awareness of road safety issues.

  • U.S. government cooperation with initiatives of nongovernmental organizations, in particular by undertaking the government-to-government communications that often are needed to facilitate such activities. If a private-sector safety initiative (e.g., the auto club road assessment programs described above) requires the support or participation of the host government, the necessary interaction with the host government can often be carried out more efficiently with the participation of the U.S. government than by the private parties acting alone.

  • Participation in established international coordinating activities, including the UN Road Safety Collaboration described above, and in international forums such as the global and regional road safety stakeholder forums being planned by the UN as part of Global Road Safety Week in 2007.

  • Efforts to ensure that infrastructure projects receiving U.S. aid incorporate safety in designs. For example, the U.S. government’s Millennium Challenge Corporation, which requires all projects it assists to have specific objectives and evaluation of results, is funding road projects in several countries. Safety improvement is an appropriate objective for any road project.

  • Public communication. Further U.S. government action on global road safety will be likely only if a constituency outside government is calling for action. The role of government agencies in advocacy is circumscribed, but certain kinds of involvement might be appropriate. Efforts can be made to ensure that all potential constituencies and influential groups—for example, the engineering and medical professions, U.S. businesses affected by road safety conditions abroad, and journalists— are included in activities.

The organizational forms of the assistance projects described during the workshop were diverse and included government-to-government

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

bilateral aid; region-to-region aid (the Nordic countries’ program with southern African governments); projects in which an international intermediary organization (WHO or the World Bank) takes on management responsibility with the financial and institutional support of the donor country; and projects carried out largely among nongovernmental entities (e.g., the Road Traffic Injury Research Network and the auto club road assessment programs), sometimes with some government support. Several of the projects described involve partnerships with numerous participants: multiple agencies in donor and recipient governments, nongovernmental organizations and contractors in donor and recipient countries, universities, and the international organizations. Formation of such partnerships is facilitated by preestablished relationships among the parties and careful planning.

Presenters made clear that attaining sustained results ultimately depends on the motivation and resources of the developing country and that the international role necessarily is limited to information dissemination and to the provision of technical and financial assistance when requested by those governments that have a commitment to action. It was noted that the character of U.S. bilateral aid projects is determined to a great extent by the priorities of the aid recipient; therefore, increasing U.S. involvement in road safety through projects delivered by USAID will require expressions of interest in the problem from the recipient governments.

The presentations identified some keys to accountability for the outcomes of assistance projects. The first is ensuring that the developing country recognizes its ownership of the project—that the country has invested its own resources and that leaders and administrators are committed to getting results. Accountability also requires projects large enough that they can be expected to produce measurable results, and that the experience and training imparted by the project make a long-term contribution to building institutional capacity.

Mixed traffic on a city street.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

Promotion of Collaboration Among U.S. Government Agencies

Several presenters emphasized that the greatest road safety benefits can be attained only through the collaborative efforts of several sectors, including the roads agency, as well as public health, law enforcement, education, and public administration. The most effective U.S. aid programs will draw on the capabilities of each of these sectors in the United States and will seek to build competence in each of the corresponding sectors and establish ties among them in those countries receiving assistance.

Because of the need for a multisectoral strategy, workshop participants from several U.S. government agencies suggested that the governmentwide response of the United States to the global road safety problem would be greatly strengthened by the creation of a permanent institutional structure with the participation of all the relevant agencies. This interagency body would be a mechanism for building working relationships, coordinating actions across agencies, and allowing agencies to benefit from each other’s efforts and knowledge; it would be a point of contact for nongovernmental organizations that might wish to partner with the government in road safety activities; and it could help ensure that U.S. government engagement in international activities is well organized and takes advantage of all available capabilities. The proposed interagency body would be in a position to formulate a governmentwide internal action plan and to propose national goals and timetables. Government participants discussed various forms the institutional structure of this body could take, including a joint program office and an official working group. These structures would differ in the formal funding commitments required from the participating agencies and in the seniority of agency staff who would be the principals of the group.

In addition to collaboration across cabinet departments, coordination within departments is necessary. The inventory of agency interests and activities produced for the workshop revealed that some departments have many offices concerned with aspects of global road safety. USDOT has created an internal coordinating and planning mechanism for work on this issue, including designation of a lead agency (NHTSA) and lead staff within the department. That arrangement may be a useful model for other departments.

Collaboration depends on transparency, participants noted. Agency staff who were interviewed sometimes hesitated to share information about their activities. A possible consequence of this attitude is that agencies may be unaware of common interests and opportunities for collaboration.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

Any administrative actions that could provide incentives for more open communication of agency activities, within the government and to the public, would contribute to overcoming this barrier.

How to Identify Needs of Developing Countries

Most participants commenting on this question emphasized that the needs most relevant to planning U.S. assistance activities are priorities articulated by the governments and institutions of the developing countries. Therefore, in contacts with other countries’ governments, U.S. parties should be prepared to listen, ask, and discuss so as to discover what kinds of initiatives are desired. Participants suggested a number of other guidelines for U.S. government interactions with governments of developing countries concerning road safety:

  • Initiatives must be structured as cooperative efforts with all parties being equal around the table, rather than the developing country being relegated to a junior partner status.

  • In communicating with other countries, the U.S. participant must clearly enunciate the nature of its interest and the scope of its commitment to cooperative initiatives.

  • Establishing genuine local ownership of projects—through commitment of resources, control, and accountability—is key to attaining sustainable results.

Car–motorbike crash.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
  • In discussions with other countries, U.S. participants should cite the relationship of safety to infrastructure development and show appreciation for the need to focus on vulnerable users as a priority.

  • U.S. initiatives should reflect the recommendations of the World Report, which refer to the fundamental needs existing in most developing countries.

  • Activities that help other countries better identify their needs, such as building data and monitoring systems and developing research capacity, are a valuable form of assistance.

  • The experience gained in successful assistance projects, that is, projects that yield results valuable to the country receiving aid, should be seen as an indicator of needs. Some earlier, small-scale safety assistance projects that failed to produce sustainable benefits evidently were not targeting critical needs. The World Bank’s second-generation projects are structured according to a hypothesis about needs; if they are successful, the hypothesis is supported.

It was suggested that case studies of ongoing major cooperative international road safety activities are needed to document the history of each project’s development, organizational structure and participants, objectives and methods, and results to date. These case studies would ensure that the lessons learned in each initiative are preserved. A particularly valuable case study would be a history of the development of international cooperative health and road safety programs in Vietnam. The critical elements involved in organizing a U.S. contribution in that country were the leadership of State Department officials and partnership among the State Department, DHHS, and U.S. nongovernmental organizations.

Next Steps

Several participants suggested immediate next steps that U.S. government agencies could take toward developing a more effective U.S. response to the global road traffic safety problem. Creation of the permanent interagency body described above would be the first step. Several other suggested immediate actions could form the initial agenda of the interagency body. These include the following:

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
  • Completing the task begun in this workshop of defining and documenting the U.S. interest in the problem of international road safety and identifying the agencies and programs already concerned with addressing it.

  • Engaging U.S. nongovernmental organizations in determining their relevant interests and resources and establishing good communications on the problem.

  • Conducting the above-discussed case studies of recent significant international road safety initiatives.

  • Coordinating a process of practical, governmentwide planning, following two tracks: first, to identify opportunities for more effective U.S. contributions using existing resources; and second, to identify initial elements of a U.S. program if new funds were made available. Plans would demonstrate that U.S. participation could support cost-effective interventions, including interventions with immediate short-term payoffs, and that the benefits would contribute to achieving overall development-related policy objectives. The above discussion of possible forms of U.S. road safety assistance includes specific activities that could be elements of these plans.

References

Kopits, E., and M. Cropper. 2005. Why Have Traffic Fatalities Declined in Industrialized Countries? Implications for Pedestrians and Vehicle Occupants. Policy Research Working Paper 3678. World Bank, Aug.

Mathers, C. D., and D. Loncar. 2005. Updated Projections of Global Mortality and Burden of Disease, 2002–2030: Data Sources, Methods, and Results. World Health Organization, Oct., pp. 5–8.

Peden, M., K. McGee, and G. Sharma. 2002. The Injury Chart Book: A Graphical Overview of the Global Burden of Injuries. World Health Organization, Geneva, Switzerland.

Peden, M., R. Scurfield, D. Sleet, D. Mohan, A. A. Hyder, E. Jarawan, and C. Mathers (eds.). 2004. World Report on Road Traffic Injury Prevention. World Health Organization, Geneva, Switzerland.

World Bank. 2006. Project Information Document (PID) Appraisal Stage. Report AB2155. Feb. 8.

Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×

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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
Page 27
Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
Page 29
Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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Suggested Citation:"Workshop Summary." Transportation Research Board, Institute of Medicine, and National Research Council. 2006. Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement, Workshop Summary -- Special Report 287. Washington, DC: The National Academies Press. doi: 10.17226/11647.
×
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TRB, the Policy and Global Affairs Division (PGA), and the Institute of Medicine (IOM) have released TRB Special Report 287, Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement. The report summarizes presentations and discussions at a workshop held on January 26-27, 2006, in Washington, D.C. The workshop focused on the sharp increases in road traffic-related deaths and injuries in developing countries with a goal of providing a view of the diversity of U.S. interests, the scope of activities of U.S. agencies addressing this problem, and prospects for further U.S. engagement. The workshop discussions were intended to help the responsible government agencies gauge whether the U.S. response is proportional to the interests at stake and to identify next steps toward a more effective response. PGA and IOM, like TRB, are part of the National Academies, which include the National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council.

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