Highlights
In January 2006, the National Academies convened a workshop entitled “Improving Road Safety in Developing Countries: Opportunities for U.S. Cooperation and Engagement.” The goal of the workshop was to provide a view of the diversity of U.S. interests affected by the worldwide problem of road traffic deaths and injuries, the scope of activities of U.S. agencies addressing the 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.
The major points made by participants during the workshop discussions include the following:
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The scale of the road safety problem is large (1.2 million deaths annually) and growing rapidly with increased motorization in the developing world. It is projected that in 2030 road traffic injuries will cause nearly 3 percent of all deaths worldwide, up from 2 percent in 2002. Experience indicates that certain interventions to reduce road injuries have the potential to be highly cost-effective compared with other large-scale international public health programs.
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The United States has capabilities to assist developing countries with the problem. Over decades of motorization, it has developed professional and institutional strengths across many sectors: data systems, road and vehicle standards, emergency medical care, intervention programs, and enforcement and adjudication.
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U.S. engagement with the problem, occurring through the efforts of government agencies and nongovernmental organizations, is at a low level compared with the scale of the problem. Activities in some agencies are aimed principally at protecting U.S. citizens traveling abroad as workers or tourists. Other government activities address aspects of the problem that affect trade and commerce, such as vehicle safety standards and cross-border trucking operations. Some assistance is provided to developing nations for research, data systems, and professional exchanges. U.S. agencies participate in road safety programs of the United Nations and the World Health Organization, although the scale of these multilateral efforts has been modest. U.S. nongovernmental organizations are participating in technical exchange and public communication programs in developing countries.
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According to government participants, stronger and more systematic collaboration among U.S. agencies and between government and private entities would increase the effectiveness of U.S. efforts. Such collaboration is important because the most effective actions would involve several sectors, including transportation, health care, emergency services, law enforcement, and education.
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If the United States became more engaged in efforts to reduce global road traffic injuries, it might be able to increase the effectiveness of its contributions by learning from the experience of other nations and international organizations. That experience indicates that the most effective interventions focus on institutional capacity building in the transportation, health, enforcement, and public administration sectors; entail long-term commitments by all parties; and incorporate monitoring and evaluation of outcomes.
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U.S. programs also could derive lessons from the response to other global health crises, including the HIV/AIDS epidemic. The lag between recognition of the epidemic and the scaling up of a meaningful response
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resulted in enormous numbers of deaths and illnesses and marked increases in the costs of prevention and treatment. Mounting a large-scale response required scientific evidence of the magnitude of the threat and the effectiveness of interventions, political will to commit resources, and a social strategy for organizing effective interventions.
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Increasing the effectiveness of the U.S. response to the global road safety problem would require planning in the government agencies concerned, first, to identify opportunities for more effective U.S. contributions with existing resources, and second, to identify initial elements of a U.S. program if new funds were made available. Careful planning could help ensure that U.S. participation would support cost-effective interventions and contribute to achieving overall policy objectives with regard to international development. Planning would also involve assembling the evidence that engagement would serve U.S. interests, while also making the ethical case for engagement.