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Estimating global road fatalities

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Estimating global road fatalities G Jacobs, A Aeron-Thomas and A Astrop Transport Research Laboratory Department for International Development Old Wokingham Road 94 Victoria Street Crowthorne, Berkshire, RG45 6AU London, SW1E 5JL TRL REPORT 445 This report is dedicated to the memory of Angela Astrop who sadly died in December 1999, just as this report was being finalised. She will be missed by her many friends and colleagues at TRL. First Published 2000 ISSN 0968-4107 Copyright Transport Research Laboratory 2000. This report has been produced by the Transport Research Laboratory as part of a contract placed by the Global Road Safety Partnership (GRSP). Any views expressed are not necessarily those of Global Road Safety Partnership. TRL is committed to optimising energy efficiency, reducing waste and promoting recycling and re-use. In support of these environmental goals, this report has been printed on recycled paper, comprising 100% post-consumer waste, manufactured using a TCF (totally chlorine free) process. The Transport Research Laboratory and TRL are trading names of TRL Limited, a member of the Transport Research Foundation Group of Companies TRL Limited. Registered in England, Number 3142272 Registered Offices: Old Wokingham Road, Crowthorne, Berkshire, RG45 6AU. CONTENTS Page Executive Summary 1 1 Introduction 3 1.1 Background 3 2 Estimating global road fatalities 3 2.1 Methodology 3 2.1.1 Regional classifications 4 2.2 1998 updates 4 2.3 Non-reporting by countries 5 2.4 Under-recording of fatalities 6 2.4.1 Fatality definition 6 2.4.2 Road crash definition 6 2.4.3 Updating procedures 6 2.5 Non-reporting by general public 7 2.5.1 HMCs 7 2.5.2 LMCs 7 2.5.3 Non-reporting adjustment factors 8 2.6 Current global fatality estimate 8 2.6.1 Comparison with WHO estimates 8 2.6.2 Global road crash injury estimate 8 2.7 Fatality forecasts 9 2.8 Summary 9 3 Economic costs of road crashes 9 3.1 Introduction 9 3.2 Methods available to cost road crashes 10 3.3 Results of crash costing procedures 10 3.4 Summary 10 4 Regional analyses 11 4.1 Introduction 11 4.2 Highly motorised countries 12 4.2.1 Current situation 12 4.2.2 Recent trends 12 4.2.3 Road crash casualties 13 4.3 Asia and the Pacific 14 4.3.1 Current situation 14 4.3.2 Recent trends 16 4.3.3 Road crash casualties 16 iii iv Page 4.4 Central and Eastern Europe 16 4.4.1 Current situation17 4.4.2 Recent trends17 4.4.3 Road crash casualties18 4.5 Latin America and the Caribbean 18 4.5.1 Current situation19 4.5.2 Recent trends19 4.5.3 Road crash casualties19 4.6 Africa 21 4.6.1 Current situation21 4.6.2 Recent trends21 4.6.3 Road crash casualties23 4.7 Middle East and North Africa 23 4.7.1 Current situation23 4.7.2 Recent trends23 4.7.3 Road user type24 4.8 Summary 25 5 Summary and Conclusions25 5.1 Areas for future consideration 26 6 Acknowledgements26 7 References26 Appendix A: Basic traffic safety and soci-economic indicators29 Abstract36 Related publications36 1 Executive Summary deaths doubled in a few Latin America countries and rose by 16 per cent in Brazil. Central and Eastern Europe showed wide variation with fatalities increasing by 31 per cent in Poland but decreasing in other countries by up to 36 per cent. Conversely road deaths in highly motorised countries fell by about 10 per cent. Growth rates are sensitive to the time period selected and analysis method used but the general trends show global road fatalities increasing at a slower rate in the next two decades. Based on trend series data from a limited number of countries (43), the increase in fatalities in Africa and Latin America is expected to continue to increase for a few more years before slowing down while the fatality growth in Asia and the Middle East is slowing down. The decrease in fatalities in the West is expected to continue but at a slower rate. A review was undertaken of those countries which have attempted to cost road crashes. It was found that as a percentage of GNP, costs ranged from as low as 0.3 per cent to over 4 per cent. In order to obtain an estimate of cost worldwide, a broad (and albeit crude) assumption was made that in developing countries the annual cost of road crashes is about 1 per cent of GNP (a value used for many years based on early research in this topic), in transitional countries about 1.5 per cent and developed countries 2 per cent. Estimates were derived of what this meant in global and regional terms and it was found that in 1998, global costs (using the above assumptions) might have been of the order of US$500 billion and in developing and transitional countries about US$60 billion. Results show that the highest fatality rates (deaths per 10,000 motor vehicles) worldwide occur in African countries, particularly Ethiopia, Uganda and Malawi whilst fatality risk (deaths/100,000 population) is highest in a disparate group of countries including Thailand, Malaysia, South Africa and Saudi Arabia. As might be expected, males in the most economically active age group make up the largest proportion of reported victims of road crashes. Previous studies have found that children in developing countries tend to be more at risk than in the developed world. However, they account for a relatively small percent of reported road crash casualties. Women’s fatality involvement appears to increase with motorisation. It should be noted that while women in less motorised countries may currently have a low accident risk, research indicates that the crash consequences can be more severe for women as there is often less investment in their medical treatment and recovery. Furthermore, their legal status as widows is often very unfavourable and the loss of a husband can mean the break up of a family. It should also be emphasised that vulnerable road users, i.e. pedestrians and two wheelers (motorcyclists and bicyclists), but especially pedestrians, are a particularly high-risk group throughout Africa and Asia as well as the Middle East. Car occupant casualties dominate in the highly motorised countries and are much more common in In recent years, major studies published by the World Health Organisation, TRL and others have identified the growing importance of road crashes as a cause of death, particularly in developing and transitional countries. This growing awareness of the problem is reflected in the recent establishment of the Global Road Safety Partnership (GRSP), an association of private sector, civil society and government organisations collaborating together to improve the road safety situation worldwide In order to provide the GRSP with an update of the road safety problem worldwide, a study was undertaken by TRL with the following objectives: To derive an estimate of road crash fatalities worldwide and on a regional basis. To provide an estimate of crash costs worldwide in relation to Gross National Product (GNP). To obtain regional analyses of fatality trends. To identify current fatality rates and risk (deaths per 10,000 vehicles and per 100,000 population respectively) and also casualty trends by age, sex and road user type. The methodology undertaken was based on official reported road fatalities, i.e. police databases, but adjusted to accommodate the following 1) countries without any published road fatality statistics, 2) updating reported road fatalities to the current year (1999), and 3) under-reporting. The latter included two different problems: under-recording, i.e. casualties reported to the police but omitted from official statistics, and non-reporting, i.e fatalities which were never reported to the police. The extent and impact of under-reporting, especially in developing countries, was highlighted with documented examples. The study estimated that in 1999 between 750,000 and 880,000 people died from road crashes and that the majority of these deaths occurred in developing and transitional nations (85 per cent). Almost half of all estimated deaths occurred in the Asia-Pacific region. This compares with a recent estimate by the World Health Organisation of over a million deaths in 1998. Study findings also indicate that over the next ten to twenty years the number of people dying annually in road crashes may rise to 1 million to 1.3 million respectively. Estimates suggest that 23-34 million people are injured worldwide in road crashes—a value almost twice that previously estimated. The problem of injury under- reporting is perceived to be even more serious with a fraction of injury road crashes being reported in many less motorised countries. Trend data showed that the total number of people killed in road crashes in regions of the developing world continued to increase, whereas in the West there has been a steady decrease over the last fifteen years or so. For example, between 1987-1995 deaths in the Asia-Pacific rose by 40 per cent, in Africa by 26 per cent (excluding South Africa where the increase was minimal) and the Middle East/North Africa region by over 36 per cent. Road 2 the Latin America/Caribbean region. Finally the report identifies weaknesses in the quality of existing data, particularly from developing countries and highlights areas that could be examined within the GRSP programme so that a greater understanding of the global road crash situation can be obtained. 3 1 Introduction 1.1 Background The problem of deaths and injury as a result of road crashes 1 is now acknowledged to be a global phenomenon with authorities in virtually all countries of the world concerned about the growth in the number of people killed and seriously injured on their roads. In recent years there have been two major studies of causes of death worldwide which have been published in the ‘Global Burden of Disease’ (1996, World Health Organisation, World Bank and Harvard University) and in the ‘World Health Report – Making a Difference’ (WHO 1999). These publications show that in 1990 road crashes as a cause of death or disability were by no means insignificant, lying in ninth place out of a total of over 100 separately identified causes. However, by the year 2020 forecasts suggest that as a cause of death, road crashes will move up to sixth place and in terms of years of life lost (YLL) and ‘disability-adjusted life years’ (DALYs) 2 will be in second and third place respectively. This growing awareness is reflected in the recent establishment of the Global Road Safety Partnership (GRSP). Under the framework of the World Bank’s Business Partners for Development (BPD) Programme, GRSP is a partnership of private sector, civil society and government organisations collaborating to improve the road safety situation around the world. A Steering Committee for GRSP is now in place with the aim of creating a global information network that aims to produce solid evidence of the positive impact of partnerships – both the development impact and the business benefits. Two important aspects of GRSP are the involvement of the private sector in promoting road safety and the promotion of greater awareness of road safety worldwide. With the setting up of the GRSP it was considered important that a comprehensive summary of the global situation was made available to all involved in the problem of road crashes in developing and transitional nations. For example, using published statistics from countries throughout the world, TRL has in the past attempted to identify the number of people killed in road crashes worldwide and also on a regional basis. The last attempt to do this however used 1990 data and is clearly out of date (Ghee et al 1996). Further, since that time, more information has been collected on under-reporting and a better estimate can be obtained of the global situation. Using different statistics, the World Health Organisation(WHO) investigated deaths from many causes in the two above studies. Differences exist in these early estimates provided by TRL and WHO, and the GRSP Steering Committee proposed that a review should be undertaken to resolve these differences and identify the current situation as accurately as possible. It was agreed that the World Bank, the Department for International Development UK (DFID) and TRL would co-fund a study which would be restricted to the analysis of published material. The study was carried out by TRL with the following objectives: To derive an estimate of road crash fatalities worldwide and on a regional basis for the year 1999 and to derive forecasts of the likely number of deaths in the year 2010 and 2020. To provide an estimate of crash costs worldwide in relation to GNP. To obtain regional analyses of fatality trends, rates and risk (deaths per 10,000 vehicles and per 100,000 population respectively) and casualty trends by age, sex and road user type. The main sources of data used for this study were the International Road Federation (IRF) annual statistical yearbooks, World Health Organisation (WHO) publications, recent regional and country studies, such as the Asian Development Bank (ADB) funded Road Safety in Asia/Pacific, the Inter American Development Bank financed Latin America Study and the European Commission PHARE Multi-Country Transport Programme. Road casualty data also came from TRL publications and country studies. 2 Estimating global road fatalities Previous reviews of global fatalities undertaken by TRL, World Bank and others have produced a wide range of estimates and whilst the problem of data reliability and under-reporting has been regularly acknowledged, traditional reliance has been on the use of officially published statistics based on police reports. In estimating causes of death and disability, the World Health Organisation (WHO) used a different method, based on registered deaths and health sector data, that produced higher estimates than those using official police statistics. For example, WHO estimated a million deaths worldwide in 1990 whilst the TRL values were of the order of half this. Using their 1990 figure, WHO then estimated deaths in 1998 to be 1.17 million worldwide. 2.1 Methodology In keeping with the traditional approach used by transport specialists in compiling road crash statistics, the starting point in this current study was the official fatality figure reported by countries. Using these values to obtain an accurate estimate of the current global fatality situation required several factors to be taken into account as follows: 1 Updating the fatality figure from the latest year (usually 1995/96) to 1999. 1Over the past decade, the term ‘crash’ has been increasingly used to replace the term ‘accident’ with motor collisions. Crash is already commonly used in the transport sector to describe air and rail disasters and avoids any misleading connotations of ‘unavoidable’. 2DALY’s express years of life lost to premature death and also years lived with a disability, adjusted for the severity of the disability. 4 2 Estimating for those countries where fatality data was not obtained. 3 Under-reporting. a recording deficiencies b non-reporting to the police The general problem of under-reporting includes both recording deficiencies, i.e ‘under recording’ where casualties are reported to the police but are not included in the published statistics, and non-reporting where the police are not notified of road casualties. To highlight the extent of under-reporting, the problems of recording deficiencies and non-reporting have been discussed separately in this study. 2.1.1 Regional classifications There is no standard approach to regional groupings used by the many different international organisations concerned with road safety. However, in order to aid interpretation of data, a total of 192 countries were assigned to six major regional groups as follows: Africa. Asia/Pacific. Central and Eastern Europe (CEE). Latin/Central America and the Caribbean (LAC). Middle East and North Africa (MENA). Highly motorised countries (HMC), i.e. North America, Australia, New Zealand, Japan and Western Europe. Less motorised countries (LMC) is the collective term used to describe the first five regions where motorisation is typically much lower than in the industrialised HMCs. 2.2 1998 updates Most countries had published road fatality data available for 1996 and so the first step involved updating to the current year of 1999. Figure 1 shows the recent fatality trends from the different regions and the global level. While the CEE region reported fatalities peaking in 1990before dropping, the reverse was reported in the LAC region with fatalities increasing in recent years. After investigating the series data available for the larger countries within each region (see Table 1), it became apparent that the use of a regional average growth rate could produce misleading predictions because the figures would be biased by some countries. Table 1 Countries with time series data Region Countries HMC Canada, France, Germany, Greece, Italy, Japan, Portugal, Spain, United Kingdom, United States Africa Ethiopia, Kenya, Malawi, Nigeria, Tanzania, Zambia, South Africa Asia-Pacific China, India, Indonesia, Korea Rep., Malaysia, Pakistan, Taiwan, Thailand, Turkey, Vietnam CEE Azerbijan, Bulgaria, Croatia, Lithuania, Poland LAC Brazil, Chile, Colombia, Ecuador, Uruguay MENA Bahrain, Cyprus, Morocco, Saudi Arabia, Syria, Yemen 1987 1988 1989 1990 1991 1992 1993 1994 1995 HMC LAC MenaAfrica Asia CEE Global % change since 1987 60 50 40 30 20 10 0 – 10 – 20 Figure 1 Regional fatality trends Road fatality trends (1987-95) Figure 1 shows recent regional fatality trends but as noted above, these will be heavily influenced by countries with relatively large numbers of fatalities for that region. The regional descriptions presented in Chapter 4 separate the large countries for this reason. For example it was found within the MENA region, that fatality statistics from Morocco and Saudi Arabia were three times those elsewhere in the region causing statistics from other countries to be ‘lost in their noise’. However, examination of data from the other countries indicated significantly different trends from those in Morocco and Saudi Arabia. Similar, though less extreme results, were found in data from other regions. For example, the rapid growth in crashes observed in India and China, which already have large number of fatalities, highly influenced any attempt to form a regression over all countries in their region. 5 A more accurate model was developed by sub-dividing each of the regions into two or three groups (see Table 2). Group 1 contained those countries with large number of road fatalities which dominated the region, all of which tended to have the same trends. Another group was formed from the other countries with fewer road fatalities. In some cases a third group was necessary, when trends between countries were significantly different. The details of the groups are shown above in Table 2. Regression equations were fitted to the total number of road fatalities in each region, and separate regressions were fitted for each group in each region. Linear regression was used unless a strongly non-linear relationship was in evidence. In other cases LOGIT and quadratic equations were fitted. The estimates shown in Table 3 are the values produced by the various equations for those countries with trend data. Where trend data was unavailable, the most conservative equation was applied within the region save for LAC and CEE where this would produce unrealistic fatality decreases (based on practical experience).2.3 Non-reporting by countries Despite a review that included many sources, road crash data could not be found for many countries in Africa and MENA (see Table 4). Africa had the lowest rate of representation and where data was available, it was often several years out of date. While representation by motor vehicles might have been more suitable, many countries did not report the size of their motor vehicle fleet so this option was not possible. Accordingly, the number of reported road crash fatalities for the region was adjusted upwards according to the ratio of regional population as follows: Population adjustment = reported fatalities by region X Total regional population Population of countries w/fatality data The population adjustment formula shown above assumes a consistent fatality risk, i.e. road fatalities per 100,000 population, within the region, yet as seen in the Table 2 Groupings used in the regions Group 1 Group 2 Group 3 Region(High fatality toll) (Low fatality toll) (different trend) HMC USA All others Africa Nigeria, South Africa Ethiopia, Malawi, Tanzania, Zambia, Kenya Asia-Pacific China, India Indonesia, Korea Rep., Malaysia, Pakistan, Taiwan, Turkey, VietnamThailand CEE PolandAzerbijan, Bulgaria, Croatia, Lithuania LAC Brazil Chile, Ecuador, UruguayColombia Middle East Morocco, Saudi Arabia Bahrain, Cyprus Syria, Yemen Table 3 1999 minimum estimates for countries with fatality data 1996 reported 1999 estimated HMC 100,116 98,822 Africa38,492 40,769 Central-Eastern Europe*58,612 60,051 Asia-Pacific 204,379 226,663 Latin/Central America & Caribbean).58,484 61,318 Middle East20,225 25,462 Global 480,308 513,085 *Higher regional growth rate applied Table 4 Regional groups and crash data (1996) Regional totals With fatality data Countries Pop. (‘000) Countries Percent Pop. (‘000) Percent HMC 27 828,175 24 89% 828,278 100% Africa 49633,545 29 57% 449,540 71% CEE 27 410,348 25 93% 382,522 93% Asia-Pacific 38 3,085,628 26 68% 3,062,094 99% LAC 34 482,050 25 74% 454,914 94% MENA 18 250,818 13 72%242734 88% Global 193 5,690,564 142 74% 5,420,082 95% 6 regional summaries in Chapter 4, this is not always the case. As those countries not reporting road crash data tend to be the less developed, an adjustment based on population may overinflate to a small extent the regional fatality estimate. As shown in Table 5, Africa was the only region where a large adjustment had to be made to adjust for those countries where published fatality figures could not be found. Overall, the global reported figure had to be adjusted by approximately 6 per cent to accommodate those countries where fatality data was not obtained. Given the lack of information on the timing of LMC road crash deaths, the assumption was made to use half the ECMT values for LMCs. Thus those LMCs reporting road crash fatalities occurring only within the first day of occurrence would have their figures increased by 15 per cent rather than 30 per cent. This approach avoids any overestimate of deaths. A second assumption was made regarding the standardised death definitions in LMCs; while many countries state the use of a 30 day definition, this could be interpreted to apply at the local level and for prosecution purposes. Road crash statistics are based on report forms that are often to be completed as soon as possible, i.e. ‘24 hour report form’. It can be very difficult to modify previously reported or submitted figures, especially where manual reporting systems are used which is the case in most LMC at the local level where casualty reporting occurs. Accordingly, it was decided that regardless of the official definition, a one-day reporting time period would be assumed to apply for all of LMC and thus a 15% inflation factor was logically applied to all LMC reported fatalities. 2.4.2 Road crash definition According to the Vienna Convention, the standard international definition of an injury road crash involves a collision of a moving vehicle on a public road in which a road user (human or animal), is injured (IRTAD, 1992). Some countries, however, require the involvement of a motor vehicle and others exclude certain types of crashes. For instance, China’s reporting policy excludes road crashes occurring at roadworks or rail crossings, a restriction which is believed to exclude thousands of deaths which are reported by the health authorities as road fatalities. Likewise, Mexico’s official statistics refer only to deaths on the Federal road network and only account for 30 per cent of those reported by the national health authorities (ADB, 1998, WHO 1996). Other countries reported incomplete crash data sets with fatalities limited to urban areas (Madagascar) or for less than a full year (Benin). 2.4.3 Updating procedures Updating and transferring records is a process prone to errors, especially when manual systems are involved, as so often is the case in LMCs. An early under-reporting study in Colombo, Sri Lanka found that while just over a half (53%) of the adult fatalities had been recorded by the hospital police post, when records were matched with the official police database, only 41 per cent were found to be included (Sayer and Hitchcock, 1984). After the introduction of a Table 5 1999 global reported fatality estimate 1999 estimatedAddition reported for non- fatalities reporting Total HMC 98,822 12 98,834 Africa41,371 16,948 58,319 Central-Eastern Europe60,051 3,489 63,540 Asia-Pacific 226,6631,742 228,405 Latin/Central America & Caribbean61,318 3,382 64,700 Middle East/North Africa25,462 3,403 28,865 Global 513,085 28,976 542,663 Table 6 ECMT standardised 30 day road crash fatality adjustment factors 30 day total Adjustment factor Scene/1 day 77%1.30 3 days 87%1.15 6 days 92%1.09 7 days 93%1.08 30 days100% 1.00 365 days103% 0.97 2.4 Under-recording of fatalities The problem of under-recording occurs when fatalities are reported to the police but are not included in the official database. There are three main causes of under-recording: Fatality definition. Road crash definition. Database updating procedures. 2.4.1 Fatality definition As defined by the Convention of Road Traffic (Vienna, 1968), a road death is deemed to have occurred when a person injured dies within 30 days of the crash (and as a result of the crash). As shown in the Appendix, however, not all countries use a 30-day definition with some countries using ‘on the spot’, within 24 hours, 3 days, etc. Adjustment factors have been developed by various organisations to bring these countries not using the 30-day definition `into line’. If this is not done, then a significant level of ‘under-recording’ will occur. Adjustment factors identified included those recommended by the Economic Commission for Europe and the European Conference of Ministers of Transport (ECMT) and the United Nations. The more recent ECMT values are shown in the Table 6. In the most recent UK Casualty Report (1998), the ECMT values were applied to Turkey (30% increase for a one day reporting definition) and Korea (15% increase for a 3 day reporting period) (DETR, 1999). Despite this, it was assumed that the ECMT values would not apply for all LMCs; a larger percentage of road crash fatalities can, unfortunately, be expected to die within the first day with the lack of advanced medical facilities as well as the higher percentage of vulnerable road user fatalities. 7 nationwide computerised crash reporting system, road fatalities in Bangladesh increased by 55 per cent. Until recently, Zimbabwe used to lose one month’s data each year when the official annual database was compiled. Even computerised crash database systems in HMCs can exclude fatalities if required details are not provided within the reporting deadline. In the UK, a crash must be reported within 30 days of its occurrence with all the required information for it to be entered onto the STATS 19 database. National centralisation policy will also affect the completeness of the database. For example, while the UK allows 6 months for the local police forces to provide their data to the national database, conversely France requires all road crashes of the preceding year to be reported by the end of January, a decision which is believed to result in some reported fatalities being excluded from the official national accident statistics. The low priority given to accurate reporting of road crashes is also a contributory factor, with data collection often seen as only a paperwork exercise and with no real practical value. In many countries, road crashes are reported by the general and not the Traffic Police who could be expected to give the data collection more priority. This is partly because the general police, unlike most Traffic Police, work around the clock seven days a week. Large inconsistencies in the LMC crash databases have been highlighted in previous studies (ADB 1996, WB 1998). Police may also be put under pressure to avoid documenting a worsening safety record. Such factors may explain how Indonesia could experience such a high rate of growth in motor vehicles in the past decade, i.e. almost 80 percent between 1986-95 while only reporting a 3 per cent rise in road fatalities. It has not been possible to develop standard adjustment factors for the problems mentioned above of updating and crash definitions but these data weaknesses will be considered in the assumptions made for adjusting for under-reporting. 2.5 Non-reporting by general public Almost all countries require road crashes to be reported to the police. The UK is unusual in that it does not have a unilateral requirement to report road crashes, even fatal ones, to the police; the parties involved are only legally required to exchange names and addresses. If this is not done, then the crash should be reported to the police. Despite this, police reported statistics are still used to assess the road safety situation in the UK. The other extreme in reporting is found in Bahrain, where vehicle damage is not allowed to be repaired without proof that the crash has been reported to the police. 2.5.1 HMCs A 1991 review on under-reporting studies worldwide included studies from the UK, USA and Canada that reported complete coverage of road crash fatalities while in Germany 5-9 per cent of road crash fatalities were not reported to the police (James, 1991). A 1994 International Road Traffic and Crash Database (IRTAD) Special Reporton the under-reporting of road traffic crashes quoted studies indicating a 3 percent level of fatality under- reporting in Spain and 2 percent in Switzerland. Research in Western Australia has also found that 5 per cent of road crash deaths were unknown to the police (Giles, 1994). Table 7 shows a comparison of the official police reported fatalities with that reported by WHO based on death certificates. The under reporting adjustment factor is the amount required to be added to the police reported figure in order to arrive at the WHO figure. Whilst the adjustment factor was found to be low in the USA, a surprisingly high 26 per cent needed to be added to official police statistics in Italy. Table 7 Road crash fatality comparisons Under reporting adjustment Country Year Police WHO factor USA 1994 40,716 41,427 2% Italy 1993 6,645 8,356 26% Source: WHO World Health Statistics (1996) Table 8 Road crash fatality under-reporting estimates Under reporting adjustment Country Year Police WHO factor Brazil1992 21,387 26,576 24% Cuba 1995 1,499 2,011 34% Ecuador1995 1,112 1,806 62% Philippines 1993 581 2,621 351% Source: WHO World Health Statistics (1996) 2.5.2 LMCs WHO World Health Statistics (1996) included examples of much worse under-reporting of fatalities in LMCs, with for example only one out of every five medically reported road deaths being included in police statistics in the Philippines (see Table 8). Similarly, in Indonesia, insurance companies reported 15,080 road fatalities in 1995, some 37 per cent more than the police reported. The Department of Health in Taiwan reported 7,250 road deaths in 1995, some 130 per cent greater than that reported by the police (3,094) although police statistics are limited to those fatalities occurring within 24 hours of a crash (Lu, 1999). Due partially to the restricted definition of a reportable road crash, the under-reporting in China appears to be very high, unfortunately so for the country with already the largest number of road fatalities in the world. The Beijing Research Institute of Traffic Engineering estimated the actual number of fatalities in China for 1994 to be 111,000, 42 per cent greater than the 77,860 reported officially by the police (Liren, 1996). Despite the progress made by computerising the police 8 reporting system in Bangladesh, road casualty reporting is still incomplete. A review of the road trauma fatalities in the capital Dhaka in 1996-1997 found 30 percent of those road fatalities reported in the newspapers were not included in the police database (IDC, 1997). In Karachi, a recent study compared the road crash casualties reported by the police with those treated by the main ambulance service. Using the capture-recapture method, the study estimated that only 56 percent of road crash fatalities had been reported by the police in Karachi in 1994 (Razzak, 1998). Another recent urban review of fatality under-reporting was conducted in Bogota, Colombia. A comparison of the police reported fatalities with those on the city’s mortuary database found major discrepancies. Only 27 per cent of the mortuary’s road fatalities were found as fatalities on the police system (another 19 per cent were reported as injured). A further concern was that 19 per cent of the total fatalities were not found on the mortuary system so that even the (presumably) most reliable system is missing almost one fifth of all road fatalities (TRL, 1998). 2.5.3 Non-reporting adjustment factors Evidence that under-reporting of fatalities ranged from 0- 26 percent in HMCs and up to as high as 351 per cent in LMCs with fatalities in China estimated to be as high as 42 per cent more than officially reported. Accordingly, to adjust for the extent of non-reporting of fatalities, as well as the under-recording weaknesses that could not be easily quantified, the conservative but realistic decision was made to use the following factors: HMC 2-5 per cent adjustment LMC 25-50 per cent adjustment The factors indicate a probable range of fatalities. Given all the uncertainty in the estimation, a range is much more appropriate than a supposedly precise figure and estimates will be shown for both factors. 2.6 Current global fatality estimate Based on the methodology described above, a realistic estimate of global road deaths is between 750,000 and 880,000 for the year 1999. The calculations and regional totals are presented in Table Comparison with WHO estimates Whilst the fatality range presented here is lower than the recent WHO estimate, two points should be kept in mind. Firstly, the recent WHO estimates were based on the data synthesis conducted by the Global Burden of Disease (GBD) (1996). The ambitious objective of the project required major assumptions to be made, especially where data were absent. For example, it was reported that estimates for the entire region of sub-Saharan Africa were based only on South Africa which in turn represented only about 1 per cent of the region’s population (Cooper et al, 1997). Secondly, two different methods of projection were used by WHO. Information on most causes of death (inc. road crashes) were based on complex forecasting techniques (usually from a base year of 1990) whilst others such as malaria, HIV/AIDS, tuberculosis were based on regional information collected as part of detailed and specific studies of these diseases. Even so, considerable variation exists in the forecasts derived for leading causes of death. Thus, for Sub Saharan Africa, deaths in 1998 from HIV/ AIDS was stated to be 1.83 million but with a possible range of 1.1 million to 2.4 million. Similarly in Africa, deaths from malaria are estimated to be in the range 758,000 to 1.3 million and global deaths from tuberculosis of 1.49 million actually lies in the range 1.1 to 2.2 million. The higher estimate derived in this study is a third less than the WHO value of 1.18 million estimated for 1998. However, as previously stated, the WHO study is based on 1990 data, and a number of assumptions about the distribution of fatalities in 1998 are made (World Health Report 1999). This, as shown above, leads to a range of possible fatalities for different diseases. Therefore, presenting a range of possible fatalities is not incongruent with the method employed by the WHO. 2.6.2 Global road crash injury estimate While the extent of under-reporting is known to be even worse with injuries than with fatalities, a minimum estimate within a likely range has been included here. Based on the IRTAD report mentioned previously and earlier studies that had estimated approximately 50 percent of road injuries were reported, a ratio of 100 injuries for every fatality was assumed to apply in the HMCs. For LMCs, a ratio of between 20 to 30 was accepted as a conservative estimate. These values produce annual road Table 9 1999 Estimated road fatalities with under-reporting (UR) adjustments 30 day fatality Low UR estimates Upper UR estimates 1999 Adjustment Adjustment Adjustment estimate factor Estimate factor Estimate factor Estimate HMC 98,834 ECMT* 105,654 1.02 107,767 1.05 110,937 Africa58,319 1.15 67,067 1.25 83,834 1.50 100,600 C/E Europe63,540 1.15 73,071 1.25 91,339 1.50 109,607 Asia-Pacific 228,4051.15 262,666 1.25 328,332 1.50 393,999 LAC 64,699 1.15 74,404 1.25 93,005 1.50 111,606 MENA28,864 1.15 33,194 1.25 41,492 1.50 49,790 Global 542,661 616,056 745,769 876,539 *ECMT standard adjustment factors applied from Table 2.7 9 crash injury estimates for 1999 of at least: 11 million in HMCs; 12 to 23 million in LMCs; global estimate of between 23 and 34 million road crash injuries per annum. This estimate is approximately twice other current global road injury figures (GRSP, 1999). An estimate of the number or percent of injuries that are disabling was beyond the scope of this review. 2.7 Fatality forecasts Forecasting future deaths worldwide is fraught with difficulties. For example, past trends may be thought to give a reasonable picture of what may happen in the future. However some countries, such as Japan experienced rapid deterioration in road safety in the 1960s with an 80 per cent growth in road fatalities but then with massive investment reduced deaths by almost 50 per cent over the next decade. However deaths started to increase once again in the early 1980s due in part to a continued increase in vehicle ownership but with a slowing down of investment in life- saving activities. Additionally, trends in many parts of the world are not consistent and there is evidence (see Section 4) that rapid increases of deaths in Africa and Asia/Pacific show signs of slowing down (that said growth rates in Africa and Asia are still high and of concern). Social, political, and economic changes may also play a part and ideally would be taken into account in any forecasting activity. However, these changes are difficult to predict. For example, in the CEE region, changes in motor crash reporting most likely has changed with the transition to market economies. Whilst the trend in this region is one of fewer fatalities, it is probable that with economic development and rapid motorisation, there is potential for growth in the number of crashes and fatalities. Forecasting future trends should be approached cautiously for the reasons outlined above. With these caveats in mind, we suggest that for 2010 the likely range of global road deaths will be between 900 thousand and 1.1 million and between 1 million and 1.3 million in 2020. 2.8 Summary Based on officially reported fatalities, this study has attempted to produce a realistic estimate of global road crash deaths for the year 1999. Different recording definitions and procedures have been considered, as has the impact of under-reporting. One of the main objectives of this report was to document the estimation process and the data reliability. As the data has been shown to have many weaknesses, the estimate produced is considered to be realistic but conservative and the true toll could be higher. The fatality estimate produced may be lower than the WHO figure but it still indicates that road crashes are a cause for concern. The burden of road fatalities is on the LMCs where 86 per cent of the world’s road fatalities occur, with almost half of all fatalities in Asia. Figure 2 shows the regional distribution of 750,000 fatalities, the low end of the range suggested for 1999.It should also be borne in mind that fatalities are only the tip of the casualty iceberg and that road safety, especially road safety engineering, is concerned with the reduction of injury road crashes. Worldwide, at least 30-45 people are being injured for every life lost. However, data on injuries and their social and economic impacts is very limited, and it is outside the scope of this study to present trends in injuries. It can reasonably be assumed that serious injuries have a major social and economic impact. Nationwide costs of road crashes (including those for injury accidents) are presented in the following chapter. 3 Economic costs of road crashes 3.1 Introduction Apart from the humanitarian aspect of reducing road deaths and injuries in developing countries, a strong case can be made for reducing road crash deaths on economic grounds alone, as they consume massive financial resources that the countries can ill afford to lose. That said, it must of course be borne in mind that in developing and emerging nations, road safety is but one of the many problems demanding its share of funding and other resources. Even within the boundaries of the transport and highway sector, hard decisions have to be taken on the resources that a country can devote to road safety. In order to assist in this decision-making process it is essential that a method be devised to determine the cost of road crashes and the value of preventing them. The first need for cost figures is at the level of national resource planning to ensure that road safety is ranked equitably in terms of investment in its improvement. Fairly broad estimates are usually sufficient for this purpose, but must be compatible with competing sectors. For example, in a recent road safety study undertaken in Mauritius, it was shown that the annual cost of road crashes nationally was about £20 million. A series of safety improvements were outlined, which, it is estimated would reduce the cost of crashes by 5 per cent per annum (i.e saving £1 million p.a.). These improvements (in highway design and layout, education, training and enforcement), were estimated to cost £500,000 in a programme of measures set over a five year period (i.e. at an average annual cost of £100,000). The average First Year Rate of Return on investment was therefore about 1000 per cent and the Benefit:Cost ratio Asia & Pacific 44% HMC 14% Latin/Central America & Caribbean 13% Central/East Europe 12% Africa 11% Middle East 6% Figure 2 Estimated road fatality regional distribution (1999) 10 about 10:1. High rates of return such as these are fairly common in road safety appraisals and (apart from the humanitarian aspects), illustrate the economic benefits of investing in national road safety programmes.A second need for road crash cost figures is to ensure that the best use is made of any investment and that the best (and most appropriate) safety improvements are introduced in terms of the benefits that they will generate in relation to the cost of their implementation. Failure to associate specific costs with road crashes will almost certainly result in the use of widely varying criteria in the choice of measures and the assessment of projects that affect road safety. As a consequence it is extremely unlikely that the pattern of expenditure on road safety will, in any sense be ‘optimal ’ in terms of equity. In particular, if safety benefits are ignored in transport planning then there will inevitably be associated under-investment in road safety. A study conducted almost a quarter of a century ago (Fouracre and Jacobs, 1977) estimated road crashes to cost on average 1 per cent of a country ’s gross national product (GNP). This figure has been used by many countries and international aid agencies to estimate the scale of costs incurred by road crashes but as countries have developed, a higher range, 1 to 3 per cent has been suggested by the World Bank and others for road crash costs. Expressing crash costs as a percentage of GNP provides an albeit crude but useful approach to costing accidents, particularly on a global or regional basis. That said, there is no real substitute in individual countries to carrying out a detailed appraisal of national accident costs. 3.2 Methods available to cost road crashes The cost of road crashes will be influenced by the valuation method used. In their papers on the cost of traffic accidents and evaluation of accident prevention in developing countries, Hills and Jones-Lee (1981, 1983) identified six different methods that have been proposed for placing a cost on road accidents. They made the point that the appropriate method to use in any particular context may depend upon the objective and priorities of those who intend to use the costs and values concerned. The reasons for costing road accidents are most likely to be either the maximisation of national output or the pursuit of social welfare objectives (such as the minimisation of injury accidents or fatalities in relation to traffic). The only accident costings/valuation methods that appear to be directly relevant to these two objectives are: a the ‘gross output ’ or ‘human capital ’ (HC) method (well suited to the objective of maximising the wealth of a country); and b the ‘willingness to pay ’ (WTP) method (especially for social welfare maximisation and for the use in cost- benefit analyses). If accident costs and values are ultimately intended for use in conventional cost-benefit analyses in order to determine the most efficient way of allocating scarce financial resources, then the most appropriate method to use by far is the willingness to pay approach. However, Whilst this method has been adopted in countries such as UK, USA, New Zealand and Sweden, the difficulty of obtaining reliable empirical estimates has been considered. It seems unlikely that reliable willingness-to-pay costs and values will be available for use in most Asian and African countries for some time. (Certainly until detailed studies of its use and application have been carried out in one or two countries). It was recommended that the gross output approach is used to cost road accidents in the countries of Africa and Asia. However, in order to try to capture some of the ‘humane ’ considerations reflected in the willingness to pay approach, gross output values should be augmented by a further allowance for ‘pain, grief and suffering ’ of those involved in road crashes. This, in fact was the approach employed in the UK prior to the recent adoption of the willingness to pay approach. 3. 3 Results of crash costing procedures A summary of results from a range of HMCs and LMCs is shown in Table 10. For a critique on costing road accidents, please see TRL Overseas Road Note 10. A recent World Bank Working Paper on Road Traffic Safety in the Europe and Central Asia Region estimated crash costs per country on the basis of average EU crash costs. Costs were estimated according to their GNP per capita figure (i.e. if a country ’s GNP per capita was 1/10 that of the EU ’s then crash costs were assumed to be 1/10 average EU crast costs). Total costs were estimated on the basis of the number of reported fatalities and injuries with a standard casualty rate per crash. This approach estimated crash costs to range from 1.1 per cent (Georgia, Turkmenistan) to 3.3 per cent (Slovenia). The overall (unweighted) average was almost 2.0 per cent (Blomberg, 1999). It should be noted that the valuations differ in their accommodation of un-reported crashes. For instance, the USA ’s estimate is for unreported crashes while in UK, unreported damage-only crashes are included but the valuation of injury crashes is limited to those reported to the police. The latter is believed to be the case for most costings in HMCs. 3. 4 Summary From the above table it can be seen that road crash costs, expressed as a percentage of GNP range from 0.3 per cent in Vietnam to almost 5 per cent in USA, Malawi and Kwa Zulu, Natal. Overall it does appear that in most countries, costs exceed 1 per cent of GNP which may now be considered to be an under-estimate of national accident costs. However, the figures also indicate that costs as a percentage of GNP may be lower in less developed countries and therefore caution should be exercised in moving from 1 per cent of GNP to a much higher level for developing countries. The following table provides a crude estimate of global and regional costs assuming that the annual cost of road crashes is about 1 per cent in developing countries, 1.5 per cent in transitional countries, and 2 per cent in highly motorised countries. 11 Table 11 implies that road crash costs may be of the order of US$65 billion in developing and transitional countries, US$453 billion in highly motorised countries, making a crude estimated total of US$518 billion worldwide.and motorisation indicators for the ten countries with the largest number of road crash fatalities. (Indicators for all countries are included in the Appendix). A review of the change in the last decade in motorisation, fatalities and population follows with sub-regions or the largest country presented separately. Lastly, information on the type of road crash casualties, including road user type, age and gender distribution, is presented. Several indicators are used here as no single indicator accurately describes the traffic safety situation in a country. The most common method used in motorised countries is the number of injury crashes per million vehicle kilometres per annum (which relates crashes to a measure of exposure to traffic) but few developing countries have vehicle usage data. Instead, fatality rates, the number of reported fatalities per 10,000 motor vehicles, are regularly used to compare traffic safety records between countries. Yet fatality rates can be expected to be of less importance within a country than the actual number of deaths taking place. Fatality risk, the number of reported fatalities per 100,000 population, is the most common indicator used by the health sector to prioritise diseases and other causes of death. In this section therefore both fatality rates and risks are presented. Fatality rates will also be prone to error in that the level of accuracy in reporting motor vehicle fleet sizes will vary widely. Vehicle registration databases suffer similar problems to casualty databases with disincentives to register and difficulties in updating databases. Some Table 11 Road crash costs by region (US$billion) Estimated Regionalannual crash costs GNP Region 1997 GNP Cost Africa 370 1% 3.7 Asia2454 1% 24.5 Latin America/Caribbean1890 1% 18.9 Middle East 4951.5% 7.4 Central & Eastern Europe 6591.5% 9.9 Sub total5615 64.5 Highly motorised countries22,665 2% 453.3 Total 517.8 Table 10 Recent estimates of economic costs of road crashes Value Study Costing Percent US$mil Country year method GNP (1997) Source LAC Brazil 1997 HC 2.0% 15,681 IADB Review of Traffic Safety Asia Vietnam 1998 HC 0.3% 72 Technical Note: Accident Costing Bangladesh 1998 HC 0.5% 220 IDC Economics Working Paper Accident Costs Thailand 1997 HC 2.3% 3,810 SWEROAD Road Safety Master Plan Report Korea 1996 HC 2.6% 12,561 Elvik, 1999 Nepal 1996 HC 0.5% 24 Road Maintenance Component, TN Accident Costing 1996 Kerala, India 1993 HC 0.8%—Chand ‘Cost of Road Accidents in India-reference to Kerala Indonesia 1995 HC — 691- 958 Accident Costs in Indonesia: A Review June 1997 (Draft Copy), TRL/IRE Africa KwaZulu Natal 199? HC 4.5%—Kwazulu-Natal Road Traffic Safety Strategy (1996-2000) Tanzania 1996 HC 1.3% 86 1996 Road Safety Programme Tanzania Ministry of Works Zambia 1990 HC 2.3% 189 TOI Study Malawi 1995 HC <5.0% 106 SWK/Iberinsa Road Safety Study, 1997 MENA Egypt 1993 HC/CA 0.8% 577 Aly, ‘Valuation of traffic accidents in Egypt’, HMC UK 1998 WTP 2.1% 28,856 Road Accidents Great Britain: 1998 The Casualty Report Sweden 1995 WTP 2.7% 6,261 Elvik, 1999 Norway 1995 HC 2.3% 3,656 Elvik, 1999 Iceland 1995 WTP 3-4% 7,175 Arnason, Nordic Road & Transport Research,1996,v8, n3 USA 1994 WTP 4.6% 358,022 NHTSA Technical Report Germany 1994 HC 1.3% 30,173 Elvik, 1999 Denmark 1992 HC 1.1% 2,028 Elvik, 1999 New Zealand 1991 WTP 4.1% 2,441 Elvik, 1999 4 Regional analyses 4.1 Introduction This chapter provides a ‘snapshot’ summary of the road safety situation in the individual regions. However the differences within the regions are often as wide as those between them. The regional summary is presented in three parts starting with the current situation and basic safety 12 countries impose a de-registration fee so few motor vehicles are removed from the official registers while in many countries, owners try to avoid registering vehicles because of the associated fees. The recent PHARE report highlighted the difference between the number of registered vehicles reported by national experts and the IRF, with most countries having more vehicles registered than reported by the IRF (Phare,1999). It should be stressed again that this short study was limited to the use of available published data. In particular, several of the summaries are based on the road safety reviews recently undertaken in different regions of the world. 4.2 Highly motorised countries 4.2.1 Current situation While HMCs have the majority of the world’s motor vehicles (60%), they account for only 14-15 per cent of the global fatalities and population. There is less variation within HMCs in terms of motorisation and wealth as well as safety levels. Motorisation level, measured by the number of motor vehicles per 1000 population, varies by a factor less than two while the other indicators of GNP per capita and fatality rate and risk vary by four or less. The ten countries (see Table 12) summarised above represent 88 per cent of total HMCs population. Most HMCs have fatality rates of about 2 or less but the poorest countries of the region, Portugal and Greece, have rates twice as high and which are the highest in the region. Japan had the second largest number of fatalities but a good safety record with a fatality risk half that of the US and a fatality rate which was 40 per cent lower. Figures 3 and 4 show the latest fatality risks and rates values for all HMCs. Four countries have less than one motor vehicle per two people. In the UK, 30 per cent of households do not own a motor vehicle and so while this region is much moreTable 12 Basic indicators for 10 HMCs (1996) Fatality Motor Fatality risk -isation rate GNP (deaths/ level (deaths/ per Road 100,000 (mv/100010,000 capita fatalities pop) pop) mv) ($) USA 41,967 15.8 787 2.0 29,339 Japan 9,942 7.9 669 1.2 38,264 Germany8,758 10.7 559 1.9 28,335 France8,080 13.8 524 2.6 26,409 Italy 6,198 10.8 617 1.8 20,224 Spain 5,483 14.0 488 1.9 14,509 UK 3,598 6.1 408 1.5 20,946 Canada 3,082 10.3 573 1.8 19,856 Portugal 2,100 21.1 436 4.8 11,024 Greece2,068 19.7 497 4.0 11,688 PortugalGreece Luxembourg United StatesNew ZealandSpain France BelgiumAustriaIrelandItaly Australia GermanyCanada Denmark SwitzerlandJapan Finland Netherlands United KingdomSwedenNorwayMalta deaths/100,000 population 21.1 19.7 17.1 15.8 14.1 14.0 13.8 13.3 12.7 12.5 10.8 10.8 10.7 10.3 9.8 8.7 7.9 7.9 7.1 6.1 6.1 5.8 3.8 motorised than the rest of the world, many remain without access to a motor vehicle. 4.2.2 Recent trends As shown in Figure 5, the safety record has improved over the past few decades in many HMCs. Annual road fatalities peaked over thirty years ago in the UK with 7,985 deaths (1966) and six years later for the USA (54,589 deaths). Fatality rates peaked much earlier with, for example the UK’s worst peacetime fatality rate of 4.5 occurring in 1930. With the US accounting for 41 per cent of the country group’s fatalities, trends are shown separately for the US and the other nine HMCs. The safety record has continued to improve in both the US and other HMC countries with fatalities decreasing while motorisation increases. Progress was even greater among the other HMC countries with a slightly larger decrease in fatalities but a motorisation and population increase almost twice that experienced in the US. motorisation increases. Progress was even greater Figure 3 HMC fatality risk (1996) 13 among the other HMC countries with a slightly larger decrease in fatalities but a motorisation and population increase almost twice that experienced in the US. The continued fatality reduction in HMCs is due to the combined effect of many measures: road safety awareness campaigns, legislation (e.g. making wearing seatbelts compulsory), driver training, road engineering and higher safety standards for vehicles. Whatever the reasons, this experience demonstrates that it is possible to reduce the number of road crash deaths through investment in road safety measures whilst the number of vehicles on the road is increasing. The recent experience of Victoria State, Australia shows how quickly a significant fatality reduction can be achieved. Since 1990, road deaths and serious injuries have been halved while injury crashes overall have decreased by one third. The ‘Victoria Solution’ involved the police, highways authority, and the state’s statutory monopoly third partyinsurers joining forces in strict enforcement of speeding and drink drive violations (Corrie, 1998). 4.2.3 Road crash casualties Road user type Not surprisingly, given the high level of motorisation, car fatalities dominate in most of the HMCs. Japan is the only HMC country reporting the number of pedestrian fatalities as being equivalent to that of car occupants (see Table 13). In many HMCs, pedestrian fatality involvement was one third to one fifth that of car occupants. Pedestrian involvement can be expected to be higher in urban areas, with for example pedestrians accounting for half of road fatalities in London (DETR, 1997) Table 13 Road fatality by class of road user Car Pedestrian USA 52% 13% Japan 28% 28% Germany 61% 13% France 63% 12% Italy 55% 13% Spain 53% 17% United Kingdom 50% 27% Canada 54% 13% Portugal 38% 23% Greece 42% 22% Source: DETR, Road Crashes Great Britain: 1998 PortugalGreeceIrelandSpain LuxembourgBelgiumFrance DenmarkAustria New Zealand United StatesGermanyAustraliaCanadaItaly Finland Netherlands United KingdomSwitzerlandSwedenJapan NorwayIceland deaths/10,000 motor vehicles 4.8 4.0 3.4 2.9 2.8 2.7 2.6 2.3 2.3 2.2 2.0 1.9 1.8 1.8 1.8 1.7 1.5 1.5 1.4 1.3 1.2 1.1 0.7 -8.7% -9.7% 9.8%17.0% 14.3%26.5% -20%0% 20% 40% USA other HMC fatalities population motor vehicles HMC 1986-96 Figure 4 HMC fatality rates (1996) Figure 5 Recent trends in the HMCs Gender and age distribution Based on the limited data readily available, females appear to represent approximately one third to one quarter of road fatalities (See Table 14). Where reported, female injuries 14 appear to be less serious than that of males with females having a larger share of total casualties than fatalities. Children accounted for a higher share of road casualties in the UK and USA than in other countries, for example, twice as high as that in Italy and Spain. The UK casualty involvement for the under 9’s is over three times that of Italy’s. Differences such as these are related to social patterns (e.g. whether children walk to school, whether they are accompanied and whether journeys are made in daylight) and, they could also be related to population distribution. Information on OECD countries has come from the publication ‘Road Traffic Statistics in Europe and North America’, which uses the age group 25-64. Not surprisingly more than 50 per cent of casualties fall in this wide age group (see Table 15). However more detailed information from specific countries such as UK, USA etc show that about 45 per cent of casualties fall in the 20-40 age group. The adult working age cohort (21-64) accounted for over 60 per cent of all casualties in every country and over two thirds of all casualties in France.4.3 Asia and the Pacific On a regional basis, road deaths take the greatest toll on the Asia and Pacific region where 44 per cent of the world’s road deaths occur and only 16 per cent of the total motor vehicles are found. Current data was available on all of the Asian countries but only a few of the Pacific countries. The Asian Development Bank (ADB) financed a large scale regional road safety review in 1996. Much of the findings shown below are summarised from the study’s ‘Road Safety Guidelines for the Asian and Pacific Region’ as well as the report on ‘Vulnerable Road Users in the Asian and Pacific Region’ (ADB, 1998). The study used the sub- regions of newly industrialised economies (NIEs), Central Asia, Southeast Asia, South Asia, Central Asian Republics and Pacific Developing Member Countries (PDMC). The analysis here is based on official statistics. As stressed in Chapter 2, the under-reporting of road fatalities is intensive and several of the documented cases came from the Asia and the Pacific Region. For instance, the actual number of China’s road deaths have been estimated by the official Beijing Traffic Engineering Research Institute to be over 40 per cent greater than that reported in official statistics. Such discrepancies in data need to be re- emphasised here as it is quite likely that the actual current situation is much worse than that being reported and acknowledged. 4.3.1 Current situation From Table 16 it can be seen that China and India dominate the region (and in fact lead the world) in terms of road deaths. The more motorised countries, Thailand, Korea and Malaysia all lose a larger share of their citizens to road deaths with a fatality risk approximately 5 times that of China and India. Bangladesh with the lowest motorisation level, almost one hundredth that of Malaysia, has the lowest fatality risk but the worst fatality rate of the region. Malaysia is reported to have the highest fatality risk in the world. Fatality risks and rates for the Asia/Pacific region are presented in Figures 6 and 7. Table 14 Female casualty involvement Country Year FatalitiesTotal casualties USA*1994/95 33% 44% UK 1996 28% 43% France1995 30% N/a Spain 1994 23% N/a * Fatality data is from the first year and casualty data is from the second year Table 15 Road casualty by age distribution Age Denmark France Italy NorwaySpain UK USA 0-9 4% 5% 2% 5% 3% 7% 6% 10-14 4% 4% 2% 4% 3% 6% 4% 15-17 7% 8% 6% 7% 6% 7% 9% 18-20 12% 10% 9% 11% 11% 10% 10% 21-24 12% 17% 14% 11% 14% 11% 10% 25-64 51% 52% 55% 50% 50% 52% 54% >65 10% 8% 8% 9% 7% 7% 7% Unknown 2% 0% 4% 2% 6% 2% N/a Recent European Union research has found that for citizens under 45 years, the death rates from road crashes are more than six times higher than from cancer and 14 times higher than from coronary heart disease (Care On The Road, August 1999). The other traditional vulnerable age group, the elderly, i.e. those aged 65 years and above, accounted for a maximum of one out of every ten road casualties (Denmark). The elderly can be expected to represent a larger percent of fatalities, given their reduced ability to recover from trauma. In the UK, the over 60 age group has a pedestrian fatality rate more than 3 times its casualty involvement rate (15 per cent of pedestrian casualties, but 47 percent of pedestrian fatalities).Table 16 Key indicators for the Asia and the Pacific region Fatality Motor (deaths/ risk -isation 10,000 mv) (deaths/ level GNP per Road 100,000 (mv/1000Fatality capita Year fatalitiespop) pop) rate (US$) China 1995 71,495 6 23 26 868 India 1995 59,927 6 31 20 378 Thailand 1996 16,782 28 294 10 2,761 Korea (Rep)1996 12,653 28 263 11 n/a Indonesia 1995 10,990 6 73 8 1,124 Malaysia1996 6,304 31 362 9 4,775 Vietnam1996 5,581 7 70 11 319 Turkey1996 5,428 9 83 11 3,179 Pakistan 1996 4,288 3 18 17 484 Bangladesh 1996 2,041 2 4 45 362 Sri Lanka1995 1,916 11 42 25 808 15 MalaysiaThailand Korea, Republic of Brunei DarassalamFiji Mongolia Sri LankaTonga Turkey Vietnam Singapore Papua New GuineaIndia China Western SamoaIndonesiaLaos Nepal Pakistan Myanmar Cambodia BangladeshPhillipinesBhutan deaths/100,000 population 31 28 28 22 11 11 10 10 9 7 7 7 6 6 6 6 4 4 3 2 2 2 1 1 Tonga BangladeshMyanmarMongoliaChina Papua New GuineaSri LankaIndia PakistanVietnam Korea, Republic ofTurkey Thailand MalaysiaLaos Indonesia Hong KongBhutan Brunei DarassalamSingaporeCambodiaPhillipinesTaiwan Fiji deaths/10,000 motor vehicles 52 44 37 30 26 25 25 20 17 11 11 10 10 9 8 8 8 5 4 4 4 3 2 2 Figure 7 Asia/Pacific fatality rates (1996) Figure 6 Asia/Pacific fatality risk (1996) 16 4.3.2 Recent trends Major changes have taken place in the Asia Region within the last few years (see Figure 8). Motorisation has increased at a rapid rate, largely with the growth in motorcycles. The number of motor vehicles almost trebled in China and more than doubled in the other large Asian countries in less than a decade.motorcyclists, etc. in different Asian countries. The highest percentages of pedestrian deaths (of the total) were found in Hong Kong (67 per cent), Korea and Sri Lanka (48 and 45 per cent respectively). Conversely, the percentage of pedestrian deaths in Thailand and PR China were particularly low, and even cyclist/non motorised vehicle (NMV) fatalities were reported to be low in China. Gender and age distribution Female road casualty involvement was relatively high in the region with Taiwan reporting the highest of all LMCs. Bhutan also had a surprisingly large female road casualty share (See Table 18). Table 17 Percentage crash distribution by Vulnerable Road User (VRU) type All VRU Pedestrian NMV Motorcycle Fatal Injury Fatal Injury Fatal Injury Fatal Injury NIE Hong Kong, China 81 56 67 35 4 4 10 17 Republic of Korea 55 n/a 48 n/a 0 0 7 6 Singapore 84 91 25 17 8 5 51 69 Taiwan, China 89 80 19 13 6 5 64 62 Central Asia China* 30 N/a 11 9 9 n/a 10 74 Southeast Asia Malaysia* 78 68 15 6 6 5 57 57 Thailand n/a n/a 9 n/a 4 n/a n/a na South Asia Sri Lanka 78 93 45 48 17 19 16 26 PDMC Fiji 47 n/a 43 n/a 3 n/a 1 9 Samoa n/a 52 n/a 37 n/a 6 n/a n/a *Data relates to fatalities and injuries instead of fatal and injury crashes. Source: ADB Vulnerable Road Users (1998) Table 18 Casualty distribution by gender (1993) Country Female Hong Kong, China 33% Taiwan, China 49% Bhutan 38% Korea 30% Turkmenistan 23% Tonga 17% Western Samoa 35% Source:ESCAP Asia-Pacific Road Crash Statistics and Road Safety Inventory fatalities population motor vehicles Asia 1987-1995 40% 39% 9%16% 183% 113% 0% 50% 100% 150% 200% China other Asian countries Figure 8 Recent trends in Asia Population growth was maintained to less than 10 per cent for China, almost half that elsewhere in the region while road deaths increased by 40 per cent in China as in the other nine Asian countries. Accordingly, the personal risk of being killed in a road crash has more than quadrupled in China and more than doubled in the other nine Asian countries. 4.3.3 Road crash casualties Road user type The following table examines the involvement of vulnerable road users, i.e. pedestrians, cyclists, andAs shown in Table 19 and as could be expected, the young and the elderly had a higher fatality involvement than with injuries but the vast majority of pedestrian casualties occurred to the economically active cohort (21-60 years). 4.4 Central and Eastern Europe The CEE Region accounts for 12 per cent of the world’s fatalities, almost twice its share of population or motor vehicles (6-7%). In terms of the number of fatalities per person, it has one of the worst personal safety record of all 17 the regions. While current crash and casualty data was readily available for the region, trend data is difficult to collect on many countries and discrepancies, especially with motor vehicles, are frequent. The European Union recently funded a Phare Multi- Country Road Safety Project that reviewed the road safety situation in 13 countries. Crash data and sector activity was analysed as with the donor funded reviews in Asia and the Pacific and the Latin America and the Caribbean studies. The summary below is based on the PHARE project findings. 4.4.1 Current situation The ten countries summarised below account for about 87 per cent of the regional population. Russia clearly dominates the fatality situation with both half of the region’s fatalities and also the highest fatality risk. Russia’s per capita risk of dying in a road crash is over three times that of the Ukraine’s (See Table 20). Figures 9 and 10 shows the fatality risks and rates for all CEE countries with data available. Motorisation ranges widely in the region with the Czech Republic reporting near one vehicle for every two people, almost ten times that of Azerbijan.4.4.2 Recent trends Trend data were available for very few countries and these did not include Russia. The recent experience of Poland is compared with that of Azerbijan, Lithuania, Bulgaria and Croatia in the figure below. Quite different experiences were reported with road fatalities rising by almost a third in Poland while they were to have decreased by over a third in the other countries. Population changed little with Poland reporting no change at all over the 8 year period. Motorisation increased much faster in Poland while in the other countries, where fatalities had decreased, the number of motor vehicles rose by less than 1 per cent per annum (See Figure 11) Table 20 Key indicators for Central and Eastern Europe Fatality Motor Fatality risk -isation rate GNP (deaths/ level (deaths/ per Road 100,000 (mv/1000 10,000 capita Year fatalitiespop) pop) mv) (US$) Russia1996 29,468 20 140 14 2,673 Poland 1996 6,359 17 291 6 3,597 Ukraine1996 3,259 6 n/a n/a 1,038 Romania 1996 2,845 13 140 9 1,406 Kazakhstan1996 2,732 17 82 20 1,294 Byelarus1996 1,730 17 153 11 2,144 Czech Republic1996 1,386 13 457 3 5,230 Hungary 1996 1,367 13 289 5 4,489 Yugoslavia 1996 1,276 12 185 6 N/a Bulgaria 1996 1,014 12 297 4 1,167 Table 19 Age distribution for pedestrian casualties Fiji Malaysia Papua New (1992) (1994) Guinea (1992) Age Death Injury Death Injury Death Injury Under 15 16% 10% 11% 10% 24% 16% 16-20 7% 14% 21% 24% 9% 13% 21-60 67% 63% 58% 62% 65% 70% Over 60 10% 3% 10% 4% 1% 0% Source: ADB Vulnerable Road Users (1998) Latvia Russia Slovenia LithuaniaByelarus KazakstanPoland Croatia Estonia Kyrgyzstan Czech RepublicHungary Romania Republic of MoldovaBulgaria YugoslaviaSlovakia Tajikstan AzerbijanArmeniaGeorgiaAlbania MacedoniaUkraine deaths/100,000 population 22 20 20 18 17 17 16 15 15 14 13 13 13 13 12 12 12 10 10 10 9 8 8 6 Figure 9 Central/Eastern Europe fatality risk (1996) 18 4.4.3 Road crash casualties Road user type The Phare Study reported the overall pedestrian involvement for Eastern European countries for which data was available at 30 per cent. Some countries had a much higher pedestrian involvement rate, including 50 per cent in Romania and Kazakhstan and 60 per cent in Albania. Bus crashes were much less common (i.e. similar to that in HMCs) with only 1-2 percent of crashes in Estonia, Latvia and Slovenia (Phare, 1998). Gender and age distribution Females accounted for 1 out of every three to four road casualties in the region (See Table 21). Not surprisingly, KyrgyzstanAlbania Azerbijan Kazakstan Bosnia and HerzegovniaRussiaLatvia ByelarusGeorgia RomaniaCroatia Lithuania YugoslaviaPoland MacedoniaSloveniaSlovakia HungaryEstonia Bulgaria Czech Republic deaths/10,000 motor vehicles 41 24 20 20 19 14 11 11 10 9 7 7 7 6 5 5 5 5 4 4 3 fatalities population motor vehicles Central/Eastern Europe 1988-96 31% -36% 0%5% 43% 12% -50%0% 50% Polandother CEE countries Figure 10 Central/Eastern Europe fatality rates (1996) Figure 11 Recent changes in Central/Eastern Europethe countries with higher level of motorisation reported more female involvement in road casualties. Females represented more casualties than fatalities. Table 21 Casualty distribution by gender Country Year Casualty type Female Russia1995Fatalities only 25% Kazakhstan1995Fatalities only 24% Bulgaria 1997All casualties 32% Estonia1997All casualties 34% Latvia1997All casualties 32% Slovenia 1996All casualties 33% There was less of an identifiable regional pattern with the age distribution of road casualties. Poland reported an exceptionally low rate of children involvement while Estonia and Latvia appeared to have a high proportion of child casualties. Working age adults (between the age of 19 and 59) accounted for between two-thirds to three quarters of all road casualties. The age cohort experiencing the largest number of casualties was the 30-49 year olds (See Table 22) with all five countries reporting a minimum of one quarter of all casualties from this age group. 4.5 Latin America and the Caribbean The Latin America and the Caribbean (LAC) region has a higher share of fatalities (13%) and motor vehicles (14%) than it does of global population (9%). Crash data was available on 25 of the 33 countries (95 % population representation). 19 The summary presented below is based on the Inter American Development Bank funded ‘Review of Traffic Safety Latin America and Caribbean Region’ (IADB, 1998) and has been updated where data has since become available. 4.5.1 Current situation The ten countries summarised below (See Table 23) are all from the South American sub region and account for over 90 per cent of the region’s fatalities. As in the other regional summaries, official reported fatality data has been used but the problem of under-reporting needs to be highlighted. The IADB review reported Argentina’s true fatality figure to be 30 per cent higher than reported while in Brazil, the actual number of fatalities could be 50-80 per cent higher (IADB, 1998). Mexico has been excluded as its fatality reporting is limited to national highways only. Peru is included but its under-reporting is serious with less than two injuries being reported for every road fatality. Venezuela and Nicaragua were reported to have begun collecting casualty data from hospital to supplement police data.Venezuela has the second worst fatality rate in the LAC region. Fatality risks and rates for all LAC countries with data available are presented in Figures 12 and 13. 4.5.2 Recent trends The Caribbean region experienced the greatest change in the last decade with motorisation almost doubling and road fatalities growing even faster. In the other two regions, motor vehicles grew twice as fast as fatalities. The rate of increase in road deaths was twice that of population in Mexico and Central America and South America and over 7 times that of population in the Caribbean. Thus the relative risk of road deaths increased throughout all LAC but dramatically so in the Caribbean. Motor vehicle ownership is still low for the region overall with half of the countries reporting motorisation levels of under 100, i.e. less than 10 per cent of the population have access to a motor vehicle. 4.5.3 Road crash casualties Road user type Data from the Latin America/Caribbean study showed wide variation in road user type involvement with little consistency reported within the sub-regions. Despite the region’s low motorisation level, pedestrians and bus passengers only accounted for over half of all fatal road crashes in Honduras and Peru (See Table 24). Mexico’s high rate of car involvement reflects the data being limited to federal highways only but the low rate of pedestrian involvement is still surprising. Car involvement was substantial in several countries. Bus involvement was low overall (though still varying by 9 times) and Ecuador appears to have a problem with commercial vehicles. Table 22 Casualty distribution by age Age Bulgaria Estonia Latvia Poland Slovenia <18 11% 23% 24% 3% 19% 19-24 7% 17% 15% 10% 20% 25-29 16% 12% 12% 26% 13% 30-49 26% 28% 30% 25% 31% 50-59 25% 10% 9% 24% 8% 60+ 14% 10% 11% 12% 9% Table 23 Key indicators for the LAC region Fatality Motor risk -isation Fatality GNP (deaths/ levelrate per Road 100,000 (mv/1000 (deaths/ capita Year fatalitiespop) pop)10,000 mv) (US$) Brazil1996 26,903 16 10 162 4,859 Colombia 1995 7,874 21 55 38 2,326 Argentina 1996 6,473 18 12 155 9,066 Venezuela1995 2,563 11 58 20 3,555 Peru1996 2,163 8 25 36 2,622 Chile 1996 1,925 13 11 113 4,890 Cuba 1996 1,424 12 20 64— Ecuador1995 1,112 9 21 45 1,606 Uruguay 1996 693 21 33 65 6,255 El Salvador1996 656 12 12 103 558 Brazil’s fatalities account for 46 per cent of the region’s total which is over 3 times as large as the next country’s, Colombia. Yet in terms of risk to population, Colombia, Uruguay and Argentina are reported losing a higher percentage of their citizens in road crashes. Brazil has the highest motorisation level of the larger LAC countries and has 8 times more vehicles per capita than does Venezuela. Yet the Bahama’s motorisation level (453 mv/1,000 pop) is almost three times that of Brazil’s. As shown in Figure 12, Guyana has the region’s worst fatality rate (238 deaths/10,000 mv), while Colombia’s fatality rate is one of the worst as is its fatality risk level,Table 24 Fatal road crash by road user/vehicle type Pedes Comm. Motor Country Year -trian Car Bus veh -cycle Other Caribbean Dominican 1995 15% 27% 5% 17% 29% 7% Republic Trinidad and 1993 29% 48% 2% 16% 2% 3% Tobago Mexico & Central America Honduras1995 25% 41% 16% 12% 3% 3% Mexico* 1995 2% 93% 3% n/a n/a 2% South America Chile 1995 24% 48% 10% 11% 2% 5% Ecuador1995 14% 19% 18% 44% 3% 2% Peru1995 45% 9% 9% 19% 1% 17% Uruguay 1993 5% 58% 4% 14% 11% 8% * Highway fatal crashes only Source: IADB, 1998 Gender and age distribution As with the other LMC regions, female fatality involvement was low with approximately one of every five fatalities being female. There was little variation between the countries reporting with females accounting for between 19 and 23 per cent of all fatalities (See Table 25). 20 VenezuelaColombiaBelize Uruguay El SalvadorNicaraguaHondurasEcuadorCuba Panama Trinidad and TobagoSaint LuciaArgentinaChile Brazil Jamaica Costa RicaBolivia BarbadosBahamas ParaguayMexicoPeru deaths/10,000 motor vehicles 58 55 34 33 31 28 26 21 20 15 13 12 12 12 10 9 5 5 4 4 4 3 2 Figure 13 Latin/Central America and the Caribbean fatality rates (1996) Belize Uruguay Colombia Trinidad and TobagoGuyana ArgentinaBahamasBrazil PanamaJamaicaChile Cuba Saint LuciaVenezuela El SalvadorNicaraguaEcuador BarbadosPeru Honduras Costa RicaMexicoBolivia Paraguay deaths/100,000 population 31 22 21 20 20 18 18 17 16 14 13 13 13 11 11 10 10 9 9 9 8 4 3 2 Figure 12 Latin/Central America and the Caribbean fatality risk (1996) 21 Of the three countries with casualty age data available, Chile’s child involvement was highest with one of every seven casualties involving a child, over twice that of Honduras. The working age cohort (15-59 years) represented the majority of all crash casualties in the three countries reporting casualty age with 92 per cent of all casualties in Honduras coming from this age group (See Table 26). Argentina appears to have a problem with the elderly in road crashes with one of every five casualties being over 60 years of age.Africa to the regional studies recently undertaken in Asia, Eastern Europe and Latin America/Caribbean. 4.6.1 Current situation There are wide differences within Africa with South Africa’s GNP per capita over 30 times greater and the motorisation level over 100 times that of Ethiopia. South Africa has more than twice as many vehicles per capita as does the next and neighbouring country of Zimbabwe. Four of the largest 10 countries have motorisation levels under 10. This extremely low motorisation level indicates it will be decades before the majority of families have access to a motor vehicle. The ten countries shown in Table 27 account for almost 90 per cent of all the road fatalities reported in the region. Two countries, South Africa and Nigeria, account for more than half of the region’s road fatalities. Africa may be known for having the highest fatality rates, but with the low number of vehicles, road crashes have not become a national health priority as relatively few people are killed. For instance, death rates (per 10,000 motor vehicles) may be ten times greater in Ethiopia than in South Africa but, in terms of per capita, South Africa’s road crash fatality risk is nine times greater than Ethiopia’s. Diseases such as malaria, HIV and tuberculosis pose a much greater threat to the regional population and rightfully take precedence on the health agenda. Fatality risks and fatality rates for African countries are shown in Figures 15 and 16. Latin America and the Caribbean (1986-95) 16%106% 17%25% 81% 45% 0% 20% 40% 60% 80% 100% 120% Brazil other LACs fatalities population motor vehicles Figure 14 Recent trends in LAC Table 25 Fatality distribution by gender Country Year Male Female Central America Mexico 1995 79% 21% South America Argentina 1993 77% 23% Brazil1993 78% 22% Chile 1994 81% 19% Colombia 1994 79% 21% Cuba 1995 77% 23% Ecuador1995 78% 22% Venezuela1994 80% 20% Source: WHO Statistics Yearbook 1996, IADB 1996 Table 26 Casualty distribution by age Argentina Honduras Chile Under 15 9% 6% 14% 15-39 47% 71% 66% 40-59 24% 21% 12% 60+ 20% 2% 8% Source: IADB, 1998 Table 27 Road safety indicators for 10 African countries Fatality Motor risk -isation Fatality GNP (deaths/ levelrate per Road 100,000 (mv/1000 (deaths/capita Year fatalitiespop) pop)10,000 mv) (US$) South Africa1994 9,981 27 158 173458 Nigeria1993 8,958 8 12 65 291 Algeria1993 3,678 13 52 241529 Kenya1993 2,516 9 14 64 353 Ethiopia 1996 1,693 3 1 195 112 Uganda1995 1,594 8 7 122 335 Tanzania1994 1,548 5 5 111 217 Zimbabwe1996 1,205 11 64 17 730 Malawi1996 1,090 11 6 193 213 Zambia1996 928 10 26 39 384 Source: IRF 1999 and country studies 4.6 Africa Africa’s global road fatality share is three times as large (11%) as it’s motor vehicle share. Crash data was available on only half of African countries but those countries accounted for two-thirds of the regional population. Even less series data was available, especially with motor vehicle data, and it was not possible to identify the recent trend in motorisation save for South Africa. It should be noted that there is, to date, no equivalent in4.6.2 Recent trends As shown in Figure 17, South Africa’s experience has been quite different from other countries. The road fatality toll has grown by over a quarter in the other large African countries (Nigeria, Kenya, Ethiopia, Tanzania, Malawi and Zambia) over the past several years. South Africa, on the other hand, experienced a boom in both motorisation and population while road fatalities, since peaking in 1991, appear to have stabilised at approximately 10,000 fatalities per year. The relative personal safety risk doubled for many African countries while it decreased for South Africa (although by comparison it is still very high). 22 SwazilandBotswana South AfricaLesotho MauritiusAlgeria Cape VerdeMalawi ZimbabweGabon Zambia SenegalKenya UgandaNigeriaBenin Guinea CameroonTanzaniaCongo Ethiopia Central African RepSierra LeoneMali Chad Madagascar deaths/100,000 population 31 28 27 16 13 13 12 11 11 10 10 9 9 8 8 7 6 6 5 5 3 2 2 1 0.3 0.2 Central African RepEthiopiaMalawi UgandaGuinea Cape VerdeTanzaniaLesothoNigeriaKenya Senegal Botswana CameroonSwazilandZambiaGabon AlgeriaCongo Sierra LeoneSouth AfricaZimbabweMali MauritiusBeninChad Madagascar deaths/10,000 motor vehicles 339 195 193 122 121 112 111 87 65 64 64 62 52 44 39 28 24 23 21 17 17 16 15 14 7 3 Figure 15 Africa fatality risk (1996) Figure 16 Africa fatality rates (1996) 23 4.6.3 Road crash casualties Casualty information was limited to the few countries where published data was found. An earlier study found that single vehicle collisions (including pedestrian crashes) accounted for two thirds of all crashes in Zimbabwe, Botswana and Ghana (Gorell, 1997) Road user type Consistent with the increased motorisation level, drivers accounted for a much larger share of road fatalities in South Africa and Zimbabwe than in Ethiopia or Zambia. However pedestrians were the most frequently reported road fatality type in all the countries save for Botswana and Malawi where passenger deaths dominated. Kenya and Tanzania also reported cyclist fatality involvement of 9 and 11 per cent respectively while motorcyclists represented 2 per cent of road fatalities in both countries (Assum, 1998).involvement was lower in Zimbabwe where only one out of every six road casualties female. Five per cent of the drivers killed in road crashes in Ethiopia were women. Children aged under 15 are estimated to represent half of Africa’s population. In relative terms, their crash involvement rate is low overall (See Table 29) but higher for pedestrians. In Zambia, boys were reported to have an involvement rate 50% higher than girls for all casualty severities. Table 28 Road fatality distribution by road user type Country Year Driver Passenger Pedestrians Ethiopia 1998 7% 43% 51% Kenya1995 11% 34% 44% Malawi1994 10% 53% 37% South Africa1994 27% 32% 41% Tanzania1995 6% 41% 40% Zambia1996 8% 38% 54% Zimbabwe1996 28% 27% 44% Source: Dhliweyo (1997), Assum (1998) and TRL internal reports Africa 1987-95 1%26% 25% 14% 22% 0% 10% 20% 30% South Africa other African countries fatalities population motor vehicles Figure 17 Recent trends in Africa There is also a clear difference between the pattern of casualties in urban and rural areas. In urban areas of Zambia, pedestrians account for two-thirds of fatalities and over half of all road traffic casualties compared to only 30 per cent of fatalities and 12 per cent total casualties in rural areas. Likewise in Ethiopia, pedestrians represented 85 per cent of all casualties within Addis Ababa yet only 40 per cent nationwide, second to passengers (50 per cent). Gender and age distribution Road casualty distribution by gender was available for Ethiopia and Zimbabwe while Zambia only records the gender of child casualties. In Ethiopia, females accounted for one out of every four road traffic casualties and the distribution was consistent with all casualty severities. CrashTable 29 Child road casualties (1996-98) Casualties Pedestrians Fatal Total Fatal Total Ethiopia 14% 12% 20% 20% Zambia 14% 10% 18% 20% Zimbabwe 9% 7% 20% 22% 4.7 Middle East and North Africa With only 2 per cent of the world’s motor vehicles, 4 per cent of the world’s population reside in the Middle East and North Africa (MENA) region which experiences 6 pe cent of the global road fatalities. Of the 18 countries assigned to this region, crash data was found for 13 of the countries (88 % regional population) The analysis below is based on published data and country reports. Bahrain, despite having the fewest number of road fatalities of all countries reporting, is to be credited for producing an annual traffic crash facts booklet which includes much data, summary and even collision diagrams at the country’s worst locations. 4.7.1 Current situation Key indicators are shown below for all countries with crash data available but it should be noted that the data is almost five years old for several countries, including the two countries with the largest number of road deaths, Egypt and Saudi Arabia. Fatality risk in Saudi Arabia is three times that of Egypt but conversely Egypt has a higher fatality rate. See Figures 18 and 19 for fatality risks and rates in order of severity. Three countries, Israel, Bahrain and Lebanon have much higher motorisation levels than the rest of the region (See Table 30). Despite Israel reporting a GNP per capita almost five times that of Lebanon, the latter has a higher motorisation level. Saudi Arabia has a low motorisation level considering its relatively high per capita income. 4.7.2 Recent trends From the limited data available, road deaths appear to be a growing problem in the MENA region (See Figure 20). In recent years, road deaths have grown faster than population, 40 per cent faster in Saudi Arabia and more than 60 per cent faster in the countries of Bahrain, Israel, Lebanon, Morocco, Syria, and Yemen. Motor vehicle data was limited and often suspect with Saudi Arabia, for example reporting a motor vehicle fleet almost halving between 1991 and 1993. The other countries reported an increase of 15 per cent in motor 24 Oman Saudi Arabia Libyan Arab JamCyprusJordanSyria MoroccoBahrainYemen deaths/100,000 population 24 21 21 17 13 11 10 10 8 Figure 18 Middle East and North Africa fatality risk (1996) Syria YemenJordan Oman Saudi ArabiaBahrain deaths/10,000 motor vehicles 36 24 19 16 14 3 Figure 19 Middle East and North Africa fatality rates (1996) Middle East/North Africa (1988-1995) 41% 22% 36% 58% 0% 20% 40% 60% 80% Saudi Arabia Other MENA countries fatalities population Figure 20 Recent trend in MENA regionvehicles between 1993 and 1996, with Israel and Syria experiencing rises of 22 and 24 per cent respectively. 4.7.3 Road user type Pedestrian deaths as a percentage of all road fatalities are amongst the world’s highest in this region, with Lebanon reporting the highest pedestrian fatality involvement rate for any country in this study (See Table 31). Table 30 Key indicators for the MENA region Fatality Motor risk -isation Fatality GNP (deaths/ levelrate per Road 100,000 (mv/1000 (deaths/capita Year fatalitiespop) pop)10,000 mv) (US$) Egypt 1994 4,400 7 37 20 1,218 Saudi Arabia1994 4,077 21 151 14 7,390 Iran1995 2,963 5 81 6 1,738 Morocco 1996 2,807 10 n/a n/a 1,272 Syria 1995 1,524 11 29 36 1,148 Yemen1996 1,267 8 34 24 279 Libya 1996 1,080 21 n/a n/a n/a Jordan1996 552 13 68 19 1,567 Israel1997 530 9 271 3 16,585 Oman1996 512 24 144 16 n/a Lebanon 1994 328 8 333 2 3,408 Cyprus1996 128 17 n/a n/a n/a Bahrain 1996 57 10 294 3 n/a Table 31 Pedestrian road fatalities Year Road fatalities Jordan1997 42% Bahrain 1997 33% Lebanon 1994 62% Pedestrians usually account for a smaller percent of injuries. For all casualties, Bahrain reported that 23 percent were drivers, 37 percent passengers and 20 percent pedestrians. In 1997, Jordan reported 244 pedestrian deaths with a further 5730 pedestrian injuries, for a pedestrian injury to fatality ratio of 23 to 1. Age and gender distribution Published data on road casualty distribution by gender was only found in two countries. Females accounted for 21 per cent of all traffic casualties in Lebanon and 29 per cent in Bahrain. Not surprisingly, males accounted for the highest percentage of driver casualties even in those countries where women were allowed to drive, e.g. 80 per cent in Bahrain. Lebanon reported high fatality involvement of both the young and the elderly; 25 percent of male and 35 percent of female fatalities occurred to those under the age of 24 while 38 per cent of male and 30 per cent of female fatalities involved those over the age of 55 (Choueiri, 1995). Jordan is reported to have a serious child pedestrian casualty problem with two out every three pedestrian casualties under the age of 20 (Elleveset, 1998). Bahrain also reported over half of all pedestrian casualties were under the age of 20. The youngest seem to be most at risk 25 with 38 per cent of all pedestrian casualties occurring to those under 10 years of age. 4.8 Summary This chapter has attempted to highlight the road safety situation within the various regions. It has shown that fatality rates (i.e death per 10,000 vehicles) were lowest in HMCs whilst the highest were found in African countries, particularly Ethiopia, Uganda and Tanzania. Fatality risk (i.e. deaths per 100,000) was highest in a disparate group of countries including Thailand, Malaysia, South Africa, and Saudi Arabia. In most of these analyses, as might be expected, values in Central and Eastern European countries lay closer to the HMCs, than to countries of Africa, Asia or Latin America. The relative regional share of fatalities, population and motor vehicles worldwide is shown in Table 32.tendency however was for females to be more involved in non fatal crashs than in fatal. This probably indicates the fact that females tend to be injured in urban crashes at lower speeds. The overall tendency was for there to be proportionately more females involved in both fatal and non-fatal crashes in the higher income countries. An analysis of casualties and fatalities by age showed that young people are involved in proportionately more crashes in Africa, Asia and the Middle East than in HMCs. In general the data from all regions indicated that crashes involving the economically active in the age group 25-40 dominate. 5 Summary and conclusions The GRSP was launched in order to ‘reduce the number of deaths, injuries and disabilities and associated social costs of road crashes through partnerships which promote collaboration and coordination of road safety activities among GRSP participants’. The World Bank, DFID (UK) and TRL agreed jointly to fund a study in order to assist the GRSP to define as best as possible the magnitude of the road safety problem, particularly in LMCs. The results of this study are presented in this report but it should be emphasized that the study itself has highlighted the difficulty in obtaining a reliable annual estimate of global road crash fatalities and injuries. Using published data as a base, the study estimates that in 1999 between 750,000 and 880,000 people may die as a result of road crashes and that the majority of these deaths are occurring in the LMC regions, with approximately half in Asia-Pacific. This compares with a recent estimate by the World Health Organisation of over a million deaths in 1998. Road fatalities, whether 750,000 each year or in excess of 1 million are still a leading cause of death and available data sources show that they are an even greater cause of premature mortality. Road fatalities are expected to continue to increase with a fatality toll between 900 thousand and 1.1 million in 2010 and reach between 1.1 million and 1.3 million in 2020. This study has also produced a fairly crude estimate of annual injuries which indicates that in 1999, between 23 to 34 million people were injured in road crashes worldwide. Due to the unreliability of the data and the extent of under- reporting, the severity of road crashes as a major cause of injury is being seriously under-estimated. Information from those countries which have attempted to cost road crashes on an annual basis now suggests that road crashes may be costing closer to 2 per cent of GNP per annum than the often used value of 1 per cent in motorised countries. However in developing countries costs are proportionately less than this and 1 per cent of GNP may still be a reasonable (but albeit crude) estimate. In transitional countries cost probably lies somewhere between the two. Estimates were derived of what this meant in global and regional terms and it was found the global cost in 1998 might have been of the order US$520 billion. The cost in the LMC regions, using the stated criteria, would have been about US$65 billion. Table 32 Distribution of road fatalities, motor vehicles and population Motor Fatalities vehicles Population HMC 14 60 15 Asia/Pacific 44 16 54 Central and Eastern Europe 12 6 7 Latin America and Caribbean 13 14 8 Africa 11 4 11 Middle East and Northern Africa 6 2 4 One of the most important differences between HMCs and the LMC regions is that over the last ten years or so the number of deaths taking place actually fell by about 10 per cent in HMCs, whilst in the Africa, Asia/Pacific and Latin America regions road deaths continued to rise. In Central and Eastern Europe there was a marked difference between Poland where deaths increased by 31 per cent and other countries where deaths fell. Over the period 1987-95 deaths in the Asia Pacific region rose by 39 per cent, in Africa by 26 per cent (excluding South Africa) and in the MENA region by over 36 per cent. In Africa and Asia there is now some evidence that the rapid increase in road deaths throughout the 1970s and early 1980s is now slowing down but nevertheless the problem still causes concern in these regions. As might be expected, the majority of people killed in HMCs are car drivers and passengers and about 20 per cent are pedestrians. In Asian countries a wide variation was found with, for example, almost 70 per cent of those killed being pedestrians in Hong Kong and about 50 per cent in Korea. In China, Malaysia and Thailand, pedestrian deaths were surprisingly low at around 10-15 per cent of the total. Conversely in Singapore, Taiwan (China) and Malaysia over 50 per cent of deaths were motorcyclists. In African countries, pedestrians were again one of the main classes of road users involved in fatal crashes. Pedestrian deaths also featured strongly in Middle Eastern countries (usually over 30 per cent of all deaths). An analysis of deaths by gender showed wide variation between countries (even within regions). The overall 26Trend data showed that the total number of people killed in road crashes in regions of the developing world continues to increase, whereas in the West there has been a steady decrease over the last fifteen years or so. For example, between 1987-1995 deaths in the Asia-Pacific rose by 40 per cent, in Africa by 26 per cent (excluding South Africa where deaths increased very little) and the Middle East/North Africa region by over 36 per cent. Road deaths doubled in a few Latin America countries and rose by 16 per cent in Brazil. Central and Eastern Europe showed wide variation with fatalities increasing in Poland by 31 per cent but while decreasing in other countries by about 36 per cent. Conversely road deaths in highly motorised countries fell by about 10 per cent. Growth rates are highly sensitive to the time period selected and analysis method used but the general trends shows global road fatalities increasing at a slower rate in the next two decades. Based on trend series data from a limited number of countries (43), the increase in fatalities in Africa and Latin America will continue to increase for a few more years before slowing down while the fatality growth in Asia and the Middle East is slowing down. The decrease in fatalities in the West is expected to continue but at a slower rate. Results also show that the highest fatality rates (deaths per 10,000 motor vehicles) worldwide occur in African countries, particularly Ethiopia, Uganda and Malawi whilst fatality risk (deaths per 100,000 population) is highest in a disparate group of countries including Thailand, Malaysia, South Africa and Saudi Arabia. Males in the most economically active age group make up the largest proportion of reported victims of road crashes. Previous studies have found that children in developing countries tend to be more at risk than in the developed world. However, they account for a relatively small percent of reported road crash casualties. Women’s fatality involvement appears to increase with motorisation. It should be noted that while women in less motorised countries may currently have a low accident risk, research shows that the crash consequences are often more severe for women as there is often less investment in their medical treatment and recovery. Furthermore, their legal status as widows is often very unfavorable and the loss of a husband can mean the break up of a family. It should be emphasised that pedestrians are a particularly high risk group throughout Africa and Asia as well as the Middle East. Car occupant casualties dominate in HMCs and are much more common in the Latin America/Carribean region. 5.1 Areas for future consideration Based on the data available, this study has provided an estimate of the current road fatality toll both globally and by region. It has also, shown the weaknesses of the existing data and the need to put any road casualty estimate into context. Data on fatalities is more readily available, but it is likely that casualty information would present a clearer overall picture of how much road crashes impact on life and the economy. The following points show possible areas that could be examined within theGRSP programme so that a greater understanding of the road crash situation can be obtained. Fatalities represent the ‘tip of the road casualty iceberg’, and much more priority needs to be given to the collection of road injury data. This information can then be used to assess the relative importance of the problem from both an economic and social viewpoint. A more accurate picture of the number of injuries sustained in road crashes would be obtained from hospital data. Hospital recording systems could be improved and complement the police system. The medical community, led by WHO, could give greater priority to monitoring road crash casualties and include road crashes in national hospital surveillance systems. The accident database in many countries could be improved with an accident recording database such as MAAP, which provides an easy to use and low cost method of storing and analysing data. Evidence exists that inadequate use is made of even the limited amount of accident information collected in developing countries. More research is needed into the dissemination and application of crash data in selected countries. The economic costs of road crashes are, in general, not well understood as much of the cost is hidden and incurred in small-scale crashes rather than in large incidents like rail or air disasters. Further research is merited on crash costing, including the application of crash costs. Crash statistics alone are insufficient to assess the road safety situation and other performance indicators, especially those which can be targeted at improving vulnerable road user safety, should be used. Possible indicators include the number of pedestrian crossings installed, number of safety audits conducted, i.e.inspecting a road for the accident , number of hazardous locations improved, etc. This study has attempted to identify the magnitude and nature of the road safety problem worldwide but particularly in the LMC regions of Africa, Asia/Pacific and Latin America and the Caribbean. Hopefully the newly formed GRSP can assist to reduce this global toll of death and injury by the mechanism of partnerships which promote collaboration and coordination of road safety activities worldwide. 6 Acknowledgements The analysis described in this report was carried out by the International Division of TRL. Thanks are given to Dr. Iain York at TRL for assistance with the statistical analysis. 7 References Adams J (1987). Objectives for road safety research. Proceedings of Seminar D Traffic Management and Safety, PTRC Transport and Planning 15 th Summer Annual Meeting, September 1987, London. 27 Asian Development Bank (1997). Road safety guidelines for the Asia and Pacific region. Asian Development Bank, Manila. Brinkmann G M (1993). Inaccuracies in the official statistics of fatal traffic accidents - Comparative studies in West Germany during two time periods. Journal of Traffic Medicine (1993), Vol 21, No.4, 165-168. Choueiri E M, Choueiri G M and Choueiri B M (1995). 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Federal Highway Administration (1996). Highway statistics 1995. US Department of Transport, Washington DC, 1996 Finnroad, ERSF and the Transport Research Laboratory (1999). Interim report 1 Volume 3 Accident Data Report. The PHARE Multi-Country Road Safety Study (1999), Helsinki. Fouracre P R and Jacobs G D (1977). Comparative accident costs in developing countries. Supplementary Report SR270. Transport Research Laboratory,Crowthorne. Ghee C, Silcock D, Astrop A and Jacobs G D (1997). Socio economic aspects of road accidents in developing countries. TRL Report TRL247. Transport Research Laboratory, Crowthorne. Giles M (1996). Peculiarities of road crash reporting by the Australian Bureau of Statistics 1925-90. Measuring the Burden of Injury, Proceedings of a Conference, February 15-16 1996. Adelaide.Gorell, R (1997). Accident data collection and analysis: the use of MAAP in the sub-Saharan region of Africa. 3 rd African Road Safety Congress, 14-17 April 1997, Pretoria, South Africa. Harrison J (1996). The burden of injury in Australia. Measuring the Burden of Injury, Proceedings of a Conference, February 15-16 1996, Adelaide Hutchinson T P (1987). Road accident statistics. Rumsby Scientific Publishing, Adelaide, South Australia. Inter American Development Bank (1998). Review of traffic safety Latin America and Caribbean region, Volume 2 accident statistics. Transport Research Laboratory and Ross Silcock. International Federation of Red Cross and Red Crescent Societies (1998). World disasters report 1998. Geneva. International Road Federation (1993). World road statistics 1988-92. Washington DC. International Road Federation (1999). World road statistics 1999. Washington DC. IRTAD (1992). Definitions and data availability, Special Report. OECD-RTR. Road Transport Programme, BASt, Bergisch Gladbach, Germany. IRTAD (1994). Under-reporting of road traffic accidents recorded by the police at the international level special report. OECD-RTR. Road Transport Programme, BASt, Bergisch Gladbach, Germany. IRTAD (1995). Seminar proceedings: international road traffic and accident databases. OECD-RTR. Road Transport Programme, Helsinki, Finland, 11-13 September 1995. James H (1991). Under-reporting of road traffic accidents. Traffic Engineering and Control, pg. 574-583, London, December 1991 Liren D (1996). Viewing China road traffic safety and the countermeasures in accordance with international comparison. Beijing Research in Traffic Engineering, Second Conference in Asian Road Safety, 28-31 October 1996. Lu T, Chou M, Lee M (1999). Regional mortality from motor vehicle traffic injury: relationships among place of occurrence, place of death and place of residence. Accident Analysis and Prevention, 32 (2000) 65-69. Mohan D and Tiwari G (1999). Traffic safety in low- income countries: issues and concerns regarding technology transfer from high-income countries. Traffic Safety Global Road Safety Trust, Australia, 1999. 28 Murray C and Lopez A (1996). The global burden of disease. World Health Organsisation/Harvard School of Public Health/World Bank, Boston. Mustapha F H and Naji J A (1995). Road accident analysis in (former) South Yemen. Proceedings of 1995 VTI Conference 5A, part 1, Birmingham, 228-238. National Highway Traffic Safety Administration (1996). Safe communities: an approach to reduce traffic injuries. US Department of Transportation, Washington, DC. National Highway Traffic Safety Administration (1997). Traffic safety facts 1996. US Department of Transportation, Washington, DC. Razzak J and Luby S (1998). Estimating deaths and injuries due to road traffic accidents in Karachi, Pakistan, through the capture-recapture method. International Epidemiological Association, 1998:27: 866-870, London. RoadPeace (1999). Road safety and social exclusion. Safety First, Issue 4, Spring 1999. London. Sayer I and R Hitchcock (1984). An analysis of police and medical road accident data: Sri Lanka 1977-81. Supplementary Report SR834. Transport Research Laboratory, Crowthorne. Simpson H (1997). National hospital study of road accidents. Road Accidents Great Britain: 1996 The Casualty Report, Department of the Environment, Transport and the Regions, Government Statistical Service, London. State of Bahrain (1997). Traffic accident facts in Bahrain, 1997. General Directorate of Traffic, 1997, State of Bahrain. Traffic and Engineering Safety Unit (1998). Road Safety Note 10: road traffic accidents 2054-55. Design Branch, Nepal Department of Roads. Katmandu, Nepal. Transport Research Laboratory (1995) Costing road accidents in developing countries. Overseas Road Note ORN10, Transport Research Laboratory, Crowthorne. United Nations (1999). 1995 statistics of road traffic accidents in Europe and North America. New York, 1995 International Road Federation, World Road Statistics 1999, Washington DC. Winston F K, Rineer C, Menon R, and Baker P (1999). The carnage wrought by major economic change: ecological study of traffic related mortality and the reunification of Germany. British Medical Journal, 1999; 313: 1647-1650 (19 June) World Bank (1999). World Bank Atlas 1999. Washington DC.World Health Organisation (1997). World health statistics 1996. Geneva. World Health Organisation (1999), The world health report 1999: making a difference. Geneva. 29 Table A1 Highly Motorised Countries (HMC) Reported30 day GNP (US$ 1997) Reported Population Reported Motor Fatality Fatality MV in use fatality 1996 Adj. fatality -isation Per Total Year definition Fatalities Injuriesindex 1996rate (‘000s) factor Fatalities risk level capita (millions) Australia1996 30 1,970 17,048 n/a 10,956,000 1.8 18,3121.00 1,97010.8 598.3 20,899 382,705 Austria1996 3 1,027 567000.02 4,554,237 2.3 8,0591.15 1,18112.7 565.1 27,965 225,373 Belgium 1996 n/a 1,356 682590.02 4,977,040 2.7 10,1591.00 1,35613.3 489.9 26,812 272,382 Canada 1996 n/a 3,082230885 0.01 17,171,776 1.8 29,9641.00 3,08210.3 573.1 19,856 594,976 Denmark1996 n/a 514 9757 0.05 2,199,000 2.3 5,2621.00 514 9.8 417.9 35,034 184,347 Finland 1996 n/a 404 9299 0.04 2,372,470 1.7 5,1251.00 404 7.9 462.9 24,858 127,398 France1996 6 8,080170117 0.05 30,558,000 2.6 58,3751.09 8,80713.8 523.5 26,409 1,541,630 Germany1996 n/a 8,758 493,1580.02 45,821,425 1.9 81,9121.00 8,75810.7 559.4 28,335 2,320,985 Greece1996 n/a 2,068 31,6580.06 5,206,776 4.0 10,4751.00 2,06819.7 497.1 11,688 122,430 Iceland 1996 n/a 10 1,5560.006 143,579 0.7 2701.00 10 3.7 531.8 —— Ireland1996 n/a 453 9,8310.04 1,339,000 3.4 3,6261.00 453 12.5 369.3 17,964 65,137 Italy 1996 7 6,198 264,2130.02 35,394,150 1.8 57,3801.08 6,69410.8 616.8 20,224 1,160,444 Japan 1996 1 9,942 942,2030.01 84,067,073 1.2 125,7611.30 12,925 7.9668.5 38,264 4,812,103 Luxembourg 1996 n/a 71 1,5380.04 256,737 2.8 4161.00 71 17.1 617.2—— Malta 1996 n/a 14 738 0.02 373 1.00 14 3.8— 9,3783,498 Netherlands1996ex. cyc 1,099 10,4620.10 7,226,000 1.5 15,5171.00 1,099 7.1465.7 25,975 403,057 New Zealand1996 30 514 16,6000.03 2,380,000 2.2 3,6351.00 514 14.1 654.7 16,379 59,539 Norway1996 n/a 255 12,0250.02 2,253,819 1.1 4,3811.00 255 5.8 514.5 36,287 158,973 Portugal 1996 n/a 2,100 66,6270.03 4,330,600 4.8 9,9301.00 2,10021.1 436.1 11,024 109,472 Spain 1996 1 5,483 124,1570.04 19,167,769 2.9 39,2601.30 7,12814.0 488.2 14,509 569,637 Sweden1996 n/a 537 20,8100.03 4,218,258 1.3 8,8431.00 537 6.1 477.0 26,225 231,905 Switzerland1996 1 616 26,5390.02 4,262,411 1.4 7,0741.30 801 8.7 602.5 43,149 305,238 United Kingdom1996 30 3,598 316,7040.01 24,001,000 1.5 58,7821.00 3,598 6.1408.3 20,946 1,231,269 United States1996 30 41,967 3,399,0000.01 208,801,157 2.0 265,2841.00 41,96715.8 787.1 29,339 7,783,092 Countries w/ RTC data 24 100,116 6,299,8840.016 521,660,273 828,175 106,305 27,368 22,665,590 Andorra 71 Monaco 1995 194 32 San Marino Countries w/o RC data* 3 103 - Regional total 27 828,278 27,365 22,665,590 Netherlands: assume exclusion refers to single vehicle cycle fatalities Data sources: IRF World Road Statistics 1997 and 1999, 1997 World Bank Atlas, UN 1997 Statistics, NHTSA Traffic Safety Facts edition Appendix A: Basic traffic safety and soci-economic indicators 30 Table A2 Asia and the Pacific ReportedGNP (US$ 1997) MV Reported Population Reported Motor Fatality Fatality in use fatality 1996 fatality -isation Per Total Year definition Fatalities Injuries index1996rate (‘000s) risk level capita (millions) Bangladesh 1996 7 2,041 3,3010.38 458,70044.5 121,671 1.7 3.8 362 44,090 Bhutan 1992 30 6 14 0.30 14,000 4.3 715 0.819.6 441 315 Brunei Darassalam1996 n/a 65 363 0.15 167,618 3.9 29022.4 578.0 - Cambodia 1996 n/a 176 1,5170.10 522,425 3.4 10,275 1.750.8 308 3,162 China 1995 7 ** 71,495 154,7340.32 27,356,00026.1 1,215,414 5.922.5 868 1,055,372 Fiji 1994 365 88 1,1650.07 90,000 9.8 80311.0 112.1 2,499 2,007 Hong Kong1996 30 263 18,8790.01 516,804 5.1 India 1995 30 59,927 307,0890.16 29,534,00020.3 945,121 6.331.2 378 357,391 Indonesia 1995 1 10,990 21,8140.33 14,454,809 7.6 197,055 5.673.4 1,124 221,533 Korea, Republic of1996 3 12,653 355,9620.03 11,990,88210.6 45,54527.8 263.3 - Laos1994 n/a 200 251,580 7.9 4,726 4.253.2 407 1,924 Malaysia1996 30 6,304 47,1710.12 7,449,053 8.5 20,56530.7 362.2 4,775 98,195 Mongolia 1996 n/a 275 1,0320.21 90,98230.2 2,51610.9 36.2 397 998 Myanmar1993 1 924 252,00036.7 45,883 2.0 5.5 - Nepal1996 30 807 22,037 3.7 0.0 221 4,863 Pakistan 1996 30 4,288 8,9860.32 2,462,55217.4 133,510 3.218.4 484 64,638 Papua New Guinea1992 1 290 1,9480.13 116,00025.0 4,401 6.626.4 951 4,185 Phillipines 1996 1 645 3,9890.14 2,674,972 2.4 71,899 0.937.2 1,229 88,372 Singapore 1995 30 225 6,7180.03 639,546 3.5 3,044 7.4210.1 33,454 101,834 Sri Lanka1995 30 1,916 16,8240.10 770,00024.9 18,30010.5 42.1 808 14,781 Taiwan1996 1 2,990 2,9390.50 14,036,434 2.1 Thailand 1996 1 16,782 43,5410.28 17,666,202 9.5 60,00328.0 294.4 2,761 165,659 Tonga 1995 n/a 10 7 0.59 1,92052.1 97 10.3 19.8 1,825 177 Turkey1996 n/a 5,428 104,5990.05 5,182,03510.5 62,697 8.782.7 3,179 199,307 Vietnam1996 7 5,581 21,5560.21 5,245,00010.6 75,355 7.469.6 319 24,008 Western Samoa1993 3 10 106 0.09 172 5.8 1,157 199 Countries w/ RTC data 26 204,379 1,106,1190.156 141,943,514 3,062,094 801 2,453,010 Cook Islands Democratic Korea 22,451 Kiribati 82 927 76 Maldives 7,980 256 1,176 301 Marshall Islands 57 1,702 97 Micronesia 109 1,954 213 Narau Niue Palau 17 Solomon Islands 389 900 350 Tuvalu Vanuatu 8,000 0.0 173 1,376 238 Countries w/o RTC data 12 23,534 54 1,275 Regional total 38 141,959,494 3,085,628 795 2,454,285 China motor vehicles (1994) Data sources: IRF World Road Statistics 1999 and 1997, 1997 World Bank Atlas, Journal of Traffic Medicine, Nepal’s DOR’s TESU, RETA 31 Table A3 Central-Eastern Europe ReportedGNP (US$ 1997) MV Reported Population Reported Motor Fatality Fatality in use fatality 1996 fatality -isation Per Total Year definition Fatalities Injuries index1996rate (‘000s) risk level capita (millions) Albania 1996 n/a 257 258 0.50 106,63024.1 3,286 7.832.4 773 2,540 Armenia1996 n/a 359 1,6390.18 12,960277.0 3,774 9.5 3.4 560 2,112 Azerbijan 1996 7 763 2,4200.24 373,77420.4 7,58110.1 49.3 513 3,886 Bosnia and Herzegovnia1996 30 199 2,4870.07 107,10118.6 Bulgaria 1996 30 1,014 7,3250.12 2,477,426 4.1 8,35612.1 296.5 1,167 9,750 Byelarus1996 n/a 1,730 7,4920.19 1,578,60611.0 10,29816.8 153.3 2,144 22,082 Czech Republic1996 30 1,386 37,9170.04 4,711,039 2.9 10,31513.4 456.7 5,230 53,952 Croatia 1996 n/a 721 16,1820.04 967,148 7.5 4,77115.1 202.7 4,054 19,343 Estonia1996 30 213 1,5470.12 489,411 4.4 1,46614.5 333.8 3,342 4,899 Georgia1995 n/a 494 1,9770.20 496,13010.0 5,411 9.191.7 860 4,656 Hungary 1996 n/a 1,367 23,8450.05 2,945,914 4.6 10,19313.4 289.0 4,489 45,760 Kazakstan 1996 3 2,732 14,4000.16 1,342,00820.4 16,47116.6 81.5 1,294 21,317 Kyrgyzstan1994 7 622 3,4230.15 150,20041.4 4,57613.6 32.8 483 2,211 Latvia1996 n/a 550 4,3240.11 488,52311.3 2,49022.1 196.2 2,408 5,995 Lithuania 1996 30 667 5,2230.11 901,263 7.4 3,70918.0 243.0 2,254 8,360 Macedonia 1996 n/a 154 3,3970.04 304,464 5.1 1,980 7.8153.8 1,105 2,187 Poland 1996 30 6,359 71,4190.08 11,250,900 5.7 38,61816.5 291.3 3,597 138,909 Republic of Moldova1995 n/a 544 3,0690.15 4,32712.6 0.0 456 1,974 Romania 1996Scene 2,845 7,7160.27 3,146,000 9.0 22,60812.6 139.2 1,406 31,787 Russia1996 7 29,468 207,8460.12 20,636,90014.3 147,73919.9 139.7 2,673 394,861 Slovakia 1996 30 640 11,6240.05 1,291,733 5.0 5,34312.0 241.8 3,706 19,801 Slovenia 1996 30 389 7,7580.05 778,223 5.0 1,99119.5 390.9 9,819 19,550 Tajikstan1993 7 604 2,6850.18 5,92710.2 0.0 339 2,010 Ukraine1996 n/a 3,259 18,8720.15 50,718 6.4 0.0 1,038 52,625 Yugoslavia 1996 n/a 1,276 19,0520.06 1,960,905 6.5 10,57412.1 185.4 - Countries w/ RTC data 25 58,612 483,8970.108 56,517,258 382,522147.7 1,652 631,946 Turkmenistan 7 4,598 650 2,987 Uzbekistan 7 23,228 1,043 24,236 Countries w/o RTC data 2 27,826 978 27,223 Regional total 27 410,348 1,606 659,169 Data sources: IRF World Road Statistics 1999 and 1997, 1997 World Bank Atlas, United Nations, PHARE Study, 32 Table A4 Latin and Central America and Caribbean ReportedGNP (US$ 1997) MV Reported Population Reported Motor Fatality Fatality in use fatality 1996 fatality -isation Per Total Year definition Fatalities Injuries index1996rate (‘000s) risk level capita (millions) Argentina 1996 30 6,473 2,0020.76 5,449,64011.9 35,22018.4 154.7 9,066 319,293 Bahamas1991 n/a 50 1,5980.03 128,500 3.9 28417.6 452.5 - Barbados1996 365 24 1,8230.01 54,619 4.4 264 9.1206.9 - Belize1996Scene 69 704 0.09 20,17034.2 222 31.1 90.9 2,766 614 Bolivia 1995Scene 220 2,0540.10 428,478 5.1 7,588 2.956.5 997 7,564 Brazil1996 30 26,903 323,2950.08 26,069,00010.3 161,36516.7 161.6 4,859 784,044 Chile 1996 1 1,925 52,4220.04 1,622,40811.9 14,41913.4 112.5 4,890 70,510 Colombia 1995Scene 7,874 52,5270.13 1,434,00054.9 37,45121.0 38.3 2,326 87,125 Costa Rica1996Scene 260 10,6920.02 475,738 5.5 3,442 7.6138.2 2,695 9,275 Cuba 1996 n/a 1,424 9,3290.13 706,69020.2 11,01912.9 64.1 - Dominica 1995 n/a 367 74 495.9 3,041 225 Ecuador1995Scene 1,112 6,3440.15 527,37421.1 11,698 9.545.1 1,606 18,785 El Salvador1996 n/a 656 8,5900.07 212,58430.9 5,81011.3 36.6 1,842 10,704 Guyana1995 n/a 166 1,8240.08 7,072234.7 839 19.8 8.4 807 677 Honduras1995 1 523 1,8430.22 201,00026.0 6,101 8.632.9 725 4,426 Jamaica1995 365 367 3,0440.11 400,552 9.2 2,54714.4 157.3 1,553 3,956 Mexico 1995Scene 3,397 33,8600.09 13,303,000 2.6 93,182 3.6142.8 3,741 348,627 Nicaragua 1995 n/a 457 3,5850.11 163,71027.9 4,50310.1 36.4 423 1,907 Panama1996 30 416 8,9610.04 285,64014.6 2,67415.6 106.8 3,131 8,373 Paraguay 1995Scene 98 7,6870.01 252,861 3.9 4,955 2.051.0 2,055 10,183 Peru1996Scene 2,163 3,2700.40 8,662,289 2.5 24,288 8.9356.6 2,622 63,672 Saint Lucia 1994 n/a 20 308 0.06 16,28012.3 158 12.7 103.0 3,532 558 Trinidad and Tobago1993 7 264 31,6950.01 197,28213.4 1,29720.4 152.1 4,281 5,553 Uruguay 1996Scene 693 1,8630.27 207,74233.4 3,20321.6 64.9 6,255 20,035 Venezuela1995 n/a 2,563 25,9950.09 438,90058.4 22,31111.5 19.7 3,555 79,315 Countries with RTC data 25 58,484 595,3150.09 61,265,529 9.5 454,91412.9 134.7 4,079 1,855,421 Antigua and Barbuda 66 7,409 489 Dominican Republic1993 611,623 7,964 1,776 14,148 Grenada 99 3,030 300 Guatemala1993 199,000 10,928 1,517 16,582 Haiti1993 53,000 7,336 390 2,864 Saint Kitts and Nevis 41 6,244 256 Saint Lucia 158 3,532 558 St Vincent & the Grenandines 112 2,429 272 Suriname1995 59,400 432 1,259 544 Countries w/o RTC data 9 27,136 1,327 36,013 Regional total 34 123,454,081 482,050 3,924 1,891,434 Data sources:IRF World Road Statistics ’97 edition, 1997 World Bank Atlas IADB Review of Traffic Safety in Latin America and Caribbean Region, 1998 33 Table A5 Africa ReportedGNP (US$ 1997) MV Reported Population Reported Motor Fatality Fatality in use fatality 1996 fatality -isation Per Total Year definition Fatalities Injuries index1996rate (‘000s) risk level capita (millions) Algeria1993 n/a 3,678 35,7170.09 1,505,00024.4 28,73412.8 52.4 1,529 43,927 Benin 1996 9 mos 412 2,9700.12 295,83013.9 5,632 7.352.5 395 2,227 Botswana1995 n/a 410 5,2470.07 66,33061.8 1,48027.7 44.8 3,426 5,070 Cameroon 1993 n/a 840 5,3120.14 162,00051.9 13,676 6.111.8 630 8,610 Cape Verde1993 n/a 46 670 0.06 4,100112.2 389 11.8 10.5 1,121 436 Central African Republic1995 n/a 58 519 0.10 1,710339.2 3,344 1.7 0.5 330 1,104 Chad 1993 n/a 22 427 0.05 29,640 7.4 6,611 0.3 4.5 246 1,629 Comoros1994 11 14,000 7.9 505 2.2 414 209 Congo 1994 n/a 124 903 0.12 53,00023.4 2,705 4.619.6 675 1,827 Ethiopia 1996 n/a 1,693 7,4550.19 86,756195.1 58,234 2.9 1.5 112 6,507 Gabon 1993 n/a 116 964 0.11 41,00028.3 1,12510.3 36.4 4,224 4,752 Ghana1996 987 8,3720.11 135,00073.1 17,522 5.6 7.7 398 6,982 Guinea1993 n/a 423 3,9060.10 35,000120.9 6,759 6.3 5.2 567 3,830 Kenya1993 n/a 2,516 21,8240.10 391,00064.3 27,364 9.214.3 353 9,654 Lesotho1993 n/a 326 1,6500.16 37,62086.7 2,02316.1 18.6 676 1,368 Madagascar1995 City 25 823 0.03 78,210 3.2 13,705 0.2 5.7 261 3,575 Malawi1996 n/a 1,090 3,9280.22 56,430193.2 10,01610.9 5.6 213 2,129 Mali 1994 City 72 797 0.08 44,55016.2 9,999 0.7 4.5 266 2,656 Mauritius 1996 n/a 146 3,6090.04 96,28715.2 1,13412.9 84.9 3,919 4,444 Namibia1996 127 595 136,726 9.3 1,584 8.0 2,164 3,428 Nigeria1993 n/a 8,958 22,8820.28 1,379,00065.0 114,568 7.812.0 291 33,393 Senegal 1995 n/a 791 8,7830.08 123,94963.8 8,534 9.314.5 560 4,777 Sierra Leone1996 n/a 75 718 0.09 36,22420.7 4,630 1.6 7.8 165 762 South Africa1994 6 days 9,981 128,4400.07 5,929,00016.8 37,64326.5 157.5 3,458 130,151 Swaziland1996 n/a 290 1,6590.15 66,18843.8 926 31.3 71.5 1,575 1,458 Tanzania1994 n/a 1,548 12,3270.11 139,000111.4 30,494 5.1 4.6 217 6,632 Uganda1996 n/a 1,594 6,4770.20 130,785121.9 19,741 8.1 6.6 335 6,608 Zambia1996 n/a 928 5,5640.14 237,00039.2 9,21510.1 25.7 384 3,536 Zimbabwe1996Scene 1,205 18,0700.06 717,00016.8 11,24810.7 63.7 730 8,208 Countries w/ RTC data 29 38,492 310,6080.11 12,028,335 449,540 689 309,889 Angola 232,000 11,100 271 3,012 Burkina Faso 161,430 10,669 242 2,579 Burundi 37,240 6,423 144 924 Cote d’Ivoire 456,000 14,347 708 10,152 Democratic Rep. of Congo 45,234 115 5,201 Equatorial Guinea 2,040 410 1,083 444 Eritrea 5,940 3,698 230 852 Continued over 34 Table A5 (Continued) ReportedGNP (US$ 1997) MV Reported Population Reported Motor Fatality Fatality in use fatality 1996 fatality -isation Per Total Year definition Fatalities Injuries index1996rate (‘000s) risk level capita (millions) Gambia 17,640 1,147 355 407 Guinea Bissau 12,740 1,094 241 264 Liberia 41,160 2,810 - Mozambique 12,350 18,028 133 2,405 Niger License w/d 53,460 9,335 210 1,962 Rwanda Declared 30,070 6,727 250 1,680 Sao Tome and Principe 5,580 135 296 40 Seychelles 9,100 77 6,974 537 Somalia 9,805 - Sudan 27,272 290 7,917 Togo 173,000 4,230 351 1,485 Tunisia 9,132 2,128 19,433 Countries w/o RTC data 20 184,005 328 60,387 Regional total 49 13,307,485 633,545 584 370,276 Data sources: IRF World Road Statistics ’97 edition, 1997 World Bank Atlas, Zambia Country Report 35 Table A6 Middle East and North Africa ReportedGNP (US$ 1997) MV Reported Population Reported Motor Fatality Fatality in use fatality 1996 fatality -isation Per Total Year definition Fatalities Injuriesindex 1996rate (‘000s) risk level capita (millions) Bahrain 1996 n/a 57 2,2570.02 176,164 3.2 599 9.5294.1 Cyprus1996 n/a 128 4,5160.03 740 17.3 Egypt 1994 n/a 4,400 22,1350.17 2,205,00020.0 59,272 7.437.2 1,218 72,164 Iran1995 n/a 2,963 29,5090.09 5,049,585 5.9 62,509 4.780.8 1,738 108,614 Israel1997 n/a 530 47,4510.01 1,542,870 3.4 5,692 9.3271.1 16,585 94,402 Jordan1996 n/a 552 15,3750.03 293,39618.8 4,31212.8 68.0 1,567 6,755 Lebanon 1994 n/a 328 3,0320.10 1,358,450 2.4 4,079 8.0333.0 3,408 13,900 Libyan Arab Jam1996 n/a 1,080 7,7500.12 5,16720.9 Morocco 1996Interurban 2,807 57,2850.05 27,02010.4 1,272 34,380 Oman1996 n/a 512 6,6540.07 312,50016.4 2,17323.6 143.8 Saudi Arabia1994 n/a 4,077 32,1330.11 2,935,00013.9 19,40921.0 151.2 7,390 143,430 Syria 1995 n/a 1,524 7,8970.16 421,52236.2 14,50210.5 29.1 1,148 16,643 Yemen1996 n/a 1,267 6,7400.16 535,15323.7 15,778 8.033.9 279 4,405 Countries w/ RTC data13 20,225 242,7340.08 14,829,64013.6 221,25267.0 2,236 494,693 Afghanistan 56,000 24,167 Dijibouti 619 Kuwait 693,000 1,590 Qatar 190,000 658 United Arab Emirates1996 2,807 5,636 252,000 2,532 Countries w/o RTC data5 29,566 - - Regional total 18 16,020,640 250,818 1,972 494,693 Data sources: IRF World Road Statistics ’97 edition, 1997 World Bank Atlas 36 Abstract This report indicates that in 1999 between 750,000 to 880,000 people were killed in road crashes worldwide and 23 to 34 million injured. Officially reported fatalities underestimate the true extent of the problem and examples of under-reporting of road fatalities are provided. A crude estimate of accident costs suggests a total global figure of about US$500 billion (1997). Trend data shows road deaths continuing to increase in developing regions of the world but falling in the highly motorised countries of western Europe, North America and Japan. Pedestrians are shown to be a particularly high risk group throughout Africa, Asia and the Middle East Related publications TRL382The numerical context for setting national casualty reduction targets by J Broughton, R E Allsop, D A Lynam and C M McMahon. 2000 (price £35, code H) TRL272National hospital study of road accident casualties by H F Simpson. 1998 (price £35, code H) TRL247Socio-economic aspects of road accidents in developing countries by C Ghee, D Silcock, A Astrop and G Jacobs. 1997 (price on application) TRL227Pedestrian accidents and road safety education in selected developing countries by I A Sayer and A J Downing. 1996 (price on application) ORN10 Overseas Road Note - Costing road accidents in developing countries. 1995 (price on application) SR270Comparative accident costs in developing countries by P R Fouracre and G D Jacobs. 1977 (price £20) SR834An analysis of police and medical road accident data: Sri Lanka 1977-81 by I A Sayer and R Hitchcock. 1984 (price £20) Prices current at April 2000 For further details of these and all other TRL publications, telephone Publication Sales on 01344 770783 or 770784, or visit TRL on the Internet at http://www.trl.co.uk.