Economic modernization is the path toward healthier, longer lives, but it has a deadly unintended consequence, a sharp rise in traffic deaths. Developing countries are suffering an epidemic in highway fatalities and injuries.
The worldwide highway death toll rivals that caused by some infectious diseases. The International Federation of Red Cross and Red Crescent Societies calls the situation a worsening disaster destroying lives and livelihoods, and hampering development.
The World Health Organization (WHO) says more than one million people die and 50 million are hurt in road crashes every year at an estimated cost of more than $500 billion. The agency says that without appropriate action, road traffic casualties will rise 66 percent by 2020 to become the third leading contributor to the global burden of disease, up from the ninth position in 1990.
The problem is in the developing world, where the economic cost is expected to exceed the foreign aid they get. University of Sydney public health professor Robyn Norton says traffic deaths in industrial nations are predicted to decline nearly 30 percent by 2020, but China, for example, could have almost twice as many as now and India two-and-a-half times more.
"You see the demise of the bicycle in China and the rise of the motor vehicle. It's dramatic. So it's not surprising that we're on the start of what will be a major epidemic," she said.
Although automobile casualties are rising on developing nation roads, the most vulnerable highway travelers are still those on foot or two wheels. In an article in the medical journal "Lancet," Norton and colleagues from the University of Auckland and Mexico's National Public Health Institute cite studies showing that motorcyclists and bicyclists have high injury rates in Asia, while pedestrians are the most often hurt in Africa.
A 2004 World Health Organization report and the subsequent collaboration of 42 agencies worldwide led the United Nations General Assembly to pass a road safety resolution last year. It recommends implementing the health agency's report and observing the first global road safety week next April.
"What has happened over the last couple of years has been an incredible about face, increasing recognition. Governments are now starting to recognize that this is an issue, but I still don't think people appreciate the extent of the epidemic," she added.
The World Health Organization recommends that low and middle income nations adopt road safety practices that have lowered traffic casualties in rich countries in recent decades, despite increases in the number of drivers and motor vehicles.
Norton says isolated experiences show that they can be transferred. Introducing speed bumps in Ghana cut traffic deaths in half. Use of daytime running lights on motorcycles reduced fatal crashes in Singapore 15 percent. Other successful measures include graduated driver licensing systems for teenagers and installation of seat belts.
"We know, again, that seat belts and other protective measures are very effective in reducing morbidity and mortality in road traffic crashes, but in many low and middle income countries, seat belts are not even fitted into cars," she explained.
Norton and her Mexican and New Zealand co-researchers also call for nations to establish programs to monitor their particular patterns of highway accidents and to track how preventive strategies work.
"Aspirations for cars are part of what people see as their right, but it does come with a price," she said.