Traffic accidents are a major public health concern, even though they don?t get as much media attention as diseases. The World Health Organization considers this a serious problem. For example, in 2000, the WHO estimated that Africa averaged about 164-thousand deaths a year from traffic accidents alone. Margie Peden of South Africa is a coordinator for road accident prevention for the WHO.

Ms. Peden says the problem of deaths and injuries from traffic accidents is greatest in lower and middle income countries. There is a direct relationship, she says, between the increasing number of cars and traffic collisions.

?I need to point out, however, that in lower and middle income countries, the majority of these deaths are not the drivers of vehicles but rather what we call vulnerable road users. These are people like pedestrians, motorcyclists, cyclists, and passengers in buses or taxis.?

Statistics reveal that many of those killed are young adults between the ages of 15 and 44. And they are breadwinners -- the primary source of income for their families.

Ms. Peden says governments need to recognize that road traffic deaths and injuries are a major public health problem. She says they can do this by setting up road safety agencies that include all of what she calls the ?major players.? Agencies such as health, transport, education, and the police need to have authority to coordinate culturally sensitive road safety efforts.

?There are some specific lessons that can be learned from the developed world. Many interventions have been programmed to work in high income countries, such as speed management, alcohol and seatbelt laws, and the enforcement of these laws ? helmet use, child restraint use, vehicle standards and then also improving trauma case systems.?

In other words, Ms. Peden says hospitals need to have essential services for road accidents ? such as emergency rooms that deal with trauma.

In addition to the challenge of getting governments to recognize the need for road traffic safety, The WHO Co-ordinator says they need to make funding these programs a high priority.

Ms. Peden also says communities and local citizens can be effective in their own right.

?They can be encouraged to identify their own unique traffic problems. They can help plan ? efficient transportation systems; they can encourage safety programs for children. They can demand optimal safety in cars they buy, and encourage the strong enforcement of traffic safety laws and regulations ? lobby groups of ordinary citizens can put considerable pressure on communities and governments to institute change."

Ms. Peden says the time for government action is now. If not, according to the WHO data, road traffic injuries will jump from the ninth leading cause of injury to the third leading cause, by the year 2020.

She adds that historically, authorities have viewed road traffic safety as a transport problem, rather than a health issue. But Ms. Peden notes that the developing world should take what she calls a more ?hollistic? approach ? meaning that road safety must encompass many disciplines. Then, she says, the problem can become one of the country?s financial priorities - and road safety can develop a greater support base for reducing accident mortality and injury quickly and efficiently.