Annals of Health Law
MAKING A POSITIVE IMPACT
Indeed, the observation that the burden of road trauma is
disproportionately felt in the developing world is not new. As noted in the
World Report, around 85% of all global road deaths and 90% of days-adjusted life years (“DALYs”; a measure of healthy years lost)38 are lost due
to crashes. Moreover, 93% of all deaths of children worldwide as a result of
road traffic injuries occur in low-income and middle-income countries.39
Finally, in its 2009 Global Status Report on Road Safety,40 the WHO
assessed, for the first time, the number of people killed in each country, the
in-country institutional structures that are charged with coordinating national
road safety programs, and the range of legislative and regulatory
mechanisms. The WHO noted that 1.23 million people were killed on the
world’s roads in 2007 and estimated that 20-50 million people are also
The impact of road trauma is disproportionately shared. Specifically,
high-income countries, which account for 15.6% of the global population,
yet own 52.1% of all registered vehicles globally, account for only 8.5% of
the annual road toll.42 In contrast, 41.9% of road deaths occur in low-income
countries (36.7% of the global population43) despite those countries owning
only 9.2% of vehicles.44 Similarly, 49.6% of deaths occur in middle-income
countries,45 which account for 47.8% of the global population and 38.7% of
registered vehicles.46 As these low- and middle-income countries motorize,
37. See KOPITS & CROPPER, supra note 8, at 1 (statistically modelling the impact of
increased wealth and motorization on road deaths).
38. WHO WORLD REPORT, supra note 17, at 4. Days adjusted life year (“DALY”) is a
measure of morbidity, or loss of function due to disability or death, and is best conceptualized
as “one lost year of healthy life”; the DALY is central to the Global Burden of Disease
program, which seeks to rank causes of disability due to injury, communicable, and non-communicable disease. WHO, HEALTH STATISTICS AND HEALTH INFORMATION: GLOBAL
BURDEN OF DISEASE, http://www.who.int/healthinfo/global_burden_disease/en/ (last visited
March 26, 2013); see also C.J.L. MURRAY, QUANTIFYING THE BURDEN OF DISEASE: THE
TECHNICAL BASIS FOR DISABILITY-ADJUSTED LIFE YEARS, 72 BULLETIN OF THE WHO 429,
429–45 (1994); C.J.L. Murray et al., Disability-Adjusted Life Years (DALYs) for 291 Diseases
and Injuries in 21 Regions, 1990-2010: a Systematic Analysis for the Global Burden of
Disease Study 2010, 380 THE LANCET 2197, 2197-223 (2013).
39. WHO, WORLD REPORT ON CHILD INJURY PREVENTION 31 (2008), available at
40. See generally WHO GLOBAL STATUS REPORT 2009, supra note 26.
41. Id. at vii.
42. Id. at 11.