Annals of Health Law
MAKING A POSITIVE IMPACT
an exponential increase in deaths and injuries is expected: indeed this
scenario has already been observed in a number of countries.47
Notably, countries such as Australia and the United States, by way of
example, experienced the same phenomenon of an increasing “road toll”
experienced by developing countries today.48 For instance, the fatality rate
in Australia in 1970 (30.5 deaths per 100,000 persons) and in the United
States in 1972 (26.0 deaths per 100,000 persons) was well above the present
day global fatality rate of 18.8 deaths per 100,000 persons and higher than
that for all regions except the Eastern Mediterranean region (32.2) and the
African Region (32.2) in 2007.49 A key challenge is the successful transfer
of road safety programs developed in high-income countries to developing
countries.50 Indeed, the stabilization then reduction in the number of people
killed on the world’s roads relies on the successful adoption by governments
of road safety countermeasures known to be successful.51 It is clear, then,
that government action is required: at a high level, the income disparity in
fatality rates is made clear by the following: high–income countries (10.3
deaths per 100,000 persons), middle–income countries (19.5), and low–
income countries (21.5).52
Injury resulting from road crashes also has a significant impact on the
social and economic development of communities. Apart from the personal
cost to the crash-involved individual, his or her family, and his or her
community, the economic cost of road crashes to the community in the
aggregate is immense. In low- and middle-income countries, the cost of road
crashes in economic terms has been estimated to equate to 1%-2% of gross
domestic product (“GDP”).53 The authors of this article estimate that road
47. For instance, the fatality rate in Botswana increased by 383.8% between 1975 through
1998, while in China that rate increased by 243.0% during the same period; in contrast, the
fatality rate in high income countries fell, e.g., United States: 27.2% reduction; Sweden: 58.3%
reduction. KOPITS & CROPPER, supra note 8, at 2; see also WHO WORLD REPORT, supra note
17, at 37.
48. See WHO WORLD REPORT, supra note 17, at 37.
49. See WHO GLOBAL STATUS REPORT 2009, supra note 26, at 12. Countries were
classified within WHO regions as high ($US11,456), middle ($US936 to $11,455) or low
income (< $US936) per the World Bank (Atlas Method) gross national income per capita
(“GNI”); WHO regions are African region (3.2% traffic injury facility rate per 100,000
population); Region of the Americas (15.8); South East Asia region (16.6%); Eastern
Mediterranean region (32.2); European region (13.4), and the Western Pacific region (15.6).
Id. at 13, 246 (Table A-2, footnote c).
50. See WHO WORLD REPORT, supra note 17, at 36.
51. Press Release, United Nations General Assembly, General Assembly Adopts Text
Proclaiming Decade of Action for Road Safety, U.N. Press Release (March 2, 2010), available
at http://www.un.org/News/Press/docs/2010/ga10920.doc.htm .