Annals of Health Law
MAKING A POSITIVE IMPACT
crashes cost the global community US$500 billion per annum, of which
US$465 million is shouldered by middle and low–income countries.54
Moving beyond the statistics, it is crucial to consider the impact of deaths
and injuries on the social fabric of a country and the country’s ability to climb
the development ladder quickly. This is important because road safety is an
issue of social equity.55 This point is particularly pertinent when one
considers that “pedestrians, cyclists and riders of motorized two-wheelers
and their passengers account” for almost half of global road deaths.56
Pedestrians alone account for approximately 45% of deaths in low-income
countries and 18% of deaths in high-income countries.57 Despite rapid
motorization in middle- and low-income countries, walking and public
transport remain the dominant modes of mobility for most people.58 Coupled
with comparatively slow, and frequently inadequate, infrastructure
development due to competing socio-economic and health development
demands, the most marginalized or least economically empowered members
of society are frequently most at risk. The pedestrian fatality statistics are a
manifestation of the lack of provision of safe pedestrian walkways in many
developing countries. This situation principally impacts those who by
necessity walk to their workplace, the market, or to a form of public
transportation. Dependence on the latter may itself perpetuate exposure to
unsafe modes of transport, due to vehicle over-loading and older, less safe
vehicles. It is frequently the case that economic circumstance dictates the
need to walk on roadways that are unsafe.59
It is also recognised that a large proportion of road deaths are young
adults60—at a time when they are most productive in an economic sense—
and that these deaths are overwhelmingly male ( i.e., greater than 80%).61 The
impact of death and injury has real and lasting economic and social impacts
54. See id. at 33; WHO GLOBAL STATUS REPORT 2009, supra note 26; WHO WORLD
REPORT, supra note 17, at 51.
55. See WHO WORLD REPORT, supra note 17; KEVIN WATKINS, THE MISSING LINK: ROAD
TRAFFIC INJURIES AND THE MILLENNIUM DEVELOPMENT GOALS (2010).
56. WHO GLOBAL STATUS REPORT 2009, supra note 26, at 14.
57. Aruna Chandran et al., The Global Burden of Unintended Injuries and an Agenda for
Progress, 32 EPIDEMIOLOGIC REV. 110, 113 (2010).
58. See Mohiuzzaman Quazi, Road Safety and Poverty Dynamics in Bangladesh,
WORLDBANK.ORG (May 1, 2013; 3:23 p.m.), http://siteresources.worldbank.org/
59. See WHO GLOBAL STATUS REPORT 2009, supra note 26, at 15 (Box 1).
60. WHO, YOUTH AND ROAD SAFETY vii (2007), available at http://www.who.int/