Addressing road injuries in Western Asia: A public health perspective

Adnan A. Hyder, MD MPH PhD

International Injury Research Unit, Department of International Health,

Johns Hopkins University, Bloomberg School of Public Health, USA

Road traffic injury improvements in the 20th Century in high income countries:

A Public Health Success Story!

What accounts such a decline in RTI fatalities?

• Speed control

• Roadway designs

• MV safety standards

• Visibility

• Seat belt use

• Car seat use

• Drinking and driving

• Helmets

Impact of Seat Belts:

Traffic injuries – what works?Interventions for RTI: Newly recognized needs…

Visibility Aids Helmets for Kids

Evidence based interventions for further consideration

• Child safety seat laws with distribution and education programs

• Primary seat belt laws with active enforcement

• Graduated driver’s licensing programs

• Sobriety checkpoints, minimum drinking age laws, .08 BAC legislation

Cost Effective Interventions Exist

Intervention Cost per Disability Adjusted Life Year

Improved enforcement

(LMIC average)

$5.25

Speed bumps at top 25%ile dangerous junctions (LMIC average)

$8.89

Bicycle helmets

(China)

$107

Motorcycle helmets

(Thailand)

$467

(Bishai and Hyder, 2006)

For Child Road Traffic Injuries:

Investment of US$ 1 in…

Reaps savings/benefits of

US$

Child restraints 29

Bicycle helmets 29

How did these changes occur?

How did these changes occur?

• Comprehensive, multi-disciplinary approaches

• Government leadership

• Sustained commitment to research

• Advocacy and public support

IOM, 1999; MMWR, 1999

The Focus of Road Safety…

On protecting people

On the pursuit of “efficiency” and “effectiveness”

Such a systems approach will deliver interventions which provide the largest reduction of injuries and deaths

• Identify a lead agency in government to guide the national road traffic safety effort.

• Assess the problem, policies and institutional settings.• Prepare a national road safety strategy and plan of

action. • Allocate financial and human resources to address the

problem. • Implement specific actions to prevent crashes, minimize

injuries and their consequences and evaluate the impact of these actions.

• Support the development of national capacity and international cooperation.

Recommendations World Report 2004:

Institutional Base

Interventions

Results

A Systems-Based Public HealthApproachTo Road InjuryPrevention

Such crashes are unacceptable in Western Asia in the 21st Century

Thank you!

Dr. Adnan Hyder

(ahyder@jhsph.edu)

International Injury Research Unit

www.jhsph.edu/IIRU