1 The Western Hemisphere Transport Initiative 9 th Executive Committee Meeting Kingston, Jamaica August 23 rd – 24 th 2006 Road Traffic Injuries – Staggering.

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The Western Hemisphere Transport Initiative9th Executive Committee Meeting

Kingston, Jamaica August 23rd – 24th 2006

Road Traffic Injuries – Staggering Global Crisis

Paul Anthony Clemetson BSc, MBA

Director, Road Safety Unit

Ministry of Housing, Transport, Water and Works

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Road Traffic Injuries—a modern plague—slipping under the radar

• Road Traffic Injuries (RTIs) take approximately 1.2 million lives per year

- 3,287 deaths/day or

- one death every 26.3 seconds

• 20-50 million people are seriously injured each year.

- 15 or more serious injuries/second or

- over 900 serious injuries/minute

Source: World Health Report 2004. Chart reproduced from Jacobs G, Aeron-Thomas A, Astrop A. Estimating global road fatalities. Crowthorne, Transport Research Laboratory, 2000 (TRL Report 445).

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Road Traffic Injuries – a Modern Plague

• For men aged 15-44 road traffic injuries rank second (behind HIV/AIDS) as the leading cause of premature death and ill health worldwide.

• 10th leading cause of death globally.• Low and middle income countries account for

more than 75% of global deaths from road traffic crashes.

• Responsible for 2.2% of annual global deaths.

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Fatality rates are notably higher in developing countries

Fatalities per 10,000 Crashes

1000 1500 2000 2500 3000 3500

3,181

Viet Nam

1000 1500 2000 2500 3000 3500

1,786

Kenya

66

1000 1500 2000 2500 3000 3500

U.S.

Source: Reich MR, Nantulya V. Road Traffic Injuries in Developing Countries: Strategies for Prevention and Control. Presented at the Road Traffic Injuries and Health Equity Conference, Harvard University, Cambridge, MA, April 10-12, 2002.

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< 10.0 (Low risk) Anguilla, Argentina, Bolivia, Canada, Chile, Dominica, Haiti*, Nicaragua, Paraguay, Saint Kitts and Nevis, Saint Vincent and the Grenadines

10.0-20.0 (Medium risk)

Antigua and Barbuda, Aruba, Bermuda, Brazil, Cayman Islands, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Honduras, Jamaica, Mexico, Panama, Peru, Puerto Rico, Saint Lucia, Trinidad and Tobago, United States, Uruguay, Virgin Islands (UK)

> 20.0 (High risk) Bahamas, Belize, Guatemala, Guyana, Venezuela

CountriesRange of fatality rates (per 100,000)

Road traffic fatalities (per 100,000) in the Americas, by level of risk

Road traffic fatalities (per 100,000) in the Americas, by level of risk

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0.0

5.0

10.0

15.0

20.0

Canada 15 13.2 12.3 12.6 11.2 11.4 10.4 10.2 9.8 9.8 9.5 9.0 9.4

Mexico* 16.1 15.9 15.3 15.3 15.0 14.9 14.2 14.6 13.3 11.9 13.7 13.5

United States 17.9 16.5 15.4 15.6 15.6 15.9 15.9 15.7 15.4 15.3 14.9 14.8 14.9

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

*Figure for 1998 is the average of values for 1997 and 1999.Sources: Canada—Rates calculated with fat. from Transport Canada and pop. from Statistics Canada (pop. for 1998 estimated using trend in rest of pop. figures); Mexico – INEGI (data presented in Foro Nacional Sobre Accidentes de Tránsito en México); United States – NHTSA and U.S. Bureau of the Census.

Mortality rate per 100,000 inhabitanats 1990 - 2002

Mortality rate per 100,000 inhabitanats 1990 - 2002

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0.0

5.0

10.0

15.0

20.0

25.0

Cayman Islands 2.9 10.8 16.2 12.5 14.6

Jamaica 18.5 17.7 17.8 15.6 14.7 13.6 14.6 13.9 11.4 12.9 13.8 15.5 14.8

Puerto Rico 15.5 16.4 17.2 17.1 17.1 17.1 17.5 16.4 14.8 16.2 16.3 14.4 14.6

Saint Lucia 15.9 14.3 16.1 16.5 15.6 17.4 15.8 14.3 14.1 17.1

Trinidad and Tobago 10.1 12.0 10.2 10.8 11.2 10.1

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

Mortality rate per 100,000 inhabitanats 1990 - 2002

Mortality rate per 100,000 inhabitanats 1990 - 2002

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Road Traffic Injuries in Latin America and the Caribbean are alarming

• Latin America and the Caribbean have the highest RTI fatality rate of any region of the world (26.1 deaths per 100,000 inhabitants).

• This fatality rate is expected to climb 48% by 2020 so that the region is still predicted to have the highest rate in 2020.

• Colombia’s crash mortality rate rose 237% between 1975-1998.

• El Salvador has the highest road traffic fatality rate in the world (42.4 deaths per 100,000 inhabitants)

• By 2002, death rate from RTI in Latin America and the Caribbean is expected to surpass death rate by HIV/AIDS

Sources: The World Report on Road Traffic Injury Prevention, 2004; Kopits E and Cropper M. Traffic fatalities and economic growth. Washington, DC: The World Bank, 2003 (Policy Research Working Paper No. 3035).

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RTIs are an enormous barrier to development

• The direct cost of road crashes was approximately US$518 in 2000.

• On average, crash costs equal 1-1.5% of developing nations’ annual GDP.

• Crashes cost developing nations US$65 billion, and US$18.9 billion in Latin America and the Caribbean—more than double the amount of annual development assistance the region received.

Source: Jacobs, Aeron-Thomas, and Astrop, 2000

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RTIs are an enormous barrier to development

• In Jamaica direct costs of road crashes to the health sector was approximately J$518 in 2002.

• Cost per patient varied form J$3,00 - $128,000

• Cost to the Motor Vehicle Insurance Industry exceeded J$3 billion

Source: Division of Health Promotion and Protection - MOH

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We should learn the lessons from AIDS

• The public health community failed to respond adequately to the problem while it was growing rapidly in developing nations.

• The world now faces the worst public health disaster it has witnessed

• We risk making the same mistake now in road safety.

• The number of those killed in crashes annually is already 42% of the number killed by HIV/AIDS.

• Very little is being committed by the U.S. or other developed nations to road safety in developing countries.

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Similar to HIV/AIDS

• Deaths from the RTI pandemic is increasing globally

• The highest growth rates are in developing countries

• Forecast for the future is dismal– 83% increase in fatalities in developing

countries by 2020– RTI threaten to become the #1 cause of

premature death in the region.

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We must act now

• We must get ahead of this plague now - before the predicted explosion takes place.

• We missed one of the worst public health disasters of our lifetime with AIDS. Will we miss another?

• “The biggest single failure in the fight against AIDS in the first 15 years of the pandemic, was the failure to collaborate.” — Dr. Michael Merson, former Dean, Yale School of Public Health

• We cannot let what happened to the AIDS epidemic happen to road traffic injuries.

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Some Imperatives

• Establish a dynamic, sustainable regional corpse to coordinate and evaluate strategies and policies for RTI reduction

• Build local capacity to address road safety (drawing on multi-sectoral collaboration - civil society, the private sector and all relevant government sectors)

• Build a network to share knowledge and generate political will

• Develop and establish a common data system for sharing data and best practices

• Develop regional and national plans and policies supported by Ministerial endorsements

• Sustain ongoing efforts to implement regional and national plans and programmes

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No time for complacency

• “When you accept any injury as inevitable, you are on the road to failure.”

quoted by: Sir Don Berwick

• Every system is perfectly designed to produce exactly the results it produces (is that the reason why RTIs are out of proportion?)

• Let us create the will to succeed• Use our hearts and our heads• Act quickly and deliberately• Work collaboratively

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Paul Anthony Clemetson, BSc, MBA1876-960–8575

[email protected]; [email protected]

Ministry of Housing, Transport, Water & Works 1876-754-2584 -90

www.mhtww.gov.jm

Road Safety Unit 145 Maxfield Avenue Kingston 10, Jamaica WI

[email protected]

MINISTRY OF HOUSING, TRANSPORT, WATER & WORKS

Road Safety Unit Contact Information