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A disquieting prospect

Preventing death and injury on the road is a policy objective that is becoming more and more critical universally. The World Health Organisation database of death and disability caused by traffic accidents indicates that over the past quarter century, vehicle ownership in most developing countries has grown much faster than fatalities per vehicle have fallen. In the same period, many industrialised countries with saturation levels of vehicle ownership appear to have turned the corner by reducing the ratio of accident deaths to vehicles. The importance of such trends for low- and middle-income countries has been highlighted in a set of review papers recently published in Lancet and the British Medical Journal. Developing countries not only face the prospect of losing tens of thousands of citizens in the productive age-group to accidents but must also bear the sharply increased healthcare costs of treating the injured. Using turn-of-the-century figures and policies as the base, the World Bank has projected a 147 per cent rise in deaths for India over two decades and a 92 per cent increase for China; in contrast, high-income countries are expected to achieve a reduction of 28 per cent in deaths. In the case of injuries, both major and minor, the situation could be much worse than believed because of under-reporting; data for India put the number of injured in 2000 at about 342,000 but evidence-based statistical modelling by IIT Delhi suggests that when adjusted for under-reporting, the figure is more likely to be over six million, one million of them in the `serious' category. This burden of injury is borne largely by the poor and the vulnerable road users such as pedestrians and cyclists.

The policies of the United Progressive Alliance Government to improve safety for vulnerable road users, and promote urban public transport and infrastructure are welcome correctives. Although they will not be completed in the immediate future, the Mumbai and Bangalore metro rail systems promise a safer and faster alternative to personal automobiles; the good response to the metro in Delhi and earlier in Kolkata demonstrates that such an option may be the preferred choice of commuters in all fast-growing cities. High capacity bus systems also have an impressive record of improving traffic conditions in the crowded cities of countries in transition such as Brazil and Colombia. State governments cannot afford to ignore such good practices. By encouraging the expansion of affordable bus networks, they can directly contribute to lower traffic density and greater road safety. The agenda for injury reduction also requires the creation of a transport safety administration staffed by experts. India is widely seen as a laggard in this area. It has no system of repute for transport data collection, analysis, and systems engineering. No strong response to the `modern epidemic' of death and injury on the roads is possible without modernising transport administration.

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