The Challenge of Non-Communicable Diseases and Road Traffic ...

An Overview 43
• Secure sustainable and adequate funding for the
lead agency and key stakeholders, and strengthen
their management and operational capacity to
achieve safety targets; and
• Enhance nationwide RTI-surveillance systems
to collect data, better understand the nature and
characteristics of the problem, and evaluate the results
of interventions.
Sustained support is also needed to implement
effective Interventions with a results focus. This requires
the following:
• Road safety should be integrated in all phases of
planning, design, and operation of road infrastructure.
Improved project design is helped by
analyses of the safety performance of road networks,
conducted at the planning stage of new
road construction, and complemented by road
safety audits and safety impact assessments. Also,
reviews of road sections with high concentrations
of crashes help target investments towards places
with the highest crash-reduction potential.
• Intersection controls, crash barriers, signs, markings,
traffic calming measures around schools, and
road maintenance are effective interventions.
• Vehicle design and safety equipment: The use during
the daytime of cars and motorcycle lights, and
other safety technologies such as electronic stability-control
systems, seat belts, and airbags, contribute
towards reducing road traffic crashes and
fatalities. Fiscal and transport policies, customer
information, and incentives can be used to ensure
motor vehicles reach internationally-agreed standards,
provide high levels of road user protection,
and discourage the import and export of new or
used cars with reduced safety standards [268].
• Legal measures to improve road-user behavior
include: issuing graduated driving permits for
teenagers that require six months of driving with
learners’ permits, curfews prohibiting driving between
midnight and 5:00 a.m., and passenger restrictions
on the first year of driving after getting a
license. Mandatory seat belt use helps reduce road
traffic deaths and serious injuries once a crash has
occurred. Requirements on the use of motorcycle
and bicycle helmets protect against fatal head injuries.
Setting and enforcing speed limits reduces
RTIs by up to 34 percent, particularly among pedestrians,
cyclists, and motorcyclists. The introduction
of speed cameras has led to a 14 percent
reduction in fatal crashes and a 6 percent reduction
in nonfatal crashes in developed countries.
• Comprehensive programs can improve road-user
behavior, but laws and standards need to be enforced,
monitored, and combined with public
awareness and education campaigns to increase
seatbelt and helmet wearing and to reduce speed
and drink-driving and distractions such as texting
on mobile phones while driving. Only 11 countries
in Africa have national speed limits on urban
roads less than or equal to 50km/hour and allow
local authorities to reduce these, and only three
countries rate their enforcement of speed laws as
good. Whereas 35 African countries have national
seat belt laws, these only cover all occupants in 18
countries, and only six of these rate enforcement
as good. Almost two-thirds of countries have national
laws regulating the use of mobile phones
while driving, but very few collect data to monitor
use [59].
• RTIs are also reduced by setting and enforcing legal
blood alcohol limits and minimum drinking
age laws, using checkpoints to stop drivers randomly
to detect alcohol, and running mass media
campaigns to reduce drinking and driving. Other
measures, such as license revocation and suspension,
markedly reduce fatalities from alcohol-related
crashes. Measures to outlaw the use of cell
phones and texting devices by young drivers are
starting to show positive results in countries such
as the United States.
• Effective post-crash medical care and treatment
can prevent deaths and limit the severity of injuries.
France’s Service d’Aide Médicale d’Urgence
(Emergency Medical Assistance Service, SAMU),
and the effective service arrangement established,
for example, in Kenya, Nigeria, and Namibia, are
good practices in this area.
A strategy that simultaneously implements multiple
road safety interventions produces the most health
gains for a given investment [60]. The adoption by
governments and international agencies of “shared