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ROAD SAFETY

CALL FOR ACTION

IN THEWESTERN PACIFIC REGION

ii Road Safety in the Western Pacific Region: Call for Action

WHO Library Cataloguing in Publication Data

Road safety in the Western Pacific Region : call for action. 1. Accidents, Traffic – statistics and numerical data. 2. Accidents, Traffic – trends.3. Wound and injuries – epidemiology. 4. Traffic safety. 5. Data collection.6. Western Pacific. I. World Health Organization. Regional Office for the Western Pacific. ISBN 978 92 9061 449 4 (NLM classification: WA 275)

© World Health Organization 2009

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iiiRoad Safety in the Western Pacific Region: Call for Action

Table of ContentsAcknowledgements iv

Preface v

Summary vii

Background 1

Burden of road traffic injuries in the Western Pacific Region 2

A response to the burden 3

Survey method 5

Road Safety in the Western Pacific Region 7

Road traffic injuries are a major threat to growth 7

Death rates are highest in low- and middle-income countries, but high-income countries cannot be complacent

8

Vulnerable road users account for more than half of road traffic deaths 11

Effective transportation policies are important 16

Well-enforced comprehensive road safety laws are needed 18

Trauma care systems should be improved 40

Few countries have reliable data on road traffic injuries 41

Monitoring and evaluation 45

A coordinated approach to road safety is crucial 46

Key Messages 49

Key findings 49

Key recommendations 50

Country profiles 53

Statistical annex 83

iv Road Safety in the Western Pacific Region: Call for Action

AcknowledgementsThe Who Regional Office for the Western Pacific gratefully acknowledges the contributions made to this Regional report by the following:

Headquarters: Margie Peden, Tami Toroyan, Alison Harvey, Kidist Bartolomeos, Kacem Iaych, Ala Alwan, Meleckidzedeck Khayesi, Etienne Krug, Pascale Lanvers-Casasola, Steven Lauwers, Colin Mathers, Susan Piazza and Laura Sminkey.

Western Pacific Region: Li Dan, Mayet Darang, Olga Diaz, Florecita Franco, Hisashi Ogawa, Jonathon Passmore, Krishnan Rajam (Regional Data Coordinator) and Marilyn Salcedo.

External reviewers: Shanthi Ameratunga, Joan Ozanne-Smith, and Alan Ross.

Country level data could not have been obtained without the invaluable input of: • The WHO Representatives and staff in countries; • The National Data Coordinators: John Goldsworthy, Rozaly Saidon, Prak Piseth Raingsey,

Duan Leilei, Josephine Herman, Timaima Tuiketei, Shinji Nakahara, Mweritonga Rubeiariki, Phisith Phoutsavath, Rosnah Ramly, Russell Edwards, Vita A. Skilling, Ariuntuya Sakhiya, David Dowiyogo, Jennifer Brown, Ismael Aguon, Peri Kanguma, Theodora Cecile Magturo, Kim Young-Taek, Ponifasio Vasa, Ho Seng Tim, Lee Alvin, Divinol Ogaoga, Siale Akau’ola, Kakee Pese Kaitu, Ben Taura and Nguyen Thi Hong Tu;

• All respondents and attendees of the consensus meetings in countries; and • Government officials who provided clearance of the information for inclusion in the report.

We would also like to acknowledge the New Zealand Transport Agency and the International Association for Traffic and Safety Sciences for granting permission to reprint certain texts that were used in this report.

Finally, the World Health Organization wishes to thank Bloomberg Philanthropies for its generous financial support for the development and publication of this Report.

vRoad Safety in the Western Pacific Region: Call for Action

PrefaceIn the Western Pacific Region, road crashes cause approximately 300 000 deaths (a quarter of the world’s total of 1.2 million deaths). This amounts to more than 800 people dying every day in the Region. Millions more are injured and are permanently disabled. In addition to the human suffering, road traffic crashes place a huge burden on national economies. More than 90% of road traffic deaths occur in low- and middle-income countries. As most countries in the Region experience economic growth and motorization, road traffic injuries are expected to increase in the future.

According to this Report, about half of those killed on the roads are “vulnerable” road users i.e. pedestrians, motorcyclists and cyclists. This proportion is even higher in low- and middle-income countries.

Road safety should be taken into consideration in the planning of land use and transportation. Safer vehicles and roads, infrastructure which protects pedestrians and cyclists, adequate public transportation and enforcement of safety laws would reduce injuries. This Report draws attention to the needs of all road users including the most vulnerable groups.

Intersectoral cooperation is vital. All relevant stakeholders must play their role in a concerted and coordinated manner to make roads safer for all road users. Interventions should be evidence-based and well aligned by all sectors.

This Report, the first of its kind, assesses the road safety situation in Member States in the Region. The data must be put to good use by all concerned with road safety. There are enough opportunities to inspire us to take action.

Shin Young-soo, MD, Ph.D.Regional Director

viiRoad Safety in the Western Pacific Region: Call for Action

SummaryBackground

• About 300 000 people die each year on roads in the Western Pacific Region.• Millions more suffer nonfatal injuries. • The threat of road traffic injuries to growth is increasing.• There has been no regional assessment of road safety.• This report is the first assessment of the status of road safety in the Region.

Methods• A standardized survey was conducted in 2008.• Respondents from multiple sectors took part and reached consensus on the final answers

to the questionnaire.• Twenty six countries in the Region participated in the survey.

Key findings• Low- and middle-income countries have higher road traffic fatality rates (15.6 and 16.9

per 100 000 population, respectively) than high-income countries (7.3 per 100 000).• Death rates have been declining over the last four to five decades in most high-income

countries in the Region. • More than half of those who die in road crashes are pedestrians, cyclists or users of

motorized two-wheelers–collectively known as “vulnerable road users”.• The proportion of vulnerable road users to total road fatalities is highest (70%) in low-

income countries in the Region compared to middle-income and high-income countries.• There is a lack of policy measures that allow road users to walk and cycle safely.• Measures to improve the quality of and access to public transport are limited.• Only 19 participating countries have helmet laws that are comprehensive in scope (i.e.

require both drivers and passengers of motorized two-wheelers to wear helmets on all roads and regardless of engine type).

• Almost all countries have some kind of national drink–driving law, yet only eight countries have a law that uses a blood alcohol concentration (BAC) limit of less than or equal to 0.05g/dl, as recommended in the World Report on Road Traffic Injury Prevention.

• Of 17 countries in the Region that have speed limits on urban roads of less than or equal to 50km/h, only four countries allow local authorities to reduce national speed limits.

• Of 18 countries reporting national or subnational seat belt laws, only eight countries require all vehicle occupants in front and rear seats to wear seat belts.

• Only 11 countries have legislation about the use of child restraints.• Enforcement for all of these risk factors generally is lax. • While 23 countries report having a lead agency for road safety, only nine countries have

a national road safety strategy that was endorsed by the government, sets targets and funds the strategy.

• Huge gaps remain in the quality and coverage of the data that countries collect on road traffic injuries.

viii Road Safety in the Western Pacific Region: Call for Action

• Underreporting of road traffic fatalities remains a big problem in many countries. The situation is worse with regard to nonfatal injuries.

• The lack of standardization of terminology among sectors within a country and between countries limits comparability of data.

• Only nine countries indicated that they had data on fatal and nonfatal road traffic injuries, estimates of the cost to their economy and data on monitoring and evaluation indicators such as the rates of helmet use and wearing of seat belts.

Key recommendations for governments• The needs of all road users should be taken into consideration when making policy

decisions that impact on road safety. • Vulnerable road users should be given due consideration when decisions are made

about road design and infrastructure, land use planning and transport services. • Public transportation should be strengthened both in urban and rural areas in order to

reduce exposure.• Member states should enact comprehensive laws that require all road users to be

protected through the enforcement of speed limits that are suitable for the type and function of the road, the stipulation of blood alcohol concentration limits that help reduce drink-driving and the use of helmets for motorcyclists and seat belts and child restraints for vehicle occupants. These occupant protection devices should conform to national or international standards. Existing legislation should be reviewed and amended to conform to good practices that are based on sound evidence of effectiveness.

• Enforcement of all road safety laws should be improved. Enforcement efforts must be well-publicized, sustained and implemented through the use of appropriate measures and penalties for infringement.

• Collaboration among different sectors involved in collecting and reporting road traffic injury data should be encouraged. This involves improving data linkages among police, transport and health services, standardization of case definitions and increasing the human capacity to undertake data collection.

• Institutions responsible for road safety should have the necessary human and financial resources to act effectively. The formulation and endorsement of a national strategy with realistic targets and earmarked funding for implementation would help achieve long-term road safety goals.

ixRoad Safety in the Western Pacific Region: Call for Action

Leading causes of death, 2004 and 2030 compared

TOTAL 2004 TOTAL 2030

RANK LEADING CAUSE % RANK LEADING CAUSE %

1 Ischaemic heart disease 12.2 1 Ischaemic heart disease 14.2

2 Cerebrovascular disease 9.7 2 Cerebrovascular disease 12.1

3 Lower respiratory infections 7.0 3 Chronic obstructive pulmonary disease 8.6

4 Chronic obstructive pulmonary disease 5.1 4 Lower respiratory infections 3.8

5 Diarrhoeal diseases 3.6 5 Road traffic injuries 3.6

6 HIV/AIDS 3.5 6 Trachea, bronchus, lung cancers 3.4

7 Tuberculosis 2.5 7 Diabetes mellitus 3.3

8 Trachea, bronchus, lung cancers 2.3 8 Hypertensive heart disease 2.1

9 Road traffic injuries 2.2 9 Stomach cancer 1.9

10 Prematurity and low birth weight 2.0 10 HIV/AIDS 1.8

11 Neonatal infections and other 1.9 11 Nephritis and nephrosis 1.6

12 Diabetes mellitus 1.9 12 Self-inflicted injuries 1.5

13 Malaria 1.7 13 Liver cancer 1.4

14 Hypertensive heart disease 1.7 14 Colon and rectum cancer 1.4

15 Birth asphyxia and birth trauma 1.5 15 Oesophagus cancer 1.3

16 Self-inflicted injuries 1.4 16 Violence 1.2

17 Stomach cancer 1.4 17 Alzheimer and other dementias 1.2

18 Cirrhosis of the liver 1.3 18 Cirrhosis of the liver 1.2

19 Nephritis and nephrosis 1.3 19 Breast cancer 1.1

20 Colon and rectum cancers 1.1 20 Tuberculosis 1.0

Source: World health statistics 2008 (http://www.who.int/whosis/whostat/2008/en/index.html)

WHO predicts that road traffic injuries will rise to become the fifth leading cause of death by 2030.

1Road Safety in the Western Pacific Region: Call for Action

The Western Pacific Region is a diverse collection of 37 countries and areas with large variations in population, geography, wealth, ethnicity and governance systems (Figure 1). Economic progress in recent decades has brought major social improvements to this Region.

Progress has been associated with increased private and public transportation needs. Road use is the primary type of transportation and provides benefits both to countries and to individuals by facilitating the movement of goods and people. However, the increase

1Background

Figure 1. Countries and Areas of the WHO Western Pacific Region

2 Road Safety in the Western Pacific Region: Call for Action

in road transportation also has placed a considerable burden on people’s health in the form of road traffic injuries, respiratory illnesses, noise-induced hearing impairment and the health consequences that ensue from a reduction in physical activity. There are additional negative economic and environmental consequences such as greenhouse gas emissions and consumption of finite resources.

Burden of road traffic injuries in the Western Pacific RegionRoad traffic injuries are one of the top two causes of death for people aged between 5-44 years old (Table 1). According to the 2004 Global Burden of Disease project, there were a total of 336 000 road traffic deaths in this Region that year (1). Of these road traffic deaths, 93% occurred in low- and middle-income countries.

Table 1. Western Pacific Region leading causes of death by age, GBD 2004 (1)0-4 5-14 15-29 30-44 45-69 70+ Total

1 Perinatal causes Drownings Road traffic injuries Road traffic injuries Cerebrovascular disease

Cerebrovascular disease


2 Diarrhoeal diseases Road traffic injuries Self-inflicted

injuriesSelf-inflicted injuries

Chronic obstructive pulmonary disease



3 Lower respiratory infections

Lower respiratory infections Drownings Tuberculosis Ischaemic heart

diseaseIschaemic heart disease

Ischaemic heart disease

4 Congenital anomalies Leukaemia Tuberculosis Cerebrovascular

disease

Trachea, bronchus, lung cancers

Lower respiratory infections


5 Drownings Congenital anomalies Violence Liver cancer Stomach cancer



6 Meningitis Malaria Falls Ischaemic heart disease Liver cancer Hypertensive heart

diseaseHypertensive heart disease

7 Endocrine disorders Falls Leukaemia Falls Oesophagus

cancer Stomach cancer Stomach cancer

8 Tetanus Self-inflicted injuries HIV/AIDS Stomach cancer Tuberculosis Liver cancer Liver cancer

9 Upper respiratory infections Dengue Poisonings HIV/AIDS Self-inflicted

injuriesOesophagus cancer

Oesophagus cancer

10 Malaria Tuberculosis Lower respiratory infections


Road traffic injuries Diabetes mellitus Diabetes mellitus

11 Measles Epilepsy Epilepsy Cirrhosis of the liver

Hypertensive heart disease

Colon and rectum cancers

Colon and rectum cancers

12 Protein-energy malnutrition Violence Ischaemic heart

disease Violence Cirrhosis of the liver Tuberculosis Tuberculosis

13 Road traffic injuries Poisonings Nephritis and nephrosis Poisonings Diabetes mellitus Nephritis and

nephrosisNephritis and nephrosis

14 Poisonings Meningitis Congenital anomalies Drownings Colon and rectum

cancersInflammatory heart diseases

Inflammatory heart diseases

15 Leukaemia Lymphomas, multiple myeloma


Nephritis and nephrosis


Alzheimer and other dementias

Alzheimer and other dementias

16 Falls Endocrine disorders Liver cancer Breast cancer Breast cancer Self-inflicted

injuriesSelf-inflicted injuries

17 HIV/AIDS Cerebrovascular disease Stomach cancer Colon and rectum

cancersNephritis and nephrosis

Cirrhosis of the liver

Cirrhosis of the liver

18 Tuberculosis Fires Rheumatic heart disease Leukaemia Falls Falls Falls

19 Fires Nephritis and nephrosis

Endocrine disorders


Rheumatic heart disease



20 Syphilis Japanese encephalitis

Maternal haemorrhage

Rheumatic heart disease Pancreas cancer Pancreas cancer Pancreas cancer

Source: WHO (2008), Global Burden of Disease: 2004 update


A response to the burdenIn 2004, WHO and the World Bank jointly launched the World Report on Road Traffic Injury Prevention (2). The main recommendations of the report for countries to follow were as follows:

(1) identify a lead agency in government to guide the national road traffic safety effort;(2) assess the problem, policies and institutional settings relating to road traffic injury and the

capacity for road traffic injury prevention;(3) prepare a national road safety strategy and plan of action;(4) allocate financial and human resources to address the problem;(5) implement specific actions to prevent road traffic crashes, minimize injuries and their

consequences and evaluate the impact of these actions. These actions include measures to reduce excessive and inappropriate speed, to reduce drink-driving, to increase the use of motorcycle helmets, seat belts and child restraints and to incorporate safety features in land use and transport planning; and

(6) support the establishment of national capacity and international cooperation.

Efforts to implement road safety measures increasingly are being undertaken in the Region. The Western Pacific Regional Office convened two meetings in 2006 and 2007 to discuss and formulate a Regional Framework for Action on Injury and Violence Prevention, 2008–2013. The framework contains recommended actions pertaining to national policies and plans, including recommendations for specific injury prevention such as road traffic injuries (Table 2) and child and adolescent injuries.

What can be done?

• Identify a lead agency• Assess the problem• Prepare national plan• Allocate adequate resources • Implement specific actions• Develop national capacity• Cooperate with partners

Source: World Report on Road Traffic Injury Prevention


Table 2. Recommended action for road safety Themes and objectives Action categories Key players Targets (optional)

Motorcylist injury prevention Advocate for and support of:• implementation of helmet

legislation• enforcement of helmet

wearing laws• enforcement of helmet

standards• enforcement of general

road traffic lawsMinistry of Health and UN agencies to set policy for staff helmet wearing.

Government, police, NGOs, role models

Ministry of Health,United Nations agencies

Reduce head injuries to motorcyclists by 75%.

Safer routes for pedestrians and bicyclists

Advocate for and support implementation of:• construction of footpaths

and bicycle paths• construction of pedestrian

barriers in unsafe locations• provision of median strips,

overpasses, subways, traffic lights for safe pedestrian crossing points

• separation of bicycles from other traffic

• school policies on safe transport to school

Government, road designers/engineers

Reduce pedestrian deaths by 25%.Reduce bicyclist deaths by 30%.

Vehicle occupant protection Advocate for and support of:• implementation of

mandatory seat belt wearing laws for all vehicle occupants

• enforcement and publicizing of seat belt laws

• enforcement of child restraint laws

• implementation of seat belt reminder systems

• implementation of new vehicle safety rating system

Ministry of Health to establish child restraint loan programmes and set policy for seat belt wearing by staff.

Government, police, automobile associations, automobile industry media

Ministry of Health

Turn around rising trends in occupant deaths and injuries by 2010.Seat belt wearing and child restraint use by at least 80% of vehicle occupants.Awareness of safety rating scheme by new vehicle purchasers.

Make safety a key consideration in design of all roads and vehicles

Advocate for:• making safe road and

vehicle design strategies widely available to all key players

• common road signage for all countries

Government, road designers, traffic engineers, donors

Safety considerations included and funds allocated in new road works.

Reduce harmful use of alcohol Advocate for improved enforcement of alcohol and driving laws.

Transport sector, police, media Reduction in alcohol involved deaths and injuries.

Adequate public transport Advocate for the provision of public transport to lessen exposures of vulnerable road users, such as pedestrians, bicyclists and motorcyclists.

Governments Reduction in vulnerable road user deaths and injuries.

(Adapted from the Regional Framework for Action on Injury and Violence Prevention, Western Pacific Region, WHO, 2008-2013)


The United Nations Economic and Social Commission for Asia and the Pacific (ESCAP) adopted a Ministerial Declaration on Improving Road Safety in Asia and the Pacific in the Republic of Korea in 2006.

In June 2009, WHO launched the Global Status Report on Road Safety (GSRRS). This Regional report, a supplement to the GSRRS, details the progress of road safety made by countries.

Survey methodThe objectives of the survey were:

(1) to assess the status of road safety in Member States using a core set of road safety indicators and a standardized methodology;

(2) to indicate gaps in road safety;(3) to help countries identify key priorities for intervention; and (4) to stimulate road safety activities at the national level.

With these objectives in mind, WHO began to formulate the methodology for the survey in August 2007. A self-administered questionnaire was created using the recommendations of the World Report on Road Traffic Injury Prevention as a guideline.

The following areas were addressed in the questionnaire:(1) institutional settings and policies (existence of a lead agency on road safety, a national

strategy on road safety and allocation of funding for the activities of both);(2) data (road traffic fatalities, nonfatal injuries and on the cost of road traffic injuries);(3) exposure to risk (existence of policies to encourage nonmotorized modes of transport

and public transport and strategies to achieve these and levels of motorization);(4) vehicle and infrastructure standards (the existence of manufacturing standards,

requirements for safety audits of road infrastructure projects and vehicle inspection requirements);

(5) legislation on some of the main behavioural risk factors (speed, drink-driving, including BAC limits, use of motorcycle helmets, use of seat belts and child restraints and perceptions of enforcement levels relating to each of these risk factors); and

(6) pre-hospital care (existence of a formal, publicly available pre-hospital care system and of emergency access telephone numbers).

Data collection began in February 2008 and was completed in October 2008. The data were validated by WHO and the National Data Coordinators (Table A Statistical Annex) and then sent for government clearance.

Details of the methodology are given in the Global Status Report on Road Safety (www.who.int/violence_injury_prevention/road_safety_status_2009).


In the Western Pacific Region, 26 countries participated in the global survey and their data are presented in this report (Table 3).

Table 3. Participation of Western Pacific Region countries in the survey by income group

Participating countries High-income Australia, Brunei Darussalam, Japan, Republic of Korea, New

Zealand, Singapore

Middle-income China, Cook Islands, Fiji, Kiribati, Malaysia, Marshall Islands, Federated States of Micronesia, Mongolia, Nauru, Palau, Philippines, Samoa, Tonga, Tuvalu, Vanuatu

Low-income Cambodia, Lao People’s Democratic Republic, Papua New Guinea, Solomon Islands, Viet Nam

Non-participating countries Niue, Tokelau*

Note: There are 27 WHO Member States and one Associate Member State* in the Western Pacific Region.

The main text contains an analysis of aggregated information while the country profiles in the annex describe the main variables reported by each participating country. The statistical annexes include country-by-country results and modeled data on road traffic deaths and details of the modeling method.

Modeling was used to address the issues of underreporting of road traffic deaths. The model was created using a negative binomial regression and took into account the definition of road traffic death, completeness of vital registration, coding of external causes of death, population, reported number of road traffic deaths, income level, road density, vehicle density, strength of the health care system and the existence of mitigating factors. It was then used to estimate the expected number of road traffic deaths for countries with vital registration completeness that was less than 85% or external causes of death coded to undetermined intent that were greater than 30%.

The survey methodology required respondents from multiple sectors to take part and reach consensus on the final answers. However, there are a number of limitations. Sources of data and interpretations of terms used in the questionnaire were different. Countries reported data for different years. Subnational legislation was not recorded since the survey focused on national data. There was a potential for bias in rating the perception of enforcement. Incomplete data affected the ability to analyse and report data. Nevertheless, this methodology fostered multisectoral collaboration by linking road safety practitioners in the country.


Road Safety in the Western Pacific Region2

Road traffic injuries are a major threat to growth

Road traffic injuries remain a major threat to growth in the Region. The total number of deaths reported in this survey of the Region is 139 156 (using a 30-day definition since countries use different definitions for a road traffic death) (Table 4 and Table

B, Statistical Annex). When these data are modeled (see explanatory notes in Statistical Annex), the total 30-day number for the 26 countries included in the study is 278 321. The Global Burden of Disease 2004 estimated a figure of 336 000 deaths for the Region in 2004. This indicates vast underreporting in road traffic injury deaths. According to the modeled data, the Western Pacific Region accounted for 23% of the global road deaths and 24% of the global motorized vehicles.

Table 4. Global and Western Pacific Region road traffic deathsSource Global WPR

Global burden of disease, WHO 2004 1 270 000 336 000

Reported number of deaths in this study (using a 30-day definition)

668 907 139 156

Modeled data (see statistical annex) 1 237 774 278 321

Modeled fatality rate/100 000 population (using a 30-day definition): all countries

18.7 15.7

Low-income countries (LIC) 21.3 15.6

Middle-income countries (MIC) 19.5 16.9

High-income countries (HIC) 10.3 7.3


Death rates are highest in low- and middle-income countries, but high-income countries cannot be complacent

Low- and middle-income countries contribute to 88% of the Region’s population and 60% of the Region’s total vehicles and yet account for 95% of the Region’s road traffic deaths (Figure 2). These countries also had higher rates per 100 000 population than high-income countries (Table 4). Unlike the global trend, middle-income countries in the Region have a slightly higher rate than low-income countries. This is probably because of rapid motorization, especially in populous middle-income countries such as China.

Figure 2. Population, vehicle ownership and road traffic deaths in the Western Pacific

Region by income group (modeled data) According to the modeled data, 93% of the Region’s deaths occurred in the following four low- and middle-income countries (in descending order): China, the Philippines, Viet Nam and Malaysia.

High-income countries in the Region had similar high levels of road traffic death rates more than three decades ago (Figure 3). A concerted and systems approach in these countries has been responsible for the reduction in road traffic death rates over the last few decades. Current road safety policies and interventions in place are given in Table 5 and in Box 1.


Figure 3: Trends in road traffic deaths in high-income countries in the Western Pacific Region

Table 5. Major road safety efforts by high-income countries in the Region Australia Japan New

ZealandRepublic of

KoreaSingapore

Lead agency within government

Yes Yes Yes Yes Yes

National road safety strategy with funds and targets

Yes Yes Yes Yes Yes

Has a drinking and driving law (BAC in g/dl)

0.05 0.03 0.08 0.05 0.08

Seat belt law enforced for all occupants

Yes Yes Yes Yes Yes

Child restraint law Yes Yes Yes Yes Yes

Helmet law for all occupants, all roads, all engines

Yes Yes Yes Yes Yes

Urban speed limits (in km/h) 50 * 50 60 40-70

* Different system of road classification.


Box 1: Road safety initiatives in high-income countries in the RegionThe Federal Government of Australia has a broad strategic role in road safety. Legislative and operational responsibility for road safety rests with state and territorial governments. This includes road rules, traffic regulation and enforcement, vehicle registration, driver education and licensing and road construction and maintenance. Legislative efforts by state governments include legislation for seat belts, child restraints, helmets (motorcycle and bicycle helmets), drinking and driving and speed limits. This legislation, strategically combined with effective enforcement and educational campaigns, has resulted in the continuous decline in road traffic death rates despite an increase in population and number of vehicles.

The Republic of Korea has a multisectoral Committee on Traffic Safety. The committee coordinates a wide range of activities such as enforcement, education of target groups, safety audit of roads and vehicles and research. Institutions that conduct road safety research include the Korea Transport Institute and the Traffic Sciences Institute. Effective coordination of multisectoral efforts has resulted in a reduction in road traffic injury death rates.

In Japan, the Central Committee on Traffic Safety Measures, consisting of 13 cabinet members, is chaired by the prime minister. The committee is responsible for preparing regular road safety plans, including the Eighth Fundamental Traffic Safety Programme during the period 2006-2010. Areas covered under this plan included adequate and efficient public transportation, design of roads to serve all categories of users, including pedestrians, strict enforcement of road safety legislation and educational programmes. Effective leadership and implementation of these comprehensive plans has resulted in the reduction in road traffic death rates.

The New Zealand “Road Safety to 2010” strategy was launched by the minister of transport in 2003. The strategy seeks to reduce road traffic deaths to no more than 300 deaths and 4500 hospitalizations by 2010. Similar previous road safety plans played an important role in reducing deaths from 729 in 1990 to 404 in 2002. The focus of the strategy is on enforcement, education and improvement in road and vehicle design to compensate for human error. The strategy was formulated in consultation with the multisectoral National Road Safety Committee. Implementation of well-drafted action plans has resulted in an overall reduction in road traffic deaths.

Singapore’s land use and transportation strategies include the planning of residential and commercial areas, investment in pedestrian paths and crossing facilities, an integrated, efficient and sustainable public transportation system and financial disincentives for car ownership. These strategies, together with efforts to strictly enforce traffic laws and improvement in trauma care, have resulted in a safe environment with a road traffic death rate of 4.8 per 100 000 population in 2007.


Road traffic injury prevention remains very relevant to high-income countries as well. The downward trends in road traffic fatalities that began in the 1970s and 1980s have started to flatten in recent years. Strategic action is needed in these countries in order to reduce these rates further. Opportunities for improvement in road safety include setting targets and formulating appropriate strategies, investment in alternate forms of transport, safer vehicles, improvement in trauma care systems and better enforcement of laws (Box 2).

Box 2: Setting road safety targets

(Adapted from the “National Road Safety Strategy 2001-2010”, Australian Transport Council)

Australia achieved significant reductions in the road toll in the early and mid-1990s, but since 1997 the road toll has remained constant. There is much more that we can and must do.

Our target is to achieve a 40% reduction in the number of fatalities per 100 000 population by 2010. It is a difficult target, but an achievable one. Achieving this target will save about 3 600 lives over the next 10 years. It is a target that will require strenuous effort by all parties involved in road safety. In addition to our own transport agencies, we therefore ask for the continuing support of road users and user groups, the media, police, health care providers, schools, local government, vehicle builders, employers and the wider community.

The challenge is to move our thinking from ways to limit the toll to how to create a genuinely safe road transport system and to work out how to achieve such a system.

Vulnerable road users account for more than half of road traffic deathsVulnerable road users (pedestrians, cyclists, and those using motorized two- or three-wheelers) constitute the majority of total deaths in this Region, especially in low-income countries (Figure 4). These groups of road users do not have a protective shell around them and are therefore more at risk than those in vehicles.


Figure 4. Reported deaths by type of road user (%) and income group, Western Pacific Region

Republic of Korea - Helping a child cross the street

© R

OTA

, Rep

ublic

of K

orea

“Vulnerable road users” include:

• Pedestrians• Cyclists• Riders and passengers of

motorized two- and three- wheelers


Figure 5 shows the trends in road traffic deaths in Cambodia, the Lao People’s Democratic Republic and Viet Nam where the proportion of motorized two-wheelers form more than three quarters of motorized vehicles.

Figure 5. Trends in road traffic deaths in Cambodia, the Lao People’s Democratic Republic and Viet Nam

Cambodia Lao People’s Democratic Republic

Viet Nam

Most likely, the increase in road traffic death trends in these three countries is associated with the sudden escalation in the number of motorized two-wheelers.

Table 6 shows the proportion of motorized two- and three-wheelers to the total number of vehicles and the proportion of deaths among these vulnerable road users in selected countries. Though the data for the two variables may not be for the same year, the table shows that riders and passengers of two- and three-wheelers are over-represented in fatality figures in these countries.

As the number of motorcycles increase in a country, the risk to motorcycle riders and passengers increases disproportionately because they are more vulnerable if a crash occurs.


© r

ota, Republic of Korea

Table 6: Motorized two- and three-wheelers in selected countries in the Western Pacific Region

countryMotorized 2-and 3-wheelers as a

proportion of all vehicles (%)

DEATHS in 2-and 3- wheeler riders/ passengers as a proportion of total

road deaths (%)

Australia 4 15

Brunei Darussalam 4 11

Japan 14 18

Kiribati 13 44

Malaysia 47 58

Mongolia 1 17

New Zealand 3 9

Republic of Korea 10 21

Singapore 17 48

Note: Data may not be for the same year

Reducing, or at least controlling the increase in the volume of two-and three-wheelers through affordable and effective public transportation is an important road safety strategy for countries at all income levels. However, at the very least, these vulnerable road users should be separated from vehicular traffic and mandated by law to use safety devices and reflective garments.

More than 80% of registered vehicles in Cambodia are motorcycles.

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Box 3: Road safety in ASEAN countriesThe Association of South East Asian Nations (ASEAN) consists of seven countries in the Western Pacific Region (Brunei Darussalam, Cambodia, the Lao People’s Democratic Republic, Malaysia, the Philippines, Singapore and Viet Nam) and three countries in the South-East Asian Region (Indonesia, Myanmar and Thailand). This grouping is used by many international and regional road safety organizations and therefore is shown together in this box.

Among these 10 countries, Malaysia has the highest death rate per 100 000 population and Singapore has the lowest rate.

a These countries are included in the South-East Asia Region.Source: GSRRS Table A.2, Statistical Annex (based on modeled numbers)

Road safety laws pertaining to helmets, drinking and driving, speed limits, seat belts and child restraints in the ASEAN countries are in the table below.

Country BAC law ≤0.05 g/dl

Seat belt law applies to all occupants

Child restraint law

Helmet law and standards

Urban speed <50km/hr

Brunei Darussalam

Cambodia

Indonesiaa

Lao People’s Democratic Republic

Malaysia

Myanmara – –

Philippines

Singaporeb

Thailanda

Viet Nam

a These countries are included in the WHO South-East Asia Region.b Urban speed limit is 40-70km/hr.– No data

present

not present


Box 3: continued

All countries except Cambodia, Lao People’s Democratic Republic and Philippines have a helmet law and have established helmet standards. Cambodia and Lao People’s Democratic Republic have a national helmet law while the Philippines has subnational laws. All countries except the Philippines have a drinking and driving law. However, only two countries have a legal blood alcohol concentration limit of <0.05 g/dl as recommended in the World Report on Road Traffic Injury Prevention. Three countries, Brunei Darussalam, Indonesia and Thailand, have urban speed limits of >50 km/hr. The seat belt law applies to all occupants in three countries only: Lao People’s Democratic Republic, Philippines and Singapore. The child restraint law exists only in Brunei Darussalam, Cambodia and Singapore.

All ASEAN countries should have comprehensive legislation on all these risk factors in order to improve their safety situation.

All countries have lead agencies for road safety in the government. However, only six countries, Indonesia, Malaysia, Myanmar, the Philippines, Singapore and Thailand, have a government-endorsed road safety strategy with specific targets and earmarked funds.

In 2004, the ASEAN ministers of transport made a declaration on road safety and adopted the Regional Road Safety Strategy and Action Plan 2005–2010, which is modeled on successful road safety action plans from around the world. It encompasses the individual road safety action plans being implemented in each ASEAN country. The plan was produced with the support of the Asian Development Bank. In recent years, the Transport Advisory Group of ASEAN, in conjunction with the Global Road Safety Partnership (GRSP), has organized annual workshops to discuss common issues and monitor progress in road safety.

Effective transportation policies are importantInformation obtained from the survey suggests that many countries are not giving sufficient attention to public transport policies and the needs of vulnerable road users in the planning of land use or road construction (Tables 7 and 8). Roads are planned and built to allow motor vehicles to travel faster while little consideration is given to the needs of vulnerable road users. Pedestrians and bicyclists also face increasing risks in using and crossing the roads (3,4). Countries should introduce mandatory safety audits when planning and designing roads. The Asian Development Bank has produced guidelines on road safety audit (http://www.adb.org/Documents/Books/Road-Projects/Road-Safety-Audit-for-Road-Projects.pdf). Public transport users such as buses also may be vulnerable, particularly when public vehicles are unsafe, overcrowded or unregulated.


Table 7. National policies to encourage walking and cycling

Country Investment in bicycle lanes

Investment in footpaths

Traffic calming measures

Support increased cycling

Australia YES YES YES YES

Malaysia NO YES YES NO

Mongolia NO YES YES NO

New Zealand Yes YES YES NO

Nauru NO YES NO NO

Palau NO YES NO NO

Republic of Korea Yes YES YES YES

Solomon Islands YES YES Yes NO

Note: The Philippines and Singapore reported subnational policies. Other countries in the Region did not report policies.

YES denotes presence of policy; NO denotes no mention of policy.

Table 8. National policies to support public transport

CountrySubsidized pricing of public transport

Improved service of public transport

Disincentives for private car use

Australia YES YES NO

China YES YES NO

Japan NO YES NO

Malaysia YES YES YES

Mongolia YES NO NO

New Zealand YES YES NO

Philippines YES YES NO

Republic of Korea YES YES YES

Singapore YES YES YES

Viet Nam YES NO YES

Note: The Lao People’s Democratic Republic and Palau reported policies to support public transport and did not specify details. Other countries in the Region did not report policies.

YES denotes the presence of policy; NO denotes no mention of policy.

Reducing exposure to the risk of injury or death on the roads also may be achieved by reducing the total amount of motorized road transport. This requires considerable investment in infrastructure that facilitates public transportation and pedestrian safety (Box 4). Policy-makers need to address the ability of road users to walk and cycle safely, ensure the availability of affordable and safe public transport and seek ways to reduce dependency on the use of private vehicles. Separate lanes for different categories such as pedestrians, cyclists, motorcyclists and buses, depending on the traffic flow, should be considered when planning roads.

b

c


Box 4: Transport planning in AsiaThe United Nations Centre for Regional Development (UNCRD) launched the Regional Environmentally Sustainable Transport (EST) Forum in Asia with the “Aichi Statement” in 2005. This statement outlined specific actions that Asian countries and cities can take in major areas, including public health, land-use planning, urban infrastructure, public transportation, road safety, air quality, traffic noise, clean fuel and vehicle emission. The EST Forum brings together all major regional stakeholders in addressing the urgent problems facing Asia’s urban transport sector.

Source: http://www.uncrd.or.jp/env/est/

Zebra crossing and overhead pedestrianbridges in Japan

Walk to school programmes in the Philippines

Well-enforced comprehensive road safety laws are neededEnacting and enforcing legislation on a number of risk factors for road traffic injuries and deaths is critical in influencing exposure to risk, crash occurrence, injury severity and post-crash injury outcomes. Comprehensive and clear laws, enforced with appropriate penalties

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and accompanied by public awareness campaigns, have been shown to be a critical factor in reducing road traffic injuries and deaths associated with speed, drink–driving, and the nonuse of occupant protection measures (helmets, seat belts and child restraints). The results of the global survey suggest that laws relating to these risk factors are not comprehensive in many countries and enforcement often is lacking. Similarly, many countries lack the institutional mechanisms and resources that would allow them to implement planned activities in a coordinated fashion, including adopting and enforcing laws, which may result in a piecemeal approach to road safety efforts that is prevalent in many countries.

Motorcycle helmets (Table C, Statistical Annex)In the Region, 22 countries have laws at either the national or subnational level that require helmets to be worn by users of motorized two-wheelers. However, laws are incomplete in some countries. For instance, some countries make exceptions for motorcyclists using low-powered engines while other countries exempt all passengers, including children or people with religious headgear. This survey found that 19 countries in the Region have helmet laws that are comprehensive in scope (i.e. to require both drivers and passengers of motorized two-wheelers to wear helmets on all roads and regardless of engine type).1 Further, the results show that helmet standards are lacking in nine countries (with laws), thus calling into question the ability of a law on helmet-wearing to achieve its purpose.

Even where laws are in place, enforcement is weak in most countries. Only 6 countries rate their enforcement of helmet-use laws as higher than seven on a scale of 0 to 10. The impact of helmet laws that are in place is also difficult to ascertain in many countries. Only 14 countries have some data on helmet-wearing rates, and the reliability of the results may vary considerably. Wearing rates ranged from 0 to 100 percent, and in some instances the data were for drivers only (not for passengers) and for certain sites only (not national data).

Helmet wearing - Summary• 22 countries of the 26 participating countries have a helmet law• 19 countries have comprehensive helmet laws• 13 countries have helmet standards• 6 countries rate their enforcement level as adequate

1 Some of these have exceptions, such as exempting those for medical reasons or for religious reasons.


Figure 6: Motorcycle helmet laws and helmet standards by country

© Krishnan/w

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What is known?

• Wearing a motorcycle helmet correctly can reduce the risk of death and severe injury.

• When motoryclcle helmet laws are enforced effectively, helmet-wearing rates can increase.

• Requiring motorcycle helmets to meet a recognized standard is important to ensure that helmets can effectively reduce the impact of a collision to the head in the event of a crash.


RecommendationsAll countries should have mandatory laws and strong, consistent enforcement on helmet use on motorized two- and three-wheelers.

• These laws should cover all riders who are legally permitted to ride on motorized two- or three-wheelers, all engine types and all road types.

• Countries should enact laws requiring helmets to meet a national or international standard.• Legislation should be supported by systems to collect data on rates of helmet-wearing.

For more details of implementation of helmet laws, log on to http://www.who.int/roadsafety/projects/manuals/helmet_manual/en/

It is dangerous for young children to ride pillion (as passengers) on a motorized two-wheeler. Adults should be encouraged not to transport young children in this way and to find alternate travel options. However, in many countries, the reality is that the motorized two-wheeler is the family vehicle and alternate transport options are limited. The use of standardized, correctly fitted helmets for all children on motorcycles is encouraged as an injury-reduction strategy.

Children are not exempted by law fromwearing helmets in Viet Nam

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Box 5: The implementation of the national helmet law in Viet Nam

Motorcycles represent 95% of Viet Nam’s registered vehicles. An estimated 60% of all road traffic fatalities are motorcycle riders and passengers.

In response to the high burden of motorcycle injuries and deaths, Viet Nam has had some form of national helmet law since 1995. But the impact of this and successive laws was limited due to barriers where the laws applied and the lack of enforcement and lack of quality, climatically suitable helmets.

Viet Nam introduced the first comprehensive mandatory helmet law on 29 June 2007. It took effect on 15 December 2007, covering all riders and passengers on all roads nationwide.

There was strict enforcement and education campaigns were established as priorities before implementation of the law. Penalties were increased tenfold. More than 600 000 tickets were issued against riders and passengers for not wearing helmets in the first year of the helmet law.

In selected provinces under observation, helmet-wearing increased significantly in the first six months of the helmet law. In Da Nang, for example, helmet-wearing in riders and passengers increased from 27% to 99%. Such increases are anecdotally indicative of the nationwide situation. Data from a sample of hospitals indicated that the risk of road traffic head injuries and deaths decreased by 16% and 18%, respectively, in the three months after the helmet law was introduced.

Viet Nam has joined a growing list of countries that are tackling motorcycle injuries by formulating a mandatory helmet law. The implementation and thorough enforcement of this law has contributed to a substantial increase in helmet-wearing and significant reductions in road traffic head injuries and fatalities.

Despite the progress, challenges remain. The high levels of enforcement that have contributed to almost universal compliance and education programmes need to be maintained. Also, helmets sold in the market need to meet national standards for quality.

The motorcycle helmet law took effect in Viet Nam on 15 December 2007.

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Box 6: Bicycle safety There are an estimated 800 million bicycles in the world. In Asia alone, bicycles carry more people than do all of the world’s motor cars. However, bicycle injuries are not receiving their due attention.

To reduce bicycle injuries, several types of interventions are likely to be effective:

Changes to the road environment, including:• Separate lanes for bicycles• Engineering measures to control traffic flow• Traffic signals for bicyclists• Painted lines on the side of the road

Removing obstacles from road and bicycle paths• Creating clear lines of sight• Repairing road surfaces to remove potholes and dangerous curbs

Measures involving changes to bicyclists’ behaviour, including:

• Use of a bicycle helmet• Safe bicycling practices

Legislative measures, including:• Laws mandating helmet use• Legal limits on alcohol use while bicycling• Speed restrictions• Enforcement of traffic laws

Introducing a package of these measures is likely to be more effective than if they are introduced singly.Adapted from the World Report on Road Traffic Injury Prevention

Malaysia has implemented bicycle helmet programmes for school children

Separate bicycle lanes are an important component of the road infrastructure in China

© Krishnan / W

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© Passm

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Drinking and driving (Table D, Statistical Annex)All participating countries in the Region, except the Philippines, report having either national or subnational laws on drink-driving. However, only eight countries have a drink-driving law that uses a BAC limit of less than or equal to 0.05g/dl, as recommended in the World Report on Road Traffic Injury Prevention.

Young or novice drivers are at a much increased risk of having a road traffic crash when under the influence of alcohol. Consequently, the World Report on Road Traffic Injury Prevention advised that BAC limits for this group be set lower than limits for the general population. Only Australia and New Zealand have lower stipulated BAC limits for young and novice drivers than for the general population and accompany them with hard-hitting messages to sensitize this vulnerable group of drivers (Box 7).

Use of breath analyser to detect drinking and driving in Mongolia

Making the message relevant - a poster campaign from Papua New Guinea

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What is known?

• Drinking and driving increases the risk of a crash and the likelihood of death or serious injury.

• The risk of involvement in a crash increases significantly above a BAC of 0.04 g/dl.

• Enforcing laws and random breath testing can lead to reductions in alcohol related crashes.


Box 7: Land Transport New Zealand launches hard-hitting campaign against drink-driving

In spite of significant gains in the past 20 years, drink-driving in New Zealand remains a leading cause of death and injury on the country’s roads. Each year, nearly 2 000 people are killed or injured in drink-driving crashes. For almost 10 years, Land Transport New Zealand has run a hard-hitting road safety campaign using vivid and realistic road safety images. Since 2004, it also has tried through its advertising campaigns to increase the demand from society for a change in behaviour by dangerous drivers.

The organization’s approach targets those associated with the drunk-driver rather than the would-be offenders directly. Friends, family and work colleagues–the people who can influence a drunk-driver–are encouraged to take on the problem themselves and attempt to change the person’s behaviour. The government supports this road safety campaign with annual funding of about NZ$ 9.5 million (US$ 6.5 million) for advertising.

The advertising campaign approach highlights the link between drink-driving and road crashes. By presenting drink-driving as socially unacceptable and by stimulating social pressure against the practice, Land Transport New Zealand seeks to bring about a widespread change in attitudes and behaviour. The campaign is continually evaluated to assess its effect on people’s attitudes to road safety and their behaviour on the roads and, ultimately, its effectiveness in helping to cut the number of deaths and injuries.

Source: Toroyan T, Peden M (eds). Youth and Road Safety. Geneva: WHO, p.27.

Source: Land Transport New Zealand, www.landtransport.govt.nz photo © Land Transport New Zealand

Random breath-testing and police checkpoints are important enforcement mechanisms that have been shown to reduce alcohol-related crashes. Most countries report that they use one or both of these methods of enforcement. In 13 countries, the proportion of road traffic deaths attributable to drinking and driving was 25% or higher (Table 9). Drinking and driving is an important issue in the Region and yet only two countries report an enforcement rating as higher than seven on a scale of 0 to 10.


Table 9: Proportion of road traffic deaths attributable to alcohol in Western Pacific Region countries and areas

CountryProportion of road traffic deaths that are attributable to alcohol (%)

Australia 30.0

Brunei Darussalam 3.7

Cambodia …

China 4.2

Cook Islands …

Fiji 27.0

Japan 8.3

Kiribati 30.0

Lao People’s Democratic Republic 48.0

Malaysia …

Marshall Islands 70.0

Federated States of Micronesia 90.0

Mongolia 3.7

Nauru …

New Zealand 31.0

Palau 100.0a

Papua New Guinea 66.0

Philippines …

Republic of Korea 16.1

Samoa 50.0

Singapore 7.0

Solomon Islands 55.0

Tonga 25.0

Tuvalu …

Vanuatu …

Viet Nam 34.0

a Refers to only three deaths.… No data

Drinking and driving - Summary• All 26 participating countries except the Philippines have a drinking-and-driving law.• Eight countries stipulate a BAC level of <0.05 g/dl.• Two countries have lower BAC levels for novice drivers.• Two countries report adequate enforcement levels.


Figure 7: Blood alcohol concentration limits (g/dl) by country

Recommendations for drinking and driving• All countries should have a drinking-and-driving law and should strictly enforce it. • Drinking and driving laws should be based on BAC levels, or the equivalent breath alcohol

content limits, which should be 0.05 g/dl or below. • All countries should set limits of 0.02g/dl or below for young and novice drivers.

For more details of implementation of drinking and driving laws, log on to http://www.who.int/roadsafety/projects/manuals/alcohol/en/


Speed limits (Table E Statistical Annex)In the analysis of the results of this survey, the criteria used for assessing urban speed management were:

(1) speed limits on urban roads are set at less than or equal to 50km/h; and(2) local authorities are able to lower these speed limits where necessary.

Of 17 countries that have speed limits on urban roads of less than or equal to 50km/h (Table 10), only four countries allow local authorities to reduce national speed limits. Only two countries rate the enforcement of their national speed limits at higher than seven on a scale of 0 to 10. The results suggest that urban speed management is poor in most countries. Even in countries where speed limits may be more restrictive, enforcement is frequently lacking. Traffic-calming measures should be implemented in residential areas or near schools.

Table 10. Speed limits and effectiveness of enforcement in Western Pacific Region countries and areas

CountryMaximum speed Effectiveness of overall

enforcement (respondent consensus) (scale 1–10)

On urban roads (km/h)

On rural roads (km/h)

Australia 50 100 Sub-national

Brunei Darussalam 80 65 7

Cambodia 40 90 1

China 30–50 40–70 8Cook Islands 50 50 4Fiji 50 60 7Japan * * No consensusKiribati 40 60 6Lao People’s Democratic Republic 40 50 5Malaysia 50 90 6Marshall Islands 40 40 5Federated States of Micronesia 32 40 6Mongolia 60 80 4

Nauru 40 40 …

New Zealand 50 100 7Palau 40 50 5

Papua New Guinea 60 75 1

Philippines 40 40 3

Republic of Korea 60 80 7

Samoa 40 56 6Singapore 40–70 N/a. 8Solomon Islands 60 N/a. 5Tonga 40 65 7Tuvalu 64 … 6

Vanuatu 35–60 N/a. 3

Viet Nam 50 80 6* Different road classification used… No data


Urban speed limits - Summary • 17 of the 26 participating countries have urban speed limits ≤50 km/h• Only four countries allow local authorities to reduce speeds further• Only two countries rate their enforcement of speed as adequate

Recommendations on speed limits• Countries should set speed limits that reflect the function of individual roads. In doing so,

they should consider the types of vehicles using the road, the nature and purpose of the road, roadside activities, provision of facilities for vulnerable road users and the frequency of use by pedestrians and cyclists.

• Local authorities should be given the power to set speed limits to levels that may be lower than national limits where vulnerable road users are particularly at risk.

• The public should be made aware of the need for strict enforcement of speed limits.• Roads in residential or commercial areas or near schools where large numbers of

pedestrians or bicyclists can be expected should have lower speed limits and traffic-calming measures to ensure that the lower speeds are maintained at all times.

For more details of implementation of speed limits, log on to http://www.who.int/roadsafety/projects/manuals/speed_manual/en/

Box 8: Reducing speed (Adapted from “Road Safety to 2010”, New Zealand)Excessive speed contributes to about 30% of fatal crashes and it increases injury severity in crashes with other causes. Reducing actual vehicle speeds is one of the most effective ways of reducing road trauma. Lower speed tolerances and the highly visible Highway Patrol have already resulted in reduced average traffic speeds. Road design can also contribute effectively to lower speeds, particularly in urban areas. There are signs of hope in our efforts to curb speeding. There is strong support for speed cameras and speed limit enforcement as ways to reduce road deaths and injuries. But too many people still travel too fast and ignore the lethal impact of speed, with devastating consequences for drivers and their passengers as well as for pedestrians and cyclists.

Use of speed gun by police to detect speeding in Cambodia

© HIB - VIsal They


Seat belts and child restraints (Table F Statistical Annex)Of 18 countries reporting national or subnational seat belt laws, only eight, including four out of the six high-income countries, require all vehicle occupants in front and rear seats to wear seat belts. However, enforcement of seat belt laws is weak in most countries. Only four countries rate enforcement of their seat belt laws above seven on a scale of 0 to 10. Levels of seat belt-wearing were reported for 16 countries and ranged between 0 to 100% (Table 11).

There are seven countries in the Region that manufacture or assemble motor vehicles. All but one require seat belts to be fitted in all seats of vehicles.

Seat belts - Summary• Only 18 of the 26 participating countries have seat belt laws.• In 12 countries, this law applies to ALL occupants.• However, it is only enforced for ALL occupants in eight of these countries.• Four countries rate their seat belt law enforcement as adequate.

The survey found that only 11 of the participating countries have a child restraint law–all six high-income countries plus Cambodia, Fiji, Kiribati, Mongolia and Samoa. Even where legislation is in place, enforcement of child restraint laws is generally low. Only one country with a national law on the use of child restraints reports enforcement as being above seven on a scale of 0 to 10.

Child restraints - Summary• Only 11 countries have a child restraint law.• Only one country rates its child restraint law enforcement as adequate.

Malaysia introduced a law for rear seat belt use in January 2009. A law for seat belt use by drivers and front seat passengers was already in force.

A child restraint

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Table 11: Seat belt wearing rates in Western Pacific Region countries and areas

Country/Area National seat belt-wearing rateAustralia 97% front seats; 92% rear seats

Brunei Darussalam 70% front seats

Cambodia 0%

China 50%a

Cook Islands …

Fiji 95% front seats; 70% rear seats

Japan 91%–96% front seats; 9%–14% rear seats

Kiribati …

Lao People’s Democratic Republic …

Malaysia 70%

Marshall Islands 5% front seats; 0% rear seats

Federated State of Micronesia 100% front seats; 0% rear seats

Mongolia 70%–80% drivers

Nauru …

New Zealand 95% front seats; 87% rear seats

Palau …

Papua New Guinea …

Philippines 52% drivers only

Republic of Korea 77% front seats

Samoa …

Singapore 50%

Solomon Islands …

Tonga <1%

Tuvalu 0%

Vanuatu …

Viet Nam …a Guangzhou and Nanning cities only


Figure 8: Seat belt laws by country

What is known?

• Wearing a seat belt reduces the risk of fatality among front seat and rear seat passengers.

• Mandatory seat belt laws, their proper enforcement and appropriate public awareness campaigns are effective in increasing rates of seat belt wearing.


Figure 9: Child restraint legislation by country

What is known?

• Children who are unrestrained in a car are at increased risk of injury and death in the event of a collision.

• Appropriate child restraint systems are designed with the child’s development stage in mind.

• If correctly installed and used, child restraints reduce the risk of severe injury and death.

• Mandatory child restraint laws and their enforcement lead to increase in the use of child restraints.


Recommendations for seat belts and child restraints• Vehicle manufacturers and assemblers should be required by law to fit seat belts in both

front and rear seats of all vehicles, regardless of the end market.• Seat belt laws should be improved to cover all front and rear seat occupants. • Child restraint laws should be enacted and enforced. These laws should specify the

type of restraint, the child’s age for which each restraint is appropriate and the seating position. Child restraints should be made more accessible and affordable.

• Enforcement efforts should be strengthened in many countries and must be equally applied to the occupants, including children, of both front and rear seats in vehicles.

• Laws should be supported by methods to collect data on rates of seat belt and child restraint use.

• Enforcement efforts should be backed by intensive mass media education programmes that highlight the risk of injury when not wearing a seat belt or using a suitable child restraint and increase the perception of being detected and penalized.

For more details of implementation of seat belt and child restraint laws, log on to http://www.who.int/roadsafety/projects/manuals/seatbelt/en/


Box 9: New national safety laws to better protect children in cars, Victoria, Australia

All children up to the age of seven years in Victoria, Australia will need to be secured in an approved restraint or booster seat when travelling in vehicles, under new road safety laws to be introduced in November 2009 to better protect children from serious injury. The new laws are based on the latest safety research available.

According to Roads and Ports Minister Tim Pallas, “Parents are currently moving their children into adult seat belts from about the age of five and half years – but research suggests this is too early. Children up to seven years are at least four times more likely to sustain a head injury in a crash when sitting in an adult seat belt.”

“Seating children aged four to seven years old in an appropriate booster seat reduces their risk of injury in a crash by almost 60%, compared to sitting with only an adult seat belt.”

The national age-based changes to child restraint and booster seat rules require:• children less than six months to be secured in an approved, properly fastened and adjusted,

rear-facing child restraint, such as an infant capsule;• children from six months to less than four years must be secured in an approved, properly

fastened and adjusted, rear-facing child restraint or a forward-facing child restraint with an inbuilt harness; and

• children aged from four years to less than seven years must wear an approved, properly fastened and adjusted, forward-facing child restraint with in-built harness or an approved booster seat which is properly positioned and fastened.

New safety laws relating to children up to seven years old travelling in vehicles with two or more rows of seats will be introduced later.

Under the changes to be introduced in November 2009:• children under four years will not be allowed to travel in the front seat of a vehicle with two

or more rows; and• children aged between four and less than seven years will not be allowed to travel in the

front seat of a vehicle with two or more rows, unless all other back seats are occupied by children aged under seven.

These laws aim to keep children out of the front seat of a vehicle where possible to further reduce their injury risk in a crash.

Mr Pallas concludes, “Protecting the lives of children is an important part of the [Brumby]Government’s road safety strategy, Arrive Alive 2008-2017, which aims to reduce the road toll by a further 30% by 2017.”

Source: New National Safety Laws to Better Protect Kids in Cars. Melbourne, The Premier of Victoria, 28 May 2009 (http://www.premier.vic.gov.au/minister-for-roads-ports/new-national-safety-laws-to-better-protect-kids-in-cars.html,accessed 22 September 2009).


Comprehensive legislationAlthough all countries in the Region reported national or subnational legislation related to at least one of the five key risk factors (helmets, drink-driving, speed, seat belts and child restraints) only 10 countries have national or subnational laws relating to all five risk factors. Where laws on these risk factors exist, they are often inadequately enforced–particularly in low-income and middle-income countries.

Given the size of the motorcycle fleet and proportion of road traffic deaths among riders of motorized two and three-wheelers, it seems worrying that there is such inadequate coverage of helmet laws and that enforcement is weak. Similarly, there is a high proportion of deaths attributable to alcohol, yet only eight countries have BAC limits lower than or equal to 0.05, and enforcement is not perceived as effective. It is clear that much needs to be done to make legislation and its enforcement more effective across the Region.

Governments need to enact and enforce comprehensive laws that require all road users to be protected by means of appropriate occupant restraints (helmets, seat belts and child restraints) and to respect alcohol and speed limits that reduce the risk of a road traffic crash. These laws need to ensure that legal loopholes are avoided that could exempt particular road users. Enforcement efforts must be highly visible, well-publicized, sustained, and implemented by the use of appropriate measures and penalties for infringement. Enforcement is most effective when supported by intensive public awareness campaigns that both highlight the safety benefits of complying with the legislation and also increase the perception of being detected and penalized when not complying with the law. Nongovernmental organizations and other civil society groups can play an important role in generating public and political support for evidence-based road safety measures.

Training of police in road side enforcement in Cambodia

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Box 10: Road safety in the Pacific island countriesRegional estimates of road safety do not give a good picture of the situation in all countries because of a great variation in population, geography and the number of vehicles.

For the purpose of this discussion the following Pacific island countries with a population less than 1000 000 were grouped for comparison: Cook Island, Fiji, Kiribati, Marshall Islands, Federated States of Micronesia, Nauru, Palau, Samoa, Solomon Islands, Tonga, Tuvalu, Vanuatu.

Population in Pacific island countries

Over 80% (10 of the 12 countries) have less than 20 000 registered vehicles. Despite the small population, number of vehicles and number of deaths (less than 60 a year), these countries have some of the highest fatality rates in the Region (based on modeled data). Six countries in this group have a fatality rate greater than 13.8, the regional average. Cook Islands with a fatality rate of 45 per 100 000 is the highest in the Region. The Marshall Islands with a fatality rate of 1.7 per 100 000 has the lowest in the Region.


Box 10: continuedRoad traffic fatality rate in Pacific island counties (rate per 100 000 population) *

*Based on modeled data (See statistical annex)

For countries where the road user breakdown is available, data show that both vehicle occupants and vulnerable road users are equally affected. Road traffic deaths include vehicle occupants, drivers and passengers of motorized two-wheelers, cyclists and pedestrians in all countries except the Marshall Islands.

Road traffic deaths by road user category

CountryCar

Occupants ( % )

Drivers/Passengers of motorized

two- wheelers and cyclists ( % )

Pedestrians ( % )

Cook Islands 0 60 40

Fiji 75 0 25

Kiribati 51 44 6

Marshall Islands 100 0 0

Federated States of Micronesia 90 0 10

Palau 67 0 33

Tonga 50 6.25 43.75


Box 10: continuedRoad safety laws pertaining to helmets, drinking and driving, speed limits, seat belts and child restraints in these countries are given in the table.

Fiji, Palau and Solomon Islands have comprehensive helmet laws with standards. The law is applicable for all occupants and all engine types. Fiji and Kiribati have a seat belt law for all occupants. Speed limits for urban areas are within the recommended range of less than 50km/hr in all countries except Solomon Islands.

Summary of road safety strategies in Pacific island countries

CountryLead

agency in government

National road

safety strategy

with funds and target

National helmet

law for all occupants, all roads,

all engines and with standard helmet

National drinking-

driving law (BAC mg/

dl) <0.05 mg/dl

Urban speed limit (in

km)

Seat belt law for all occupants

Cook Islands

Yes No No 0.04 50 No

Fiji Yes Yes Yes 0.08 50 Yes

Kiribati Yes No No 0.08 40 Yes

Marshall Islands

Yes No No - 40 No

Federated States of Micronesia

No No No - 32 No

Nauru Yes No No 0.05 40 No

Palau Yes No Yes 0.1 40 No

Samoa Yes No No - 40 No

Solomon Islands

Yes - Yes - 60 No

Tonga Yes No No - 40 No

Tuvalu No No No - 64 No

Vanuatu No No No - 35-60 No

- data not available - Yes - No

All of these countries except the Federated States of Micronesia, Tuvalu and Vanuatu have a lead road safety agency in the government. However, only Kiribati has a national road safety strategy with targets and dedicated funds.

It is important that all countries work towards implementing a comprehensive law that addresses the major risk factors such as speed and alcohol and focuses on proven interventions such as helmet, seat belts and child restraints. Having a national road safety strategy with targets and resources will help facilitate this process.


A motorcycle ambulance in Viet Nam

Trauma care systems should be improved (Table G, Statistical Annex)Much can be done to lower the burden of death and disability from road traffic injuries by strengthening trauma care services across the spectrum, from pre-hospital care through to rehabilitation. The chain of survival starts at the scene of the incident. Prompt, good quality pre-hospital care can save the lives of many injured persons.

This survey showed that 21 countries have formal national pre-hospital care systems. Of these 21 countries, 20 have one universal pre-hospital care access telephone number (Table 12). The quality of these systems, however, was not evaluated. They could range from sophisticated systems with highly qualified staff to those that rely only on first responders, e.g. bystanders.

Table 12: Universal access telephone numbers for countries with formal pre-hospital care services in the Western Pacific Region

Country Universal Access Telephone NumberAustralia 000

Brunei Darussalam number not supplied.

Cambodia 119

China 120

Fiji 000

Japan 119

Kiribati 28100

Malaysia 999

Marshall Islands 6258444

Mongolia 103

Nauru 4443883

New Zealand 111

Palau 911

Papua New Guinea 111

Republic of Korea 119

Samoa 996 or 995

Singapore 995

Tuvalu 911

Vanuatu 112

Viet Nam 115

The rapid arrival of emergency response teams is an important factor in reducing adverse health consequences of a crash. For details of development of pre-hospital and trauma care, log on to:http://www.who.int/violence_injury_prevention/publications/services/guidelines_traumacare/en/index.html

© P

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Few countries have reliable data on road traffic injuriesA comprehensive assessment of the magnitude of road traffic injuries should consider fatal and nonfatal injuries, resulting disability, the economic cost of road crashes, injuries and the cost effectiveness of interventions.

Tables 13 and 14 give the definitions of road traffic death and the source of road traffic injury data in the Region. Sixteen countries use police or transport data while only five countries use health or other sources linked to health data.

Table 13. Time period used to define a road traffic fatality in the Western Pacific Region

No. of countries

On the scene 1

Within 24 hours 5

Within 7 days 5

Within 30 days 7

Within 1 year 5

Other/no data 3

Total 26

Table 14. Proportion of countries using different data sources for road traffic fatalities, Western Pacific Region

No. of countries

Health 3

Police 14

Transport 2

Linked to health/other sector 2

Statistics

Other 4

No data 1

Total 26

The current recommended definition of a road traffic fatality for standardization of surveillance purposes is “any person killed immediately or dying within 30 days as a result of a road traffic injury accident” (5). The choice of 30 days was based on research which showed that most people who die as a result of a crash succumb to their injuries within 30 days of sustaining them and that, while extension of this 30-day period resulted in a marginal increase in numbers, it required a disproportionately large increase in surveillance efforts (6).


Simple registers can be used to obtain minimum data set on injuries.

Box 11: Nonfatal road traffic injury database in CambodiaIn Cambodia, Handicap International Belgium developed the Road Crash and Victim Information System (RCVIS), which assists in the collection of data on all road traffic injuries. The system is based on data from police, health and private sectors. The data are then merged into one set.

Problems relating to the quality and reliability of data of nonfatal injuries are probably even more complex than those relating to data on deaths. The reliable assessment of the severity of injury requires some clinical experience or medical expertise. A few countries employ hospital staff to code injuries when the patient is discharged from care–using a standardized scoring method such as the Abbreviated Injury Scale, Injury Severity Score or the International Classification of Diseases codes–and then link these data to police and transport databases (7-9). However, a number of countries are now beginning to collect such information.

© M

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However, in many countries the level of severity of an injury is recorded by the police at the site of the crash. This results in a less reliable categorization of injuries. The lack of standardization in terminology also makes country comparisons difficult. In some countries, “serious” is defined as “requiring hospital attention”, while in others, it is “inpatient care for at least 24 hours”. Yet others have longer admission times. There is usually little liaison between the police and health facilities to track how long a patient is admitted, and so the category of “serious” can range from a few cuts and bruises to severe head injuries.

Underreporting has been acknowledged for many years as an important reason why it is difficult to compare road traffic crash data among countries (Table 14). Some countries have taken steps to address this issue and to adjust their own data or link their different databases, but many have not. Factors that can affect the quality of data reported include political influences, competing priorities and availability of resources.

The extent of underreporting is also influenced by: • the sector that records the information; • the proportion of crashes involving vulnerable road users (in many countries, these types

of crashes are more likely to be underreported); • poor or absent links among police, transport and health service data, which means that

statistics for people who die after admission to a hospital may not be reflected in police or transport data;

• exemptions from reporting certain crashes, such as those involving military vehicles; and • whether sampling strategies are used and extrapolated.


Table 14. Reported number of road traffic injury deaths and modeled number of deaths

Country

Reported number of road traffic

deathsa

Modeled number of road traffic deathsb Estimated road

traffic death rate per 100 000

populatione Point

estimate90% Confidence

Interval

Australia 1 616 1 616 7.8

Brunei Darussalam 54 54 13.8

Cambodia 1 668 1 749 1 385–2 410 12.1

China 96 611 220 783 183 428–333 623 16.5

Cook Islands 6 6 45.0

Fiji 59 59 7.0

Japan 6 639 6 639 5.0

Kiribati 7 7 7.4

Lao People’s Democratic Republic

656 1 075 864–1 328 18.3

Malaysia 6 282 6 282 23.6

Marshall Islands 1 1 1.7

Federated States of Micronesia

2 16 12–20 14.4

Mongolia 562 507 366–719 19.3

Nauru 1 1 9.9

New Zealand 423 423 10.1

Palau 3 3 14.8

Papua New Guinea 308 901 684–1 249 14.2

Philippines 1 185 17 557 12 457–33 741 20.0

Republic of Korea 6 166 6 166 12.8

Samoa 19 24 20–29 12.8

Singapore 214 214 4.8

Solomon Islands 19 84 64–118 16.9

Tonga 7 7 7.0

Tuvalu 1 1 9.5

Vanuatu 7 42 29–58 18.6

Viet Nam 16 640 14 104 11 987–16 387 16.1

a Adjusted for 30-day definition of a road traffic deathb Modeled using negative binomial regression. Data from countries with good vital registration and countries

with a population of less than 100 000 were not included in the model. (See statistical annex.)

Finally, an important factor in the quality of a country’s health data in general is the lack of accessibility of some population groups to hospital facilities.

One way of improving this problem is to link data sources. Studies have shown higher levels of underreporting in data collected by the police and transport sectors compared to health sector data, which suggests the need for links to improve data quality (10).


Recommendations to improve the quality of data on road traffic injuries and economic cost

• Encourage the use of the 30-day definition of a road traffic fatality for standardization across data sources.

• Improve data linkages among police, transport and health sectors.• Increase the human capacity to undertake data collection, analysis and interpretation.• Improve use of the International Classification of Disease (ICD)2 coding in vital registration

to adequately reflect road traffic deaths.• The data collected by the health sector should be improved. This is particularly true with

regard to data on nonfatal injuries. This can take the form of discharge data using ICD coding, injury surveillance systems or, where infeasible, intermittent surveys or “casualty registers” which collect only minimum data (11).

• There is a need for standard definitions of levels of severity of nonfatal injuries to allow them to be accurately recorded and collated. The definitions should be simple enough to be administered by both health and nonhealth personnel.

• Countries should be encouraged to conduct national studies on the costs of road traffic crashes and the cost effectiveness of interventions they put into place.

• Where possible, costing should include both direct and indirect costs.

Monitoring and evaluationA number of indicators can, if monitored accurately and regularly, provide essential information to governments in targeting their interventions and in evaluating the effectiveness of their current national road safety programmes.

Targets are not the only method of monitoring or evaluating progress. The status of compliance with a number of proven interventions (e.g. the use of helmets, seat belts and child restraints) also could be used as indicators of progress in road safety.

While some countries have enacted laws to address these risk factors, few countries have established systems to collect data on monitoring or evaluating the success of these measures at a national level.

In this survey, only 14 countries reported data on motorcycle helmet-wearing rates, with the levels of helmet-wearing reported varying widely, as shown in Table C of the Statistical Annex. Levels of seat belt-wearing were reported for 16 countries and range from under 10% to over 90% (see Table F, Statistical Annex). The proportion of deaths related to alcohol reported in this study varies from countries where this figure is under 5% to those where alcohol contributes to almost all road traffic fatalities (see Table D, Statistical Annex). However, the methodologies used to determine these figures were not evaluated as part of this study. For some countries, the rates reported were the results of small studies in particular geographic areas, which limit their generalization to the whole country.

2 The International Classification of Diseases (ICD) is used to classify diseases and other health problems re-corded on many types of records, including death certificates and health records. The most recent (10th) revision of the ICD codes came into use in 1994, but some countries still use previous versions.


Recommendations to improve the quality of monitoring and evaluation• Countries should step up efforts to collect robust data on a number of intermediate

indicators that relate to road traffic injury prevention and that can be used for monitoring and evaluation research. These include:

(1) rates of helmet use; (2) rates of seat-belt use; (3) the proportion of drivers with blood alcohol concentration levels over the legal limit; and (4) rates of use of child restraints.

• Helmet and seat belt-wearing surveys are relatively simple and cheap to conduct. Surveys are essential in order for comprehensive monitoring to be conducted.

• These data are pivotal to making policy decisions based on evidence and to evaluating measures that are put in place.

• The health sector should play an important role in research related to risk factors.

A coordinated approach to road safety is crucial (Table H, Statistical Annex)The World Report on Road Traffic Injury Prevention recommends that countries identify and adequately fund an agency with the responsibility to coordinate road safety activities across multiple sectors. The report also recommends that each country should prepare a multisectoral national road safety strategy with targets and resources for the achievement of specific outcomes.

In the Western Pacific Region, all reporting countries except the Federated States of Micronesia, Tuvalu and Vanuatu have a lead agency for road safety. However, only 17 countries allocate funding for these agencies and only nine countries have a national road safety strategy which was endorsed by the government, set targets and fund the strategy. These results suggest that institutional frameworks with insufficient financial resources may be ineffective in the implementation of their activities.

Box 12: National road safety plan in TongaTonga recently reactivated its multisectoral National Road Safety Committee, which is working on a National Strategic Action Plan for road safety. The committee is pursuing legislation on seat belt use and drinking and driving.


Box 13: Road safety in ChinaChina has a population of 1.34 billion people. It has 145 million registered vehicles and hundreds of millions of bicycles. There has been a rapid rise in the number of cars and motorcycles in China in recent years. The increase in the number of cars is predominant in urban areas where bicycle lanes are gradually disappearing or being trespassed by other vehicles. However, the bicycle is still a major means of transportation in both urban and rural areas.

In this report, China has reported a total of 89 445 (adjusted to 96 611 for a 30-day definition) road traffic deaths in 2006, according to the Traffic Management Bureau of the Ministry of Public Security. The Third National Retrospective Sampling on Population Mortality published by the Ministry of Health in 2008 estimated the road traffic injury death rate during the period 2004-2005 to be 22.81 per 100 000 population for both motor vehicle and nonmotor vehicle users. Hence, the estimated number of road traffic deaths is 296 503 (for a population of 1 299 880 000 in 2004). The modeled number of road traffic deaths (see Statistical Annex) is 220 783 (30-day definition) with a 90% confidence interval 183 428 to 333 623.

Currently, road traffic injury data is predominantly collected by the Ministry of Public Security and excludes road deaths of certain categories. This shows a discrepancy of data collected by different authorities and the need for merging data from both police and health sources. The Ministry of Health has set up injury surveillance in many hospitals, and data from these sources should be incorporated into a road traffic injury collection system.

Vulnerable road users (pedestrians, cyclists, two- and three-wheeler riders and passengers) account for 63% of road traffic deaths. China has laws pertaining to speed limits, drinking and driving, motorcycle helmet and seat belt use. Local authorities are allowed to set lower speed limits. Enforcement of speed limits and drinking and driving laws were perceived to be high in this survey. A helmet-wearing rate of 16% was based on a study in Guanxi. A seat belt-wearing rate of 50% was based on a study in Nanning and Guangzhou.

Enforcement of laws pertaining to drinking and driving, seat belt use and motorcycle helmet use should be strengthened. A law mandating the use of child restraint should be introduced. The government is promoting the concept of a “walkable city”, restoring bicycle lanes and facilitating a more convenient public transport system.

Separate lanes for different road users in China

© Krishnan / W

HO


Box 14: Japan - People first(Adapted from the Eighth Fundamental Traffic Safety Program 2006–2010, Japan)

The principle of people first for traffic safety policyIt is necessary to secure the safety of pedestrians, who are vulnerable in relation to cars, as well as the safety of those especially vulnerable such as the elderly, the disabled and children, when they use any type of transportation.

Basic approaches to traffic safety measuresIt would be a significant step to promote people first traffic safety measures for school routes, community roads and thoroughfares in urban areas such as pedestrian walkways.The government shall drive forward traffic safety activities involving citizens’ participation and collaboration by creating a system in which citizens can participate in traffic safety measures of the national and local government from the planning phase onward, encouraging citizens’ independent efforts to thoroughly check the road environment and promoting community efforts that appropriately take into account the characteristics of each locality.

Box 15: Road safety in MongoliaMongolia has a population of 2.63 million with a land area of 1 566 500 sq. km. Although the overall national population density is less than two people per sq. km, about one third of the total population live in Ulaanbaatar, the capital. Occupants of four-wheelers constitute two thirds of road traffic fatalities. The law mandates the use of seat belts for both front and rear seats and child restraints. Enforcement of seat belt, child restraint and helmet laws should be strengthened.

Enforcement of traffic rules in Mongolia

© Krishnan / W

HO


Key findingsThe main findings are as follows:

• Road traffic fatalities remain a major public health problem and threat to growth. The fatality rates per 100 000 population are highest in middle- and low-income countries.

• Pedestrians, cyclists and users of motorized two- or three-wheelers (vulnerable road users) together account for more than half of all road traffic deaths in the Region.

• While many countries have a basic legislative framework in place for certain aspects of road safety, only 10 countries have laws relating to all of the five key risk factors reviewed–speed, drink-driving, helmets, seat belts and child restraints. These laws frequently are not comprehensive in their scope.

• Enforcement of laws relating to these risk factors is perceived to be less than ideal in many countries.

• Institutional frameworks are insufficiently established or resourced in many countries to be effective. While 23 countries report having a lead agency for road safety, only nine countries have a national road safety strategy which was endorsed by the government, sets targets and had funding for the programme.

• There are several limitations in the data that countries collect and use to report on road traffic injuries. Underreporting of road traffic deaths–a crucial indicator in terms of assessing magnitude–is a major problem in many countries. In addition, only nine countries indicated that they had data on fatal and nonfatal road traffic injuries, estimates of the cost to their economy and data on monitoring and evaluation indicators such as rates of helmet use and seat belt-wearing.

3Key Messages


Key recommendations(1) Governments should take into consideration the needs of all road users when making

policy decisions that impact on road safety. The needs of vulnerable road users should be given emphasis, particularly when decisions are made about road design and infrastructure, land-use planning and transport services. Public transportation should be strengthened both in urban and rural areas in order to reduce the exposure to danger of vulnerable road users.

(2) Governments should enact comprehensive laws that require all road users to be protected through the enforcement of speed limits that are appropriate to the type and function of the road, the stipulation of BAC limits that help reduce drink-driving and the use of helmets for motorcyclists and seat belts and child restraints for vehicle occupants. These occupant protection devices should conform to national or international standards. Existing laws should be reviewed and amended to conform with good practices that are based on sound evidence of effectiveness.

(3) Enforcement of all road safety laws should be improved. Enforcement must be well-publicized, sustained and implemented through the use of appropriate penalties for infringement.

(4) Countries should encourage collaboration among different sectors involved in collecting and reporting road traffic injury data. This involves improving data linkages among police, transport and health services, standardization of case definitions and increasing the human capacity to undertake data collection.

(5) Governments should ensure that the institutions that have been nominated as responsible for road safety have the necessary human and financial resources to act effectively. The formulation and endorsement of a national strategy with realistic targets and funding for implementation would help achieve long-term road safety goals.

Banners from a multisectoral forum on road safety in China

© P

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References

1. The Global Burden of Disease: 2004 update. Geneva, WHO, 2008 (http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_AnnexA.pdf, accessed 7 April 2009).

2. Peden M. et al., eds. World report on road traffic injury prevention. Geneva, World Health Organization, 2004 (http://www.who.int/violence_injury_prevention/publications/ road_traffic/world_report/en/index.html, accessed 7 April 2009).

3. Vasconcellos E.A. Urban transport, environment and equity: The case for developing countries. London: Earthscan Publications, 2001.

4. Khayesi M. Livable streets for pedestrians in Nairobi: the challenge of road traffic accidents. World Policy and Practice, 1997, 3:4–7.

5. Economic Commission for Europe Intersecretariat Working Group on Transport Statistics. Glossary of transport statistics, 3rd ed. New York, NY, United Nations Economic and Social Council, 2003 (TRANS/WP.6/2003/6).

6. Jacobs G, Thomas AA, Astrop A. Estimating global road fatalities. Crowthorne, Transport Research Laboratory, 2000 (TRL Report 445) (http://www.transport-links.org/ transport_links/ filearea/publications/1_329_TRL445.pdf, accessed 7 April 2009).

7. Joint Committee on Injury Scaling. The Abbreviated Injury Scale: 1990 revision. Chicago, IL, Association for the Advancement of Automotive Medicine, 1990.

8. Copes W.S. et al. The Injury Severity Score revisited. The Journal of Trauma, 1988, 28:69–77. 9. International statistical classification of diseases and related health problems, tenth

revision. Volume 1: Tabular list; Volume 2: Instruction manual; Volume 3: Index. Geneva, WHO.

10. Derriks H.M., Mak P.M. IRTAD special report. Underreporting of road traffic casualties. The Hague, Netherlands Ministry of Transport, Public Works and Water Management, 2007 (http://www.who.int/roadsafety/publications/irtad_underreporting.pdf, accessed 7 April 2009.

11. Holder Y. et al. Injury surveillance guidelines. Geneva, WHO, 2001.


Country profiles

1. Explanatory notes • Background • Methodological variations • Terminology and interpretation • Presentation of data

2. Individual country profiles (listed alphabetically)


Explanatory notes

BackgroundThe country profiles presented in this section of the report present a selection of information about road safety as reported by each of the 26 participating countries in the Region. Additional country level data can be found in the Statistical Annex (Tables A – H). The country survey tools may be downloaded from the following website: www.who.int/violence_injury_prevention/road_traffic/road_safety_status/2009.

Methodological variationsTwenty-six countries participated in the Global status report on road safety. While most countries followed the standardized methodology, in Singapore, the questionnaire was completed by the National Data Coordinator, and no consensus meeting was held.

Data reported for population, income group and gross national income per capita are for the latest year available (see Statistical Annex explanatory notes for more details).

Terminology usedThe following terms and issues should be considered when reviewing the individual country profiles:

• The questionnaire asked for information on a number of topics, with follow-up questions exploring each topic in further detail. For many topics respondents were asked to skip follow-up questions depending on their answer to the top-level question. Consequently, the country profiles do not report information from follow-up questions if these should have been skipped. However, if these questions were answered, responses are shown in the statistical annex.

• Road classifications (in particular the definition of urban/rural roads or a highway) vary greatly from country to country, so respondents were asked to report on speed limits of roads according to the definitions they use.

• Respondents were asked, as individuals, to rate the effectiveness of enforcement of various national road safety legislations based on their professional opinion or perception. A scale of 0 to 10 was used, where 0 was not effective and 10 was highly effective. The group of respondents then tried to reach consensus on an enforcement score. These scores are thus subjective and should only be seen as an indication of how enforcement is perceived at country level. Many respondents expressed difficulty in assessing enforcement at national level, since it often varies from region to region within a country and the intensity of enforcement may vary during different time periods.

• Blood alcohol concentration (BAC) limits refer to the maximum amount of alcohol allowed in the blood that is legally acceptable for a driver on the road, i.e. the blood alcohol level above which a driver may be punished by law. For the purposes of this report, the BAC limit in countries where alcohol consumption is prohibited have been recorded as zero, with an explanatory footnote.

• Where respondents provided explanatory information on helmet wearing and/or seat belt wearing rates–for instance, a description of methodology or geographical coverage–this information is reported in the footnotes.


• Motorcycle helmet laws are assessed as “applies to all riders – yes” if the law requires drivers and passengers, adults and children to wear a helmet. Laws with exceptions for reasons such as religion or medical conditions are indicated with the footnote “some exceptions.”

• Respondents were asked to report on vehicle standards required for car manufacturers or assemblers in the country. No information is thus included on vehicle standards from countries where manufacture or assembly do not take place. Some countries apply stringent standards relating to imported vehicles, however, data on such standards were not collected as part of this survey.

• Variables have been coded “Data not available (–)” if the information was not provided through the national data collection process.

Data presentation

Country profiles contain data on road traffic fatalities and non-fatal injuries as reported by respondents. Data from different countries is not necessarily comparable, as different definitions and timeframes have been used. Due to space constraints in footnotes, the data source has been summarized as Police, Transport or Health if the data is from the Ministry of Interior, Transport or Health, respectively. The proportion of deaths where gender is unknown has not been reported in the profiles.

In the charts presenting data on deaths by road user category, proportions may not sum to 100% due to rounding. Some countries classify road traffic fatalities according to the vehicle or road user “at fault” rather than according to who died, or use categories different from those requested in the questionnaire. In these countries deaths among vulnerable road users are even more likely to be underreported.

The standard colour coding of the pie charts used to represent the road user categories requested in the questionnaire are shown below. Additional categories are represented by non-standard colours.

● Drivers of 4-wheeled vehicles ● Cyclists● Passengers of 4-wheeled vehicles ● Pedestrians ● Occupants (drivers/passengers) of 4-wheeled vehicles ● Other● Riders (drivers/passengers) of motorized 2- or 3-wheelers ● Unspecified

Trend graphs are shown either as road traffic death rates per 100 000 population (on a green background) or as an absolute number of road traffic deaths (on a blue background), depending on which figures were supplied by the country. Due to space constraints, an arbitrary cut-off point of 1970 was applied for the few countries that provided many decades of trend data.


Where the primary source of information for both the pie and trend graphs was not stipulated, the source has been reported as ‘Country questionnaire’ and refers to final questionnaire completed by the National Data Coordinator and respondents.

Information about the number of vehicles in the country includes only registered vehicles, and proportions of various types of such vehicles. These proportions may not sum to 100% due to rounding. In some countries, respondents noted that a substantial proportion of the vehicle fleet may not be registered.

54

AUSTRALIAa

a Questionnaire completed by National Data Coordinator (no consensus meeting).

Population: 20 743 179

Income group: High

Gross national income per capita: $35 960

POST-CRASH CARE

Formal, publicly available pre-hospital care systemNational universal access number

YesYes

DATA

Reported road traffic fatalities (2007)1 616i (73% males, 27% females)

Reported non-fatal road traffic injuries (2005–2006)

31 204j

Costing study availableYes (deaths and injuries)

i Transport data, defined as died within 30 days of the crash. j Health and Transport data, hospitalized cases only.

REGISTERED VEHICLES

14 774 921 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBuses

78%4%

15%3%

<1%

— Data not available.n/a Data not required/not applicable.

INSTITUTIONAL FRAMEWORK

Lead agency

Funded in national budget Yes

National road safety strategyMeasurable targetsFunded

YesYesYes

Department of Infrastructure, Transport, Regional Development and Local Government

Pedestrians (13%)

DEATHS BY ROAD USER CATEGORY

Source: 2007, Department of Infrastructure, Transport, Regional Development and Local Government: “Monthly Road Death Series”

Drivers 4-wheelers (49%)

Riders motorized 2- or 3-wheelers (15%)

Cyclists (3%)

Passengers4-wheelers (21%)

TRENDS IN ROAD TRAFFIC DEATHS

20

10

0

30

15

5Deat

hs p

er 1

00 0

00 p

opul

atio

n

1970 19981978 1982 1986 19901974

35

Year

1994 2006

Source: 2008, Department of Infrastructure, Transport, Regional Development and Local Government

25

2002

NATIONAL LEGISLATION

Speed limits set nationallyLocal authorities can set lower limitsMaximum limit urban roadsEnforcementb

No (subnationally)n/an/an/a

Drink–driving lawBAC limit – general populationBAC limit – young or novice driversRandom breath testing and/or policeRoad traffic deaths involving alcoholEnforcementb

No (subnational)0.05 g/dlc

0.0–0.02 g/dld

n/a30%e

n/a

Motorcycle helmet lawApplies to all ridersHelmet standards mandatedHelmet wearing rateEnforcementb

No (subnational)Yesf

Yesf

—n/a

Seat-belt lawApplies to all occupantsSeat-belt wearing rateEnforcementb

No (subnational)Yesg

97% Front, 92% Rearh

n/a

Child restraints lawEnforcementb

No (subnational)n/a

b Enforcement score represents consensus based on professional opinion of respondents, on a scale of 0 to 10 where 0 is not effective and 10 is highly effective.

c No national limit, but all states and territories have a consistent BAC limit of 0.05 for general population.

d For young provisional drivers, all states and territories have a zero BAC requirement, with exception of one territory with a BAC limit of 0.02 g/dl.

e 1999–2003, Transport data. f No national law, but all states and territories require motorcycle helmets for all riders and compliance

with a helmet standard. g No national law, but all states and territories require the use of seat-belts by all vehicle occupants. h 2006, Transport data, national survey.

VEHICLE STANDARDS

Car manufacturers required to adhere to standards onFuel consumptionSeat-belt installation for all seats

NoYes

ROAD SAFETY AUDITS

Formal audits required for major new road construction projects Regular audits of existing road infrastructure

YesYes

PROMOTING ALTERNATIVE TRANSPORT

National policies to promote walking or cycling National policies to promote public transportation

YesYes

Random breath testing and/or police checkpoints

Data cleared by the Department of Infrastructure, Transport,Regional Development and Local Government.

57

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71

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)54c (80% males, 20% females)

Reported non-fatal road traffic injuries (2007)556d


c Police data, defined as died within 30 days of the crash. d Police data.

REGISTERED VEHICLES

304 432 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBusesNon-motorized vehiclesOther

83%4%4%1%

<1%<1%7%


BRUNEI DARUSSALAMPopulation: 390 056

Income group: High



Lead agencyFunded in national budget —


Multiplen/an/a

Brunei Darussalam Road Safety Council


Speed limits set nationallyLocal authorities can set lower limitsMaximum limit urban roadsEnforcementa

YesNo

80 km/h

Drink–driving lawBAC limit – general populationBAC limit – young or novice driversRandom breath testing and/or policeRoad traffic deaths involving alcoholEnforcementa

Yes0.08 g/dl0.08 g/dl

Yes3.7%b

Motorcycle helmet lawApplies to all ridersHelmet standards mandatedHelmet wearing rateEnforcementa

YesYesYes

98%b

Seat-belt lawApplies to all occupantsSeat-belt wearing rateEnforcementa

YesNo

70% Frontb

Child restraints lawEnforcementa

Yes

a Enforcement score represents consensus based on professional opinion of respondents, on a scale of 0 to 10 where 0 is not effective and 10 is highly effective.

b 2007, Police data.

VEHICLE STANDARDS

No car manufacturers

ROAD SAFETY AUDITS


NoNo



No—


4

6

9

7

7


20

0

40

30

10Num

ber o

f roa

d tra

ffic

deat

hs

2002

60

Year

2007

Source: Department of Investigations and Traffic Control, Royal Brunei Police Force

2004 2005 20062003

50


Other (2%)


Pedestrians (9%)



Cyclists (2%)

Source: Department of Investigations and Traffic Control, Royal Brunei Police Force

Data cleared by the Ministry of Communications.

58


75

CAMBODIAPopulation: 14 443 679

Income group: Low

Gross national income per capita: $540


Lead agencyFunded in national budget

National Road Safety CommitteeYes


Yesa

n/an/a

a Not formally endorsed by government.

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)1 545f (79% males, 20% females)

Reported non-fatal road traffic injuries (2007)25 858g


f Data from multiple sectors, defined as died within 7 days of the crash.g Data from multiple sectors.

REGISTERED VEHICLES

154 389 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)BusesTrucks

9%84%

4%<1%2%




YesNo

40 km/h

Drink–driving lawBAC limit – general populationBAC limit – young or novice driversRandom breath testing and/or police checkpointsRoad traffic deaths involving alcoholEnforcementb


n/ac

—n/ac


YesNoNo

21%d

Seat-belt lawApplies to all occupantsSeat-belt wearing rate Enforcementb

YesNo0%e


Yes


c Regulations are in place, but not yet enforced.d 2006, Ministry of Health observational study in Phnom Penh.e Estimation by consensus group.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoNo



NoNo

0

2

1

1

Drivers 4-wheelers (4%)Other (4%)


Source: 2007, Road Traffic Accident Victims Information System (RTAVIS)

Riders motorized2- or 3-wheelers

(63%)

Cyclists (5%)

Pedestrians (13%)Passengers

4-wheelers (11%)

Data cleared by the Ministry of Health.


400

0

800

600

200

Num

ber o

f roa

d tra

ffic

deat

hs

1 800

Year

1 000

Source: 1995–2005, Ministry of Interior/Traffic Police; 2006–2007, Road Traffic Accident Victims Information System (RTAVIS)

1 600

1 400

1 200

1995 1997 2001 2005 20071999 2003

59


82

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2006)89 455e (76% males, 24% females)

Reported non-fatal road traffic injuries (2006)431 139f


e Police data, defined as died within 7 days of the crash.f Police data.



Lead agencyFunded in national budget Yes


YesNoYes

Inter-Ministerial Convention on Road Traffic Safety

CHINAPopulation: 1 336 317 116

Income group: Middle




YesYes

30-50 km/h



Yes4%b


YesYesYes

16%c

No consensus


YesYes

50%d

No consensus


Non/a


b 2006, Police data.c Zhang J, Zhuo J, Chen NA. Study of motorcycle helmet use in Guangxi. Chinese Journal of Disease

Control & Prevention, 2004, 8(6):512–515. d 2005–2006, Study in Guangzhou City and Nanning City.


8

8

VEHICLE STANDARDS


YesYes

ROAD SAFETY AUDITS


No



NoYes

No consensus

REGISTERED VEHICLES

145 228 994 total (2006)Registered vehicle types: data not available

Drivers passenger vehicles (5%)

Passengers of cars (17%)

Other (14%)


Source: Traffic Management Bureau of the Ministry of Public Security

Riders motorbikes (28%)

Cyclists (9%)

Pedestrians (26%)



2

0

43

1Deat

hs p

er 1

00 0

00 p

opul

atio

n

10

Year

Source: Traffic Management Bureau of the Ministry of Public Security

56789

1971 1981 1991 2001 20061976 1986 1996

60


86

COOK ISLANDSPopulation: 13 325



DATA

Reported road traffic fatalities (2007)5b (80% males, 20% females)

Reported non-fatal road traffic injuries (2007)382c

Costing study availableNo

b Health data (Rarotonga only), defined as died at the crash scene. c Police and health data.

POST-CRASH CARE


Non/a




Police DepartmentYes


Non/an/a



YesNo

50 km/h

Drink–driving lawBAC limit – general populationBAC limit – young or novice driversRandom breath testing and/or police checkpointsRoad traffic deaths involving alcoholEnforcementa


——


Non/an/a—n/a


Non/a—n/a


Non/a


VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoNo



NoNo

4

4

REGISTERED VEHICLES

10 692 total (2006–2007)Registered vehicle types: data not available

Pedestrians (40%)

Riders motorized 2- or 3-wheelers

(60%)

Source: 2007, Ministry of Health Annual Statistical Bulletin




2

0

43

1

Num

ber o

f roa

d tra

ffic

deat

hs

10

Year

Source: Country questionnaire, Rarotonga only

56

87

9

1991 1995 1999 2003 20071993 1997 2001 2005

61


100

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)59e (78% males, 22% females)

Reported non-fatal road traffic injuries (2007)663f


e Police data, defined as died within 30 days of the crash. f Police data.

10

5

9

7



YesNo

50 km/h



Yes27%b


YesYesYes

90%c


YesYes

95% Front, 70% Reard


Yes


b 2006, Fiji Police. c Estimation by consensus group. d 2007, Fiji Police.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



NoNo


7DEATHS BY ROAD USER CATEGORY


Pedestrians (25%)


Source: 2007, Fiji Police

FIJIPopulation: 838 698





YesYes


YesYesYes

REGISTERED VEHICLES

78 833 total (2008)Registered vehicle types: data not available


40

0

80

60

20Num

ber o

f roa

d tra

ffic

deat

hs

1996

120

Year

2006

Source: Fiji Police

2001 2003 20041998

100

1997 1999 20022000 2005

Data cleared by the Ministry of Health, Women and Social Welfare.

62


122

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)6 639f (68% males, 32% females)

Reported non-fatal road traffic injuries (2007)1 034 445g


f Police data, defined as died within 30 days of the crash. Vital statistics data (2006): 8 195 deaths, defined using International Classification of Diseases (ICD) codes.

g Police data.





YesYesYes

Central Traffic Safety Policy Council

JAPANPopulation: 127 966 709

Income group: High




YesYesn/aa

No consensus



Yes8%c

No consensus


YesYesYes—

No consensus


YesYes

95%–99% Driversd

No consensus


YesNo consensus

a Different system of road classification used. b Enforcement score represents consensus based on professional opinion of respondents, on a

scale of 0 to 10 where 0 is not effective and 10 is highly effective.c 2007, Police data. d 2007, National Police Agency/Japan Automobile Foundation.


VEHICLE STANDARDS


YesYes

ROAD SAFETY AUDITS


Noe

Noe


National policies to promote walking or cycling National policies to promote public transportation Yes

e Some irregular or informal safety checks are conducted.

No consensus




Cyclists (13%)

Pedestrians (32%)

Riders motorized2- or 3-wheelers (18%)

Source: 2006, Police data

Data cleared by the Ministry of Health, Labour and Welfare.


0

Deat

hs p

er 1

00 0

00 p

opul

atio

n

25

Year

Source: Vital Statistics compiled by Ministry of Health, Labor and Welfare

5

10

15

20

1971 1981 1991 2001 20061976 1986 1996

REGISTERED VEHICLES

91 378 636 total (2006h & 2008i)MotorcarsMotorized 2- and 3-wheelersTrucksBusesOther

63%14%18%<1%5%

h Ministry of Internal Affairs and Communications (data on motor-driven cycles and small-sized special motor vehicles).

i Ministry of Land, Infrastructure, Transport and Tourism.

63


126

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)7c (84% males, 16% females)d

Reported non-fatal road traffic injuries—


c Police data, defined as died within 7 days of the crash. d 1999–2006, health data.


KIRIBATIPopulation: 95 067





Kiribati Police ServiceNo


YesYesNo



YesNo

40 km/h



Yes30%b

Motorcycle helmet law Applies to all ridersHelmet standards mandatedHelmet wearing rateEnforcementa

Non/an/a—n/a


YesYes—


Yes


b 2003–2008, Kiribati Police Service.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



NoNo


0

2

1

6

REGISTERED VEHICLES

16 000 total (2008)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBuses

60%13%22%

5%1%



Pedestrians (6%)

Riders motorized2- or 3-wheelers (44%)

Source: 2007, Emergency Accident Record Book, Ministry of Health and Medical Services


Data cleared by the Ministry of Health and Medical Services.

Source: Kiribati Police Service, data for South Tarawa, Betio and referral cases from other islands


4

0

8

6

2

Num

ber o

f roa

d tra

ffic

deat

hs

1999

18

Year

20072002 2004 2005

10

2000 20032001 2006

14

12

16

64


129

POST-CRASH CARE


Non/a

DATA

Reported road traffic fatalities (2007)608f



f Police data, defined as died within 7 days of the crash. g Police data.

REGISTERED VEHICLES

641 081 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBusesOther

2%79%14%

3%1%2%

LAO PEOPLE’S DEMOCRATIC REPUBLICPopulation: 5 859 393

Income group: Low



Lead agencyFunded in national budget No


YesYesNo

Ministry of Public Works and Transport



YesNo

40 km/h



Yes48%b


YesYesc

No77% Drivers, 87% Passengersd


YesYes—

n/ae


Non/a


b 2000–2007, Police data. c Some exceptions. d 2007, Handicap International Belgium, survey conducted in Vientiane. e Law not yet enforced.


VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



NoYes

3

6

5


DATA NOT AVAILABLE


Data cleared by the Ministry of Public Health.


100

0

350

300

50

Num

ber o

f roa

d tra

ffic

deat

hs

1990

450

Year

200220001994

400

1992 1996 1998

200

150

250

65


138

POST-CRASH CARE


YesYes

DATA




e Police data, defined as died within 30 days of the crash.f Police data.




YesYesYes

Cabinet Committee on Road Safety

REGISTERED VEHICLES

16 825 150 total (2007)MotorcarsMotorized 2- and 3-wheelersTrucksOther

45%47%

5%3%

MALAYSIAPopulation: 26 571 879





YesYes

50 km/h



Yes—


YesYesb

Yes90% Drivers, 70% Passengersc


YesNo

70% Frontd


Non/a


b Some exceptions. c 2007, Malaysian Institute on Road Safety Research.d 2003, International Association of Traffic and Safety Sciences Research Vol 28 No. 1 (published 2004).


VEHICLE STANDARDS


YesYes

ROAD SAFETY AUDITS


YesYes



YesYes

6

6

6

6



Passengers4-wheelers

(10%)

Other (6%)


Source: 2007, Royal Malaysian Police


(58%)

Cyclists (3%)

Pedestrians (10%)

Data cleared by the Ministry of Transport.


0

10

5Deat

hs p

er 1

00 0

00 p

opul

atio

n

35

Year

Source: Road Safety Department Malaysia

15

20

25

30

1994 1996 2000 2004 20061998 2002

66


142

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)1f (male)

Reported non-fatal road traffic injuries (2007)35g


f Police data, defined as died within 24 hours of the crash. g Police data.

MARSHALL ISLANDSPopulation: 59 286



n/a Data not required/not applicable.

DATA NOT AVAILABLE




Department of Public SafetyYes


Yesa

n/an/a




YesNo

40 km/h


YesNonec

Nonec

Yes70%d


YesYese

No95%d


Non/a

5% Front, 0% Reard

n/a


Non/a


c Drink–driving not defined by BAC limit. d Police estimate for average year. e Some exceptions.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoNo



NoNo


6

5

7

REGISTERED VEHICLES


63%1%

27%4%2%3%



YEAR DEATHS

2007 1 driver of 4-wheeled vehicle

67


146

MICRONESIA (Federated States of)Population: 111 117



POST-CRASH CARE


Non/a

DATA

Reported road traffic fatalities (2007)1–2d

Reported non-fatal road traffic injuries50e


d Police data, defined as died within 24 hours of the crash.e Police, estimate for an average year.



Non/a


No (subnational)n/an/a

REGISTERED VEHICLES


42%<1%48%

3%4%3%

n/a Data not required/not applicable.



No (subnationally)n/an/an/a


No (subnational)n/an/an/a

90%b

n/a



100%b

n/a


Non/a

10%c

n/a


Non/a


b 2007, Police and Transport data.c Police estimate for average year.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesNo



NoNo

DATA NOT AVAILABLE


Police estimate that 10% of road traffic deaths are pedestrians, 30% are drivers of motorcars, and 60% are passengers in motorcars.


Source: Country questionnaire

Data cleared by the Department of Health and Social Affairs.

68


147

MONGOLIAPopulation: 2 628 840



POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)562d (84% males, 16% females)

Reported non-fatal road traffic injuries (2007)932e


d Health data, time period not specified in definition.e Police data.



National Committee of Road SafetyYes


YesYesYes

REGISTERED VEHICLES

161 989 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBusesNon-motorized vehicles

68%1%2%

21%8%

<1%



20

10

0

15

5

Deat

hs p

er 1

00 0

00 p

opul

atio

n

2002 2003 2004 2005

25

Year

2006 2007

Source: National Center for Health Development, Ministry of Health

Pedestrians (18%)


Occupants4-wheelers (65%)

Riders motorized2- or 3-wheelers(17%)

Cyclists (<1%)




YesYes

60 km/h



Yes4%b


YesYesNo—


YesYes

70–80% Driversc


Yes


b 2007 Police data, proportion of road traffic deaths involving drunk drivers. c 2008, Police estimate, 10–20% front-seat passengers, 5–10% rear-seat passengers.

4

7

3

6

2

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



YesYes

Source: 2007, National Center for Health Development, Ministry of Health

69


153

NAURUPopulation: 10 152



POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)1b (male)

Reported non-fatal road traffic injuries (2007)9c


b Police and Health data, defined as died within 24 hours of the crash.c Police and Health data.



Nauru Police ForceYes


Multiplen/an/a

REGISTERED VEHICLES

Data not available


DATA NOT AVAILABLE


DATA NOT AVAILABLE





YesNo

40 km/h—



Yes——


Non/an/a—n/a

Seat-belt lawApplies to all occupantsSeat-belt wearing rate Enforcementa

Non/a—n/a


Non/a


VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoNo



YesNo

70


156

POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)423d (67% males, 33% females)

Reported non-fatal road traffic injuries (2007)16 013e


d Transport data, defined as died within 30 days of the crash. e Transport data.

— Data not available.




YesYesYes

Ministry of Transport

NEW ZEALANDPopulation: 4 178 525

Income group: High


REGISTERED VEHICLES

3 189 131 total (2007)MotorcarsMotorized 2- and 3-wheelersBusesTrucks

82%3%1%

15%



YesYes

50 km/h



Yes31%b


YesYesc

Yes—


YesYes

95% Front, 87% Rearb


Yes


b 2007, Transport data. c Some exceptions.


VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



YesYes

6

9

7

8

9

Other (3%)



Pedestrians (10%)



Cyclists (2%)

Source: 2007, Ministry of Transport



1999 20062001 2002 2003 20042000

Year

2005 2007

4

0

8

2

14

6

10

12

Deat

hs p

er 1

00 0

00 p

opul

atio

n

Data cleared by the National Road Safety Management Group.

71


163

PALAUPopulation: 20 314



POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)3d (100% males)

Reported non-fatal road traffic injuries (2006)91e


d Justice data, defined as died from injuries or complications resulting from a crash.

e Health data.



Patrol Division, Ministry of JusticeYes


YesYesNo

REGISTERED VEHICLES

5 530 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)Trucks

33%14%24%29%




YesNo

40 km/h



Yes100%b


YesYesc

Yes—


Non/a—n/a


Non/a


b 2007, Country questionnaire.c Some exceptions.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



YesYes

4

5

8

DATA NOT AVAILABLE



Passengers 4-wheelers (1)

Pedestrians (1)

Drivers 4-wheelers (1)

Source: 2007, Ministry of Justice


72


168

PHILIPPINESPopulation: 87 960 117



POST-CRASH CARE


YesNo




YesNo

40 km/h


Non/an/an/a—n/a



34%b

n/a


YesYes

52% Driversb


Non/a


b 2000, Health data, survey.

VEHICLE STANDARDS


NoNo

ROAD SAFETY AUDITS


YesYes



No (subnational)

3

3

DATA

Reported road traffic fatalities (2006)1 185c

Reported non-fatal road traffic injuries (2006)5 870d


c Transport data, national roads only, defined as died within 30 days of the crash.

d Transport data, national roads only.

REGISTERED VEHICLES

5 515 576 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibus, van, etc. (seating <20)TrucksBusesOther

17%48%29%

5%1%

<1%


DATA NOT AVAILABLE


Source: 2006, Metro Manila Accident Reporting and Analysis System

ROAD TRAFFIC DEATHS IN METRO MANILA, 2006

371 Deaths totalDrivers (of mechanically propelled

vehicle or pedal cycle)Passengers (of mechanically

propelled vehicle)Pedestrians

37%

12%51%

Data cleared by the Department of Health; the Department of Transport and Communications; and the Metropolitan Manila Development Authority.


Lead agencyFunded in national budget No


YesYesYes

Department of Transportation and Communication

73


POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)237d

Reported non-fatal road traffic injuries (2007)1 210e


d Police data, defined as died within 24 hours of the crash.e Police data.

PAPUA NEW GUINEAPopulation: 6 331 010

Income group: Low




National Road Safety CouncilNo



REGISTERED VEHICLES


64%2%1%

18%11%

4%


Drivers 4-wheelers (11%)Pedestrians (39%)


Source: 2007, Motor Vehicle Insurance LTD


Cyclists (1%)


0

100

50

Num

ber o

f roa

d tra

ffic

deat

hs

1991 1993 1994

250

Year

1996 1999

150

Source: Traffic Directorate, Royal Papua New Guinea Constabulary

200

1992 1995 1997 1998

Data cleared by the Department of Health and Social Affairs.



YesNo

60 km/h


YesNoneb

Noneb

Yes66%c


YesYesYes—


YesYes—


No


b Drink–driving not defined by BAC limit.c 1988, Traffic police.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoNo



——


0

1

6

5

7

74


173

POST-CRASH CARE


YesYes

DATA




e Transport data, defined as died within 30 days of the crash. f Transport data.




YesYesYes

Ministry of Land, Transport and Maritime Affairs

REGISTERED VEHICLES

18 213 228 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBuses

66%10%

6%17%<1%

REPUBLIC OF KOREAPopulation: 48 223 853

Income group: High




YesYes

60 km/h



Yes16%b

Motorcycle helmet law c

Applies to all ridersHelmet standards mandatedHelmet wearing rateEnforcementa

YesYesYes

85%c


YesYes

77% Frontd


Yes


b 2007, Traffic Accidents in Korea 2007, Road Traffic Authority. c 2007, National Police Agency. Observational study in 33 cities, drivers and passengers. d 2005, Korea National Health and Nutrition Examination Survey.


VEHICLE STANDARDS


YesYes

ROAD SAFETY AUDITS


YesYes



YesYes

7

2

8

7

7

Source: “Road Traffic Accidents in Korea 2007,” Road Traffic Authority



Pedestrians (37%)


(21%)


Cyclists (5%)

Data cleared by the Ministry for Health, Welfare and Family Affairs.


0

4

2Deat

hs p

er 1

00 0

00 p

opul

atio

n

16

Year

Source: Road Traffic Authority

6

8

10

12

14

1992 1998 2004 20071995 2001

75


180

SAMOAPopulation: 187 023



POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (average year)20c (76% males, 24% females, 2004–2007)

Reported non-fatal road traffic injuries (2006–2007)

178d


c Accident Compensation Corporation data, definition unknown. d Health data.



Land Transport AuthorityYes


YesNoNo


DATA NOT AVAILABLE




YesNo

40 km/h


Yes——Yes

50%b


YesYesNo—


YesNo—


Yes


b 2004-2007, Accident Compensation Corporation.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



NoNo

1

3

6

6

1

REGISTERED VEHICLES



10

0

25

20

5Num

ber o

f roa

d tra

ffic

deat

hs

2004

35

Year

2007

30

Source: Accident Compensation Corporation

2005

15

2006


76


SINGAPOREa

a Questionnaire completed by National Data Coordinator (no consensus meeting).

Population: 4 436 281

Income group: High




Land Transport Authority/Traffic PoliceYes


YesYesYes

DATA

Reported road traffic fatalities (2007)214f (80% males, 20% females)



f Police data, defined as died within 30 days of the crash.g Police data.

POST-CRASH CARE


YesYes



YesNo

40–70 km/h



Yes7%c


YesYesd

Yes56%e


YesYes

50%e


Yes

b Enforcement score represents professional opinion of NDC, on a scale of 0 to 10 where 0 is not effective and 10 is highly effective.

c 2007, Police data.d With some exceptions.e Source not specified.

9

7

8

8

8

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



No (subnational)

REGISTERED VEHICLES

851 336 total (2007)MotorcarsMotorized 2- and 3-wheelersBusesOther

61%17%

2%21%



Source: 2007, Traffic Police Department

Riders motorized2- or 3-wheelers

(48%)

Cyclists (10%)

Pedestrians (27%)Passengers

4-wheelers (4%)


4

2

0

3

1Deat

hs p

er 1

00 0

00 p

opul

atio

n

1998 1999 2000 2001

6

Year

2005 2007

Source: “Monthly Digest of Statistics Singapore,” May 2008

5

2002 2003 2004 2006

Data cleared by the Land Transport Authority.77


191 Data cleared by the Ministry of Health.

POST-CRASH CARE


Non/a

DATA


Reported non-fatal road traffic injuries (2007)606f


e Police data, defined as died at the crash scene or during (hospital) admission.

f Data for Honiara only, source not specified.

SOLOMON ISLANDSPopulation: 495 662

Income group: Low




Lead agencyFunded in national budget —


———

Police – Traffic Division



YesNo

60 km/h


YesNoneb

Noneb

Yes55%c


YesYesYes

100%d


Non/a—n/a


Non/a


b Drink–driving not defined by BAC limit.c Traffic Police estimate.d Year and source not specified.


3

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesNo



YesNo

5

3

REGISTERED VEHICLES


DATA NOT AVAILABLE


DATA NOT AVAILABLE


78


206

TONGAPopulation: 100 336



POST-CRASH CARE


Non/a

DATA


Reported non-fatal road traffic injuries—


e Police data, defined as died within 1 year and one day of the crash.



Traffic Department, Ministry of PoliceYes


Non/an/a

REGISTERED VEHICLES


36%1%

57%<1%<1%5%




YesNo

40 km/h


YesNoneb

Noneb

Yes25%c


YesYesNo—


Non/a

<1%d

n/a


Non/a


b Drink–driving not defined by BAC limit.c 2007 Police data.d 2003, Ministry of Health and World Health Organization observational study.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


YesYes



NoNo

5

7

7


Cyclists (6%)Source: 2006–2007, Ministry of Police


Pedestrians (44%)



4

0

8

6

2

Num

ber o

f roa

d tra

ffic

deat

hs

1987 1989 1990

18

Year

1992 1994

10

Source: Report by Dr G. Anthony Ryan: WHO STC to Tonga, 1995

16

1988 1991 1993

14

12


79


211

TUVALUPopulation: 10 530



POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2003–2006)1 per yeard (all males)

Reported non-fatal road traffic injuries

˜12 per yeare


d Health data, defined as died within 24 hours of the crash.e Police estimate.



Non/a


YesNoNo

REGISTERED VEHICLES

906 total (2005–2008)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBusesNon-motorized vehicles

7%66%

5%4%1%

17%




YesNo

64 km/h


YesNoneb

Noneb

Yes—


Non/an/a0%c

n/a


Non/a0%c

n/a


Non/a


b Drink–driving not defined by BAC limit.c 2000–2007, Police data.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoNo



NoNo

6

6


0

1

Num

ber o

f roa

d tra

ffic

deat

hs

1999

2

Year

2007


20032000 2001 2002 2004 2005 2006


Source: Princess Margaret Hospital, Ministry of Health

YEAR DEATHS

2003200420052006

1 pedestrian1 pedestrian1 pedestrian1 pedestrian


80


91

220

VANUATUPopulation: 226 180



POST-CRASH CARE


YesYes

DATA

Reported road traffic fatalities (2007)8c

Reported non-fatal road traffic injuries (2005)52d


c Police data, defined as died within 1 year of the crash.d Health data.



Non/a


Multiplen/an/a

REGISTERED VEHICLES





YesYes

35–60 km/h


YesNoneb

Noneb

Yes—


YesYesNo—


YesNo—


Non/a


b Drink–driving not defined by BAC limit.

VEHICLE STANDARDS


ROAD SAFETY AUDITS


NoYes



NoNo

1

3

6

8

DATA NOT AVAILABLE


DATA NOT AVAILABLE



81


222

DATA NOT AVAILABLE


VIET NAMPopulation: 87 375 196

Income group: Low


DATA




e Police data, defined as died within 24 hours of the crash.f Police data. Health data reports 445 048 non-fatal road traffic injuries in

2007.



National Traffic Safety CommitteeYes


Yesa

n/an/a




YesNo

50 km/h



Yes34%c


YesYesYes

85%d


YesNo—


Non/a


c 2001, Forensic Medicine data. d 2008, National Traffic Safety Committee estimate.

VEHICLE STANDARDS


YesYes

ROAD SAFETY AUDITS


YesYes



NoYes

3

6

3

7

POST-CRASH CARE


YesYes


REGISTERED VEHICLES

22 926 230 total (2007)MotorcarsMotorized 2- and 3-wheelers

5%95%


4 000

0

8 000

6 000

2 000Num

ber o

f roa

d tra

ffic

deat

hs

1998 2000 2001

14 000

Year

2003 2007

10 000

Source: 2007, National Traffic Safety Committee

12 000

1999 2002 2004 2005 2006


82



Statistical annex1. Explanatory notes

• Background • Data processing• Types of data utilized Reported data Adjusted data Modeled data• References

2. TablesA National data coordinators by countryB Vehicles, road traffic deaths and proportion of road

users by countryC Helmet laws, enforcement and wearing rates by

countryD Drinking and driving laws, enforcement and road

traffic deaths attributed to alcohol by countryE Speed laws and enforcement by countryF Seat belt and child restraint laws, enforcement and

wearing rates by countryG Pre-hospital care systems by countryH Road safety management, strategies and policies

by country


Explanatory notes

Background

Data for the Global status report on road safety were obtained through a self-administered questionnaire implemented in the 178 countries and areas that participated in the first global survey on road safety in 2008. Data from 26 reporting countries in the Western Pacific Region are presented here.

More details on the methodology used for data collection can be found at www.who.int/violence_injury_prevention/road_traffic/road_safety_status/2009.

The following sections contain country-by-country data obtained from the survey.

• Table A includes the list of NDCs who, in collaboration with national authorities, played a key part in conducting the survey.

• Table B provides detailed data on the 30-day adjusted number and rates per population of road traffic deaths, and on the proportion of road users by country/area. The table also includes modeled road traffic death numbers which have been generated. A short description of the process is presented below.

• Tables C – F provide information on the status of laws, the enforcement of laws, and the coverage/wearing rates relating to the five road traffic risk factors (helmets, alcohol, speed, seat-belts and child restraints).

• Table G includes information related to the availability of pre-hospital care.• Table H contains data on policy-related responses.

The following section gives a brief description of the data processing, the comments on the obtained results (specifically on the reported, adjusted and modeled country-level death data) and the method used to develop the model.

Data processingThe data processing involved completion of the survey instrument and data entry at a country level, and validation at a regional level. Data cleaning, analysis and report-writing were done at WHO headquarters in Geneva.

Reporting of country-level dataThe final country responses were entered by NDCs into an online database specially prepared by WHO for this project. NDCs also uploaded supporting documents where applicable and available. Data was then validated at a regional level. Once finalized and approved by Regional Data Coordinators (RDCs), the data were then exported into Microsoft Excel for cleaning. At this stage, each country’s data were examined for accuracy, consistency and validity on a question-by-question basis. Where necessary, NDCs were contacted and additional supporting documents were requested to clarify inconsistencies. A copy of the survey instrument and study protocol can be found at www.who.int/violence_injury_prevention/road_traffic/road_safety_status/2009.


As part of the data cleaning and validation process, exploratory analysis was done using STATA(1). The same software was used for all analysis and results presented in the earlier sections of this report.

Types of data utilizedThree types of data are used in this report:

- reported data from countries and secondary sources- data adjusted for the 30-day definition of a road traffic death in order to facilitate

comparability- modeled numbers

In addition to the data obtained directly from countries, secondary data sources were used to: - classify countries into income categories.- generate road safety indicators such as the adjusted road traffic deaths and modeled

road traffic death rates (with a 90% confidence interval) as reported in Table B. - Population and income data from the United Nation Population Division and the World

Bank were used for this analysis(2,3).

Population estimates for 2007 are reported in Table B. Where there was no estimate available for a country for that year, published data for the latest year were used. For the modeling process, population estimates corresponding to the year of reporting were used.

In Table B, World Bank (Atlas method) gross national income per capita (GNI) for 2007 (or latest available year) was used to categorize countries into:

- low income = $935 or less- middle income = $936 to $11 455- high income = $11 456 or more(3, 4)- More detailed subgroupings were used in the modeling process.

Adjusted dataAs discussed in the first section of this report, underreporting has been acknowledged for many years as an important reason for the difficulty in comparing road traffic crash data between countries. Additionally, the lack of harmonized definitions for road traffic deaths, the use of different data sources, and the quality of the reporting system have also been documented. Consequently a number of mechanisms were employed to address some of these issues in order to make data more comparable. This global survey employed the following two methods:

- the European Conference of Ministers of Transport (ECMT) standardized 30-day road crash fatality factors to adjust all reported country/area data(5)

- a model using negative binomial regression

The “reported” data in Table B have been adjusted to this 30-day definition (see Table I below for adjustment factors) and the new adjusted number is therefore used in the corresponding model and its result is presented in Table B.


Table I. ECMT standardized 30-day road crash fatality adjustment factors

30-day total Adjustment factor

On the scene/1 day 77% 1.30

3 days 87% 1.15

6 days 92% 1.09

7 days 93% 1.08

30 days 100% 1.00

365 days 103% 0.97

Modeled dataDeveloping a modelBefore the modeling exercise, simple exploratory analyses were done to evaluate the distribution of the reported data, to identify potential outliers and to determine the extent of missing data. Decisions as to whether to include these outliers in the analyses, or whether to exclude them, were taken at several stages of the analysis. Where appropriate, imputation was done to compensate for missing information.

Completeness of dataHaving adjusted the reported data to a 30-day definition to facilitate comparability, the next step in the process was to explore the completeness of the reported death data on the basis of reported vital registration (VR) data. Information on the completeness of VR data was obtained from previous WHO published reports, and was updated with the latest information from the WHO mortality database(6,7). This information was then used to classify countries into two groups, namely:

Group 1: countries with VR completeness greater or equal to 85% and external causes of death coded to undetermined intent less than 30% (Table J);

Group 2: countries with VR completeness less than 85% or external causes of death coded to undetermined intent greater than 30%.

Group 1 countries include 37 high-income, 36 middle-income and 2 low-income countries (Table J). Data from these countries were used as a reference in constructing the negative binomial model. As such, no estimation was done for these countries.

Group 2 countries include 3 high-income, 48 middle-income and 43 low-income countries. Estimated data based on the prediction model described above are provided for these countries.

Countries/areas with populations of less than 100 000 and thus very low numbers of deaths (Table K) were also excluded from the modeling process.

Table B gives the 30-day adjusted number of deaths for all countries, and for Group 2 countries the modeled number of deaths with a 90% confidence interval. Those without a range are Group 1 countries and those in Table K where no modeling was done.


Table J. Countries/areas in Group 1

Country/area Income Level Country/area Income

Level

Argentina MIC Lithuania MIC

Australia HIC Malaysia MIC

Austria HIC Malta HIC

Bahamas HIC Mauritius MIC

Bahrain HIC Mexico MIC

Barbados MIC Montenegro MIC

Belarus MIC Netherlands HIC

Belgium HIC New Zealand HIC

Belize MIC Norway HIC

Bosnia and Herzegovina MIC Panama MIC

Brazil MIC Poland MIC

Brunei Darussalam HIC Portugal HIC

Bulgaria MIC Qatar HIC

Canada HIC Republic of Korea HIC

Chile MIC Republic of Moldova MIC

Colombia MIC Romania MIC

Costa Rica MIC Russian Federation MIC

Croatia MIC Saint Lucia MIC

Cuba MIC Saint Vincent and the Grenadines MIC

Cyprus HIC Serbia MIC

Czech Republic HIC Singapore HIC

Estonia HIC Slovakia HIC

Fiji MIC Slovenia HIC

Finland HIC South Africa MIC

France HIC Spain HIC

Georgia MIC Sweden HIC

Germany HIC Switzerland HIC

Greece HIC Thailand MIC

Hungary HIC The former Yugoslav Republic of Macedonia MIC

Iceland HIC Tonga MIC

Ireland HIC Trinidad and Tobago HIC

Israel HIC Ukraine MIC

Italy HIC United Kingdom HIC

Japan HIC United States of America HIC

Kazakhstan MIC Uruguay MIC

Kuwait HIC Uzbekistan LIC

Kyrgyzstan LIC Venezuela (Bolivarian Republic of) MIC

Latvia MIC

LIC = low-income country; MIC = middle-income country; HIC = high-income country


Table K. Countries/areas with population size less than 100 000

Country/area Income Level

British Virgin Islandsa HIC

Cook Islands HIC

Kiribati MIC

Marshall Islands MIC

Nauru MIC

Palau MIC

San Marino HIC

Seychelles MIC

Tuvalu MICa Non WHO member/area.

MIC = middle-income country; HIC = high-income country

Variables used in the modelTable L summarizes the independent variables used in the model and the data source.

Table L. Independent variables used in modeling process

Variable Source of information Comments

Income (GNI) World Bank (3,4)

Income level World Bank (4)

Grouping used: low, middle, lower middle, upper middle, high Designation based on 2000−2004 World Bank data, corresponding to year of income level used

PopulationEstimated figures from UN Population Division (2)

Vehicle density (number of cars per population)

Number of vehicles: This GSRRS surveyPopulation: World Bank (2)

Road density: Total road per land area

2000−2006 World Road Statistics, International Road Federation, 2008 (8)

Total road/land km2

Corresponding or latest year data

Existence of national helmet law This GSRRS survey WHO questionnaire

National policies that encourage walking and/or cycling

This GSRRS survey WHO questionnaire

National policies that support investment in public transport


National speed limits on urban roads


National speed limits on rural roads


Alcohol consumption World Health Statistics, 2008 (9)Alcohol consumption among adults aged >=15 years for 2003

Strength of health system World Health Statistics, 2008 (9) Hospital beds (per 10 000 population)


Estimation methodThe third stage used data from Group 1 countries to develop a statistical model to predict road traffic deaths (point estimates) for Group 2 countries including 90% confidence limits. The framework used to predict road traffic mortality was constructed using selected variables (identified through a literature review) which have direct relationship to the outcome variable (road traffic death). These variables were later grouped into three categories: exposure factors (Ej), risk or preventive factors (Rj), and mitigating factors (Mj). Gross national income (Ij) has an influence on the first two categories (Figure A).

In this framework, the road traffic mortality outcome (Yj) is a function of a set of independent variables described as exposure factors (Ej), risk or preventive factors (Rj), mitigating factors (Mj) and gross national income (Ij). This can be expressed as follows: Yj= f (Rj, Mj, Ij, Ej).

The relationship between the outcome and the independent variables is a nonlinear function. The number of deaths (Yj) is a non-negative integer count data; thus the standard approach to be used is the Poisson regression or another form of regression based on the Poisson(10). The most commonly used regression model for count data treats the response Y as a Poisson variable. In the Poisson regression model, the mean equals the variance, conditional on explanatory variables. In practice, however, this assumption was not satisfied. For this reason, a negative binomial regression model was chosen where the assumption for the dependent variance and Poisson’s particular case of negative binomial model are adequately satisfied.

Figure A. Framework for determinants of road traffic mortality

Road traffic mortality (Outcome Yj)

Income

Determinants of road traffic mortality

Independent Variables

Exposure factors_____________

Vehicle densityRoad density

Risk factors,preventive ormoderating measures_________________

Policies on specificinterventions and their enforcement- alcohol- speed- investment in public transport

Mitigating factors_______________

Strength of health system such as the presence of pre-hospital care, emergency care


At the end, a negative binomial regression modeling technique using STATA software was used to predict the number of road traffic fatalities with population size as an exposure facture(2). The model was constructed on the basis of reported data from the 75 Group 1 countries/areas mentioned in Table 2.

The full in-depth description of the methodology and formulas for the modeling process are available at the following website www.who.int/violence_injury_prevention/road_traffic/road_safety_status/2009.


References

1. STATA – Data analysis and statistical software (http://www.stata.com, accessed 14 April 2009).

2. World population prospects: the 2006 Revision. Highlights. New York, United Nations Population Division, 2007.

3. World development indicators. Washington, DC, International Bank for Reconstruction and Development/The World Bank, 2007.

4. GNI per capita 2007: Atlas method and PPP. Washington, DC, The World Bank, 2007 (http://siteresources.worldbank.org/DATASTATISTICS/Resources/GNIPC.pdf, accessed 9 April 2009).

5. Jacobs G, Thomas AA, Astrop A. Estimating global road fatalities (TRL Report 445). Crowthorne, Transport Research Laboratory, 2000 (http://www.transport-links.org/transport_links/filearea/publications/1_329_TRL445.pdf, accessed 22 January 2008).

6. Global Burden of Disease, 2004 update. Geneva, World Health Organization, 2008 (http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html, accessed 14 April 2009).

7. Mathers CD et al. Counting the dead and what they died from: an assessment of the global status of cause of death data. Bulletin of the World Health Organization, 2005, 83:171–177.

8. World road statistics 2008. Geneva, International Road Federation, 2008.9. World health statistics 2008. Geneva, World Health Organization, 2008 (http://www.who.

int/whosis/whostat/2008/en/index.html, accessed 14 April 2009). 10. Cameron AC, Trivedi PK. Regression analysis of count data. Econometric Society

Monograph, No. 30. New York, Cambridge University Press, 1998.


Table A. National Data Coordinators by Country/Area in the Western Pacific Region

COUNTRY/AREA NAME OF NATIONAL DATA COORDINATOR(S)

Australia Goldsworthy, John

Brunei Darussalam Saidon, Rozaly

Cambodia Raingsey, Prak Piseth

China Duan, Leilei

Cook Islands Herman, Josephine

Fiji Tuiketei, Timaima

Japan Nakahara, Shinji

Kiribati Rubeiariki, Mweritonga

Lao People’s Democratic Republic Phoutsavath, Phisith

Malaysia Ramly, Rosnah

Marshall Islands Edwards, Russell

Federated States of Micronesia Skilling, Vita

Mongolia Sakhiya, Ariuntuya

Nauru Dowiyogo, David

New Zealand Brown, Jennifer

Republic of Palau Aguon, Ismael

Papua New Guinea Kanguma, Peri

Philippines Magturo, Theodora Cecile

Republic of Korea Kim, Young-Taek

Samoa Vasa, Ponifasio

Singapore Ho, Seng Tim

Solomon Islands Ogaoga, Divinol

Tonga Akau’ola, Siale

Tuvalu Kaitu, Kakee Pese

Vanuatu Taura, Ben

Viet Nam Nguyen, Thi Hong Tu


CO

UNTR

Y/AR

EA

GEN

ERAL

INFO

RMAT

ION

VEHI

CLE

SRO

AD TR

AFFI

C D

EATH

SRO

AD U

SER

DEAT

HS (%

)

Popu

latio

n nu

mbe

rsa f

or

2007

GNI

per

ca

pita

b for

20

07 in

US

dolla

rs

Inco

me

leve

lc

Num

ber o

f re

giste

red

vehi

cles

Repo

rted

num

ber o

f ro

ad tr

affic

de

aths

d

Mod

eled

num

ber o

f ro

ad tr

affic

de

aths

e

Estim

ated

road

tra

ffic

deat

h ra

te p

er 1

00 0

00

popu

latio

ne

Driv

ers/

Pass

enge

rs

of 4

-whe

eled

ve

hicl

es

Driv

ers/

Pass

enge

rs

of m

otor

ized

2-

whe

eler

s

Cyc

lists

Pede

stria

nsO

ther

or

unsp

ecifi

ed

user

s

Poin

t es

timat

e90

% C

onfid

ence

in

terv

al

Aus

tralia

20 7

43 1

7935

960

High

14 7

74 9

211

616

1 61

6

7.8

70.2

14.8

2.5

12.5

Br

unei

Dar

ussa

lam

390

056

30 5

80f

High

304

432

5454

13

.875

.811

.11.

99.

22.

1C

ambo

dia

14 4

43 6

7954

0Lo

w15

4 38

91

668

1 74

9 1

385

–2 4

10

12.1

14.9

62.8

4.7

13.3

4.2

Chi

na1

336

317

116

2 36

0M

iddl

e14

5 22

8 99

496

611

220

783

183

428

–333

623

16

.522

.628

.19.

526

.013

.8

Coo

k Isl

ands

13 3

2513

098

fM

iddl

e10

692

66

45

.0

60.0

40

.0

Fiji

838

698

3 80

0M

iddl

e78

833

5959

7.

075

.0

25

.0

Japa

n12

7 96

6 70

937

670

High

91 3

78 6

366

639

6 63

9

5.0

37.1

17.6

12.8

32.3

0.2

Kirib

ati

95 0

671

170

Mid

dle

16 0

007

7

7.4

51.0

44.0

6.

0

Lao

Peop

le’s

Dem

ocra

tic

Repu

blic

5 85

9 39

358

0Lo

w64

1 08

165

61

075

864

–1 3

28

18.3

Mal

aysia

26 5

71 8

796

540

Mid

dle

16 8

25 1

506

282

6 28

2

23.6

23.3

58.0

3.0

10.1

5.6

Mar

shal

l Isla

nds

59 2

863

070

Mid

dle

2 48

71

1

1.7

100.

0

Fede

rate

d St

ates

of M

icro

nesia

111

117

2 47

0M

iddl

e4

217

216

12–

20

14.4

90.0

10.0

Mon

golia

2 62

8 84

01

290

Mid

dle

161

989

562

507

366

–719

19

.364

.916

.70.

417

.9

Nau

ru10

152

7 84

2fM

iddl

e…

11

9.

9

New

Zea

land

4 17

8 52

528

780

High

3 18

9 13

142

342

3

10.1

76.0

9.0

2.0

10.0

3.0

Pala

u20

314

8 21

0M

iddl

e5

530

33

14

.866

.7

33

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Papu

a N

ew G

uine

a6

331

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850

Low

59 6

4530

890

1 6

84–1

249

14

.259

.90.

00.

839

.3

Philip

pine

s87

960

117

1 62

0M

iddl

e5

515

576

1 18

517

557

12

457–

33 7

41

20.0

Re

publ

ic o

f Kor

ea48

223

853

19 6

90Hi

gh18

213

228

6 16

66

166

12

.836

.620

.74.

937

.40.

5Sa

moa

187

023

2 43

0M

iddl

e15

903

1924

20–

29

12.8

Sin

gapo

re4

436

281

32 4

70Hi

gh85

1 33

621

421

4

4.8

14.9

47.7

10.3

27.1

So

lom

on Is

land

s49

5 66

273

0Lo

w10

000

1984

64–

118

16.9

To

nga

100

336

2 32

0M

iddl

e2

226

77

7.

050

.0

6.3

43.8

Tu

valu

10 5

302

441f

Mid

dle

906

11

9.

5

Vanu

atu

226

180

1 84

0M

iddl

e15

461

742

29–

58

18.6

Vi

et N

am87

375

196

790

Low

22 9

26 2

3016

640

14 1

0411

987

–16

387

16.1

a Pop

ulat

ion

Div

ision

of t

he D

epar

tmen

t of E

cono

mic

and

Soc

ial A

ffairs

of t

he U

nite

d N

atio

ns S

ecre

taria

t (20

07).

Wor

ld p

opul

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n Pr

ospe

cts:

The

2006

Rev

ision

, igh

light

s. N

ew Y

ork:

Uni

ted

Nat

ions

.b G

ross

Nat

iona

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me

(GN

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the

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orld

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Oct

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8.d A

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e Mod

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usin

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e bi

nom

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egre

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ann

ex).

Dat

a fro

m c

ount

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ith g

ood

vita

l reg

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and

coun

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with

a p

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n of

less

than

100

000

wer

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the

mod

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f 200

7 da

ta n

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vaila

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Lat

est a

vaila

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used

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http

://da

ta.u

n.or

g/.

Tabl

e B.

Veh

icle

s, ro

ad tr

affic

dea

ths a

nd p

ropo

rtion

of r

oad

user

s by

coun

try


Tabl

e C

. He

lmen

t law

s, en

forc

emen

t and

wea

ring

rate

s by

coun

try

CO

UNTR

Y/AR

EATH

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IS A

NA

TIONA

L HE

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LAW

THE

LAW

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TO TH

E FO

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WIN

G

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USE

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ESS

OF

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ONS

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S)

(sca

le 1

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TH

ERE

ARE

HE

LMET

ST

ANDA

RDS

ESTIM

ATED

NA

TIONA

L HEL

MET

W

EARI

NG R

ATE

(%)

Driv

ers

Adul

t pa

ssen

ger

Chi

ld

pass

enge

rs

Ther

e ar

e ex

cept

ions

to

the

helm

et

law

The

helm

et

law

app

lies

to a

ll ro

ad

type

s

The

helm

et

law

app

lies

to a

ll en

gine

ty

pes

Mot

orize

d 2-

and

3-

whe

eler

s (%

)

Helm

et

wea

ring

rate

(%)

DEAT

HS B

Y RO

AD U

SER

CAT

E G

ORY

(%

)

Aus

tralia

Subn

atio

nal

Yes

Yes

Yes

No

Yes

Yes

n/a

4---

15Ye

s…

Brun

ei D

arus

sala

mYe

sYe

sYe

sYe

sN

oYe

sYe

s9

498

11Ye

s98

Cam

bodi

aYe

sYe

sN

oN

oYe

sYe

sYe

s2

8421

63N

o21

a

Chi

naYe

sYe

sYe

sYe

sN

oYe

sYe

sN

o co

nsen

sus

---16

28Ye

s16

b

Coo

k Isl

ands

No

n/a

n/a

n/a

n/a

n/a

n/a

n/a

------

60n/

a…

Fiji

Yes

Yes

Yes

Yes

No

Yes

Yes

10---

90---

Yes

90

Japa

nYe

sYe

sYe

sYe

sN

oYe

sYe

sN

o co

nsen

sus

14---

18Ye

s…

Kirib

ati

No

n/a

n/a

n/a

n/a

n/a

n/a

n/a

13

44n/

a…

Lao

Peop

le’s

Dem

ocra

tic

Repu

blic

Yes

Yes

Yes

Yes

Yes

Yes

Yes

679

82---

No

77c

Mal

aysia

Yes

Yes

Yes

Yes

Yes

Yes

Yes

647

8058

Yes

90c

Mar

shal

l Isla

nds

Yes

Yes

Yes

Yes

Yes

Yes

Yes

71

95---

No

95

Fede

rate

d St

ates

of M

icro

nesia

Subn

atio

nal

n/a

n/a

n/a

n/a

n/a

n/a

n/a

<110

0%---

n/a

100

Mon

golia

Yes

Yes

Yes

Yes

…Ye

sYe

s3

1---

17N

o…

Nau

ruN

on/

an/

an/

an/

an/

an/

an/

a---

------

n/a

…

New

Zea

land

Yes

Yes

Yes

Yes

Yes

Yes

Yes

93

---9

Yes

…

Pala

uYe

sYe

sYe

sYe

sYe

sYe

sYe

s8

14---

---Ye

s…

Papu

a N

ew G

uine

aYe

sYe

sYe

sYe

sN

oYe

sYe

s7

2---

---Ye

s…

Philip

pine

sSu

bnat

iona

ln/

an/

an/

an/

an/

an/

an/

a48

34---

n/a

34

Repu

blic

of K

orea

Yes

Yes

Yes

Yes

No

Yes

Yes

710

8521

Yes

85

Sam

oaYe

sYe

sYe

sYe

sN

oYe

sYe

s6

------

---N

o…

Singa

pore

Yes

Yes

Yes

Yes

Yes

Yes

Yes

917

5648

Yes

56

Solo

mon

Isla

nds

Yes

Yes

Yes

Yes

No

Yes

Yes

3---

100

---Ye

s10

0

Tong

aYe

sYe

sYe

sYe

sN

oYe

sYe

s7

1---

---N

o…

Tuva

luN

on/

an/

an/

an/

an/

an/

an/

a66

0---

n/a

0

Vanu

atu

Yes

Yes

Yes

Yes

No

Yes

Yes

8---

------

No

…

Viet

Nam

Yes

Yes

Yes

Yes

Yes

Yes

Yes

795

85---

Yes

85a P

hnom

Pen

h on

lyb G

uang

xi pr

ovin

ce o

nly

c Driv

ers o

nly


Tabl

e D.

Drin

king

and

driv

ing

law

s, en

forc

emen

t and

road

traf

fic d

eath

s attr

ibut

ed to

alc

ohol

by

coun

try

CO

UNTR

Y/AR

EANA

TIONA

L DR

INK–

DRIV

ING

LA

W

HOW

DRI

NK–D

RIVI

NG IS

DEF

INED

RAND

OM

BRE

ATH

TEST

ING

OR

POLIC

E C

HEC

K PO

INTS

USE

D FO

R EN

FORC

EMEN

T

EFFE

CTIV

ENES

S O

F O

VERA

LL

ENFO

RCEM

ENT

(RES

POND

ENT

CO

NSEN

SUS)

(s

cale

1–1

0)

NATIO

NAL M

AXIM

UM LE

GAL

BAC

LEVE

LS

PRO

PORT

ION

OF

ROAD

TRAF

FIC

DE

ATHS

THAT

ARE

AT

TRIB

UTAB

LE TO

AL

CO

HOL %

Bloo

d Al

coho

l C

once

ntra

tion

(BAC

) le

vel

Phys

icia

n ce

rtific

ate

Brea

th

cont

ent

For t

he

gene

ral

popu

latio

n

(g/d

l)

For y

oung

or

nov

ice

driv

ers

(g/d

l)

For

prof

essio

nal o

r co

mm

erci

al

driv

ers (

g/dl

)

Aus

tralia

Subn

atio

nala

Yes

……

Yes

n/a

0.05

0.02

0.05

30.0

Brun

ei D

arus

sala

mYe

sYe

s…

Yes

Yes

60.

080.

080.

083.

7

Cam

bodi

aYe

sYe

s…

Yes

…N

ot y

et

enfo

rced

0.05

0.05

0.05

…

Chi

na

Yes

Yes

……

Yes

80.

020.

020.

024.

2C

ook

Islan

dsYe

sYe

sYe

sYe

s…

40.

040.

040.

04…

Fiji

Yes

Yes

Yes

Yes

Yes

70.

080.

000.

0027

.0Ja

pan

Yes

Yes

…Ye

sYe

sN

o co

nsen

sus

0.03

0.03

0.03

8.3

Kirib

ati

Yes

Yes

Yes

Yes

Yes

20.

080.

080.

0830

.0La

o Pe

ople

’s D

emoc

ratic

Rep

ublic

Yes

Yes

……

Yes

30.

080.

080.

0848

.0M

alay

siaYe

sYe

s…

Yes

Yes

60.

080.

080.

08…

Mar

shal

l Isla

nds

Yes

……

…Ye

s6

n/a

n/a

n/a

70.0

Fede

rate

d St

ates

of M

icro

nesia

Subn

atio

nal

n/a

n/a

n/a

n/a

n/a

Subn

atio

nal

Subn

atio

nal

Subn

atio

nal

90.0

Mon

golia

Yes

Yes

…Ye

sYe

s6

0.05

0.05

0.05

3.7

Nau

ruYe

sYe

s…

…Ye

s…

0.05

0.05

0.05

…N

ew Z

eala

ndYe

sYe

s…

Yes

Yes

60.

080.

030.

0831

.0Pa

lau

Yes

Yes

…Ye

sYe

s4

0.10

0.00

0.00

100.

0c

Papu

a N

ew G

uine

aYe

sYe

s…

Yes

Yes

5...

......

66.0

Philip

pine

sN

on/

an/

an/

an/

an/

an/

an/

an/

a…

Repu

blic

of K

orea

Yes

Yes

……

Yes

70.

050.

050.

0516

.1Sa

moa

Yes

Yes

Yes

…Ye

s1

……

…50

.0Sin

gapo

reYe

sYe

s…

Yes

Yes

80.

080.

080.

087.

0So

lom

on Is

land

sYe

sb…

……

Yes

3...

......

55.0

Tong

aYe

sb…

Yes

…Ye

s5

......

...25

.0Tu

valu

Yesb

……

…Ye

s6

......

...…

Vanu

atu

Yesb

……

…Ye

s6

......

...…

Viet

Nam

Yes

Yes

…Ye

sYe

s3

0.08

0.08

0.08

34.0

a Law

s set

subn

atio

nally

, but

they

all h

ave

the

sam

e lim

its.

b Not

defi

ned

by B

AC

or n

o st

anda

rdize

d de

finiti

on.

c Ref

ers t

o on

ly 3

dea

ths.


Tabl

e E.

Spe

ed la

ws a

nd e

nfor

cem

ent b

y co

untry

CO

UNTR

Y/AR

EASP

EED

LIMITS

ARE

SET

AT

A N

ATIO

NAL L

EVEL

SPEE

D LIM

ITS A

RE

MO

DIFI

ABLE

AT A

LO

CAL

LEVE

L

LEG

ISLA

TION

DIFF

ERS

BY V

EHIC

LE TY

PE

MAX

IMUM

SPE

EDEF

FEC

TIVEN

ESS

OF

OVE

RALL

ENF

ORC

EMEN

T (R

ESPO

NDEN

T C

ONS

ENSU

S)

(sca

le 1

–10)

On

urba

n ro

ads (

km/h

)O

n ru

ral r

oads

(k

m/h

)

Aus

tralia

Subn

atio

nal

Yes

Yes

5010

0Su

bnat

iona

l

Brun

ei D

arus

sala

mYe

sN

oYe

s80

657

Cam

bodi

aYe

sN

oYe

s40

901

Chi

naYe

sYe

sYe

s30

–50

40–7

08

Coo

k Isl

ands

Yes

No

No

5050

4

Fiji

Yes

No

Yes

5060

7

Japa

nYe

sYe

sYe

sn/

aan/

aaN

o co

nsen

sus

Kirib

ati

Yes

No

No

4060

6

Lao

Peop

le’s

Dem

ocra

tic R

epub

licYe

sN

oYe

s40

505

Mal

aysia

Yes

Yes

Yes

5090

6

Mar

shal

l Isla

nds

Yes

No

No

4040

5

Fede

rate

d St

ates

of M

icro

nesia

Subn

atio

nal

No

No

3240

6

Mon

golia

Yes

Yes

Yes

6080

4

Nau

ruYe

sN

oN

o40

40…

New

Zea

land

Yes

Yes

Yes

5010

07

Pala

uYe

sN

oN

o40

505

Papu

a N

ew G

uine

aYe

sN

oN

o60

751

Philip

pine

sYe

sN

oYe

s40

403

Repu

blic

of K

orea

Yes

Yes

Yes

6080

7

Sam

oaYe

sN

oN

o40

566

Singa

pore

Yes

No

No

40–7

0n/

a 8

Solo

mon

Isla

nds

Yes

No

No

60n/

a5

Tong

aYe

sN

oN

o40

657

Tuva

luYe

sN

oN

o64

…6

Vanu

atu

Yes

Yes

Yes

35–6

0n/

a3

Viet

Nam

Yes

No

Yes

5080

6a D

iffer

ent r

oad

clas

sifica

tion

used

.


Tabl

e F.

Sea

t bel

t and

chi

ld re

strai

nt la

ws,

enfo

rcem

ent a

nd w

earin

g ra

tes b

y co

untry

CO

UNTR

Y/AR

EA

SEAT

-BEL

TSC

HILD

RES

TRAI

NTS

Ther

e is

a na

tiona

l sea

t-be

lt la

w

The

law

ap

plie

s to

Enfo

rcem

ent i

s app

lied

to

the

follo

win

g oc

cupa

nts

Effe

ctiv

enes

s of s

eat-

belt

law

enf

orce

men

t (re

spon

dent

con

sens

us)

(sca

le 1

–10)

Natio

nal s

eat-b

elt w

earin

g ra

teTh

ere

is a

natio

nal c

hild

re

strai

nt la

w

Effe

ctiv

enes

s of c

hild

re

strai

nt la

w e

nfor

cem

ent

(resp

onde

nt c

onse

nsus

) (s

cale

1–1

0)A

ustra

liaSu

bnat

iona

lYe

sA

ll occ

upan

tsn/

a97

% fr

ont s

eats

; 92%

rear

seat

sSu

bnat

iona

ln/

a

Brun

ei D

arus

sala

mYe

sN

oFr

ont s

eat o

ccup

ants

onl

y7

70%

fron

t sea

tsYe

s4

Cam

bodi

aYe

sN

oN

o en

forc

emen

t1

0%Ye

s0

Chi

naYe

sYe

sA

ll occ

upan

tsN

o co

nsen

sus

50%

aN

on/

a

Coo

k Isl

ands

No

n/a

n/a

…

No

n/a

Fiji

Yes

Yes

All o

ccup

ants

995

% fr

ont s

eats

; 70%

rear

seat

sYe

s5

Japa

nYe

sYe

sA

ll occ

upan

tsN

o co

nsen

sus

91%

–96%

fron

t sea

ts; 9

%–1

4% re

ar se

ats

Yes

No

cons

ensu

s

Kirib

ati

Yes

Yes

Driv

er o

nly

1…

Yes

0

Lao

Peop

le’s

Dem

ocra

tic R

epub

licYe

sYe

sN

o en

forc

emen

t…

…N

on/

a

Mal

aysia

Yes

No

Fron

t sea

t occ

upan

ts o

nly

670

%N

on/

a

Mar

shal

l Isla

nds

No

n/a

n/a

n/a

5% fr

ont s

eats

; 0%

rear

seat

sN

on/

a

Fede

rate

d St

ates

of M

icro

nesia

No

n/a

n/a

n/a

100%

fron

t sea

ts; 0

% re

ar se

ats

No

n/a

Mon

golia

Yes

Yes

Fron

t sea

t occ

upan

ts o

nly

770

% –

80%

driv

ers

Yes

2

Nau

ruN

on/

an/

an/

a…

No

n/a

New

Zea

land

Yes

Yes

All o

ccup

ants

995

% fr

ont s

eats

; 87%

rear

seat

sYe

s8

Pala

uN

on/

an/

an/

a…

No

n/a

Papu

a N

ew G

uine

aYe

sYe

sA

ll occ

upan

ts6

…N

on/

a

Philip

pine

sYe

sYe

sA

ll occ

upan

ts3

52%

driv

ers o

nly

No

n/a

Repu

blic

of K

orea

Yes

Yes

Fron

t sea

t occ

upan

ts o

nly

877

% fr

ont s

eats

Yes

2

Sam

oaYe

sN

oFr

ont s

eat o

ccup

ants

onl

y3

…Ye

s1

Singa

pore

Yes

Yes

All o

ccup

ants

850

%Ye

s7

Solo

mon

Isla

nds

No

n/a

n/a

n/a

…N

on/

a

Tong

aN

on/

an/

an/

a<1

%N

on/

a

Tuva

luN

on/

an/

an/

a0%

No

n/a

Vanu

atu

Yes

No

No

enfo

rcem

ent

1…

No

n/a

Viet

Nam

Yes

No

Fron

t sea

t occ

upan

ts o

nly

3…

No

n/a

a Gua

ngzh

ou a

nd N

anni

ng c

ities

onl

y.


Table G. Pre-hospital care systems by country

Country/area Formal pre-hospital care

system

Universal access telephone number Telephone

number(s)National Regional

Australia Yes Yes … 000

Brunei Darussalam Yes Yes … …

Cambodia Yes Yes … 119

China Yes Yes … 120

Cook Islands No n/a n/a …

Fiji Yes Yes … 000

Japan Yes Yes … 119

Kiribati Yes Yes … 28100

Lao People’s Democratic Republic No n/a n/a …

Malaysia Yes Yes … 999

Marshall Islands Yes Yes … 6258444

Federated States of Micronesia No n/a n/a …

Mongolia Yes Yes Yes 103

Nauru Yes Yes … 4443883

New Zealand Yes Yes … 111

Palau Yes Yes … 911

Papua New Guinea Yes Yes … 111

Philippines Yes No Yes …

Republic of Korea Yes Yes … 119

Samoa Yes Yes … 996,995

Singapore Yes Yes … 995

Solomon Islands No n/a n/a n/a

Tonga No n/a n/a n/a

Tuvalu Yes Yes … 911

Vanuatu Yes Yes … 112

Viet Nam Yes Yes … 115


Tabl

e H.

Roa

d sa

fety

man

agem

ent,

strat

egie

s and

pol

icie

s by

coun

try

CO

UNTR

Y/AR

EA

LEAD

AG

ENC

YST

RATE

GIE

SPO

LICIE

SAU

DITS

DRIV

ING

TEST

S

CO

MPU

LSAR

Y IN

SURA

NCE

REQ

UIRE

DA

lead

ag

ency

is

pres

ent

Lead

age

ncy

statu

s

The

lead

ag

ency

is

fund

ed

Ther

e is

a na

tiona

l ro

ad sa

fety

stra

tegy

The

strat

egy

incl

udes

m

easu

rabl

e na

tiona

l tar

gets

The

strat

egy

is fu

nded

Ther

e ar

e po

licie

s to

prom

ote

wal

king

and

cy

clin

g

Ther

e ar

e po

licie

s to

pro

mot

e in

vestm

ent

in p

ublic

tra

nspo

rtatio

n

Form

al

audi

ts on

ne

w ro

ads

Regu

lar a

udits

on

exi

sting

ro

ads

Writ

ten

Prac

tical

Med

ical

Aus

tralia

Yes

Gov

ernm

enta

lYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s…

Yes

Brun

ei D

arus

sala

mYe

sG

over

nmen

tal

…M

ultip

le st

rate

gies

n/a

n/a

No

…N

oN

oYe

sYe

s…

Yes

Cam

bodi

aYe

sIn

term

inist

eria

lYe

sYe

san/

an/

aN

oN

oN

oN

oYe

sYe

s…

No

Chi

naYe

sIn

term

inist

eria

lYe

sYe

sN

oYe

sN

oYe

sN

oN

o co

nsen

sus

Yes

Yes

…Ye

s

Coo

k Isl

ands

Yes

Gov

ernm

enta

lYe

sN

on/

an/

aN

oN

oN

oN

oYe

sYe

s…

No

Fiji

Yes

Inte

rmin

ister

ial

Yes

Yes

Yes

Yes

No

No

Yes

Yes

Yes

Yes

…Ye

s

Japa

nYe

sG

over

nmen

tal

Yes

Yes

Yes

Yes

No

cons

ensu

sYe

sN

oN

oYe

sYe

sYe

sYe

s

Kirib

ati

Yes

Gov

ernm

enta

lN

oYe

sYe

sN

oN

oN

oYe

sYe

sYe

sYe

s…

No

Lao

Peop

le’s

Dem

ocra

tic

Repu

blic

Yes

Gov

ernm

enta

lN

oYe

sYe

sN

oN

oYe

sYe

sYe

sYe

sYe

s…

Yes

Mal

aysia

Yes

Inte

rmin

ister

ial

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

…Ye

s

Mar

shal

l Isla

nds

Yes

Gov

ernm

enta

lYe

sYe

san/

an/

aN

oN

oN

oN

oYe

sYe

s…

Yes

Fede

rate

d St

ates

of

Mic

rone

siaN

on/

a n/

a Su

bnat

iona

lN

oN

oN

oN

oYe

sN

oYe

sYe

s…

No

Mon

golia

Yes

Oth

erYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s…

No

Nau

ruYe

s…

Yes

Mul

tiple

stra

tegi

esn/

an/

aYe

sN

oN

oN

o…

Yes

…Ye

s

New

Zea

land

Yes

Gov

ernm

enta

lYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

sYe

s…

No

Pala

uYe

sG

over

nmen

tal

Yes

Yes

Yes

No

Yes

Yes

Yes

Yes

Yes

Yes

Yes

No

Papu

a N

ew G

uine

aYe

sG

over

nmen

tal

No

Subn

atio

nal

n/a

n/a

……

No

No

Yes

Yes

…Ye

s

Philip

pine

sYe

sG

over

nmen

tal

No

Yes

Yes

Yes

Subn

atio

nal

Yes

Yes

Yes

Yes

Yes

…Ye

s

Repu

blic

of K

orea

Ye

sG

over

nmen

tal

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Sam

oaYe

sIn

term

inist

eria

lYe

sYe

sN

oN

oN

oN

oYe

sYe

sYe

sYe

s…

No

Singa

pore

Yes

Inte

rmin

ister

ial

Yes

Yes

Yes

Yes

Subn

atio

nal

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Solo

mon

Isla

nds

Yes

Gov

ernm

enta

l…

……

… Y

esN

oYe

sN

o…

Yes

…Ye

s

Tong

aYe

sG

over

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