Burden of Road Traffic Injuries in the Eastern Mediterranean Region

Abstract

Road traffic injuries (RTIs) have been a leading cause of mortality for many years at the global level, and for persons 15 to 29 years old, it is the leading cause of death (WHO, Global status report on road safety 2015. WHO, Geneva, 2015). Road safety is receiving increased international attention on the global agenda and is now included in 2 of the 17 Sustainable Development Goals. The Eastern Mediterranean Region (EMR) comprised of 22 countries (Afghanistan, Arab Republic of Egypt, Bahrain, Djibouti, Iraq, Islamic Republic of Iran, Jordan, Kingdom of Saudi Arabia, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Republic of Yemen, Somalia, Sudan, Syrian Arab Republic (Syria), Tunisia, United Arab Emirates (UAE)) is of particular importance in the field because it has the second highest rates of road traffic fatalities. A great deal of investment started in 2010 to stimulate research on the scope of the problem, identify risk factors and to capture the health consequences in deaths and injuries in the Region, leading to several peer-reviewed publications addressing these issues. Analysis of regional data comparing the EMR average to a global average suggests a potential downward trend in road traffic injury mortality rates but with persisting inequalities in the mortality and morbidity burden in the Region. Protected road user injuries (four-wheel motor vehicle occupants) decreased 18% compared to unprotected road users (two-wheel and pedestrians) resulting in a 17% increase in injuries, with the highest being in pedestrians. When comparing by income, reductions have been achieved at all levels for both types of road users, notably a 29% decrease for unprotected road users in EMR low-income countries. Almost half of the RTI deaths in the EMR is among vulnerable road users (pedestrians, bicyclists, and motorcyclists), and the majority are pedestrians. Only two countries, Morocco and Qatar, have developed national policies and enabling environments to separate vulnerable road users from high-speed traffic. Although the majority of countries in the EMR have implemented legislation on key risk factors, these are not comprehensive enough, and enforcement needs to be strengthened. An overview of the success Oman has had in road safety is presented with key interventions undertaken to achieve ambitious safety aims.

For the EMR to ultimately attain the targets of the Sustainable Development Goals, political commitment and cooperation within and between the EMR countries is necessary in order to achieve a “safe systems” approach: a shift from a focus on crash reduction to the elimination of death and serious injury. This will require system-wide investments in vehicle quality, enforcement, safe infrastructure, and analyses of road users in the pre-crash, in-crash, and post-crash stages in order to build and manage transport systems that are safe, clean, and affordable.