Road Deaths and Injuries Hold Back Economic Growth in Developing Countries

A new World Bank study, funded by Bloomberg Philanthropies, finds that reducing road traffic deaths
and injuries could result in substantial long-term income gains for low- and middle-income countries.

While there is general recognition of road traffic injuries and fatalities, little is known about the link
between road traffic injuries and economic growth. The new report quantifies how investments in road
safety are also an investment in human capital.

The study finds that countries that do not invest in road safety could miss out on anywhere between 7
and 22% in potential per capita GDP growth over a 24-year period. This requires policymakers to
prioritize proven investments in road safety. The cost of inaction is more than 1.25 million deaths a
year globally, diminished productivity and reduced growth prospects.

Traffic Fatalities Strike Prime Working Age Adults in Low- and Middle-Income Countries
(LMICs)

Road traffic fatalities disproportionately affect low- and middle-income countries, where 90% of global
road deaths occur. Rising incomes in many developing countries have led to rapid motorization, while
road safety management and regulations have not kept pace.

Death rates from road traffic injuries are high in LMICs – in 2015, reaching 34 per 100,000 in the
countries studied. By contrast, the average across the 35 countries of the Organization for Economic
Cooperation and Development (OECD) in the same year was 8 deaths per 100,000.

The greatest share of mortality and long-term disability from road traffic crashes happen amongst the
working-age population (between 15 and 64 years old).

Reducing Road Traffic Deaths and Injuries Can Boost Income Growth 

According to the report, deaths and injuries from road traffic crashes affect medium- and long-term
growth prospects by removing prime age adults from the work force, and reducing productivity due to
the burden of injuries.

Using detailed data on deaths and economic indicators from 135 countries, the study estimates that,
on average, a 10% reduction in road traffic deaths raises per capita real GDP by 3.6% over a 24-year
horizon.

Over the period 2014-38, halving deaths and injuries due to road traffic could potentially add 22% to
GDP per capita in Thailand, 15% in China, 14% in India, 7% in the Philippines and 7% in Tanzania.

Large Welfare Gains from Proven Cost-Effective Road Safety Interventions

In addition to the GDP gains from preventing death and injury, road safety interventions improve
welfare benefits to the society.

The World Bank study has quantified these gains for the five countries using a range of income and
risk reduction scenarios. Measured in 2005 US dollars, the welfare gains range between $5,000 to
$80,000 in Tanzania, and between $850,000 to $1.8 million in Thailand.
To achieve these welfare gains the report lists interventions that include reducing and enforcing
speed limits, reducing driving under the influence of alcohol, increasing seat-belt use through
enforcement and public awareness campaigns, and integrating road safety in in all phases of
planning, design, and operation of road infrastructure.

https://www.worldbank.org/en/news/press-release/2018/01/09/road-deaths-and-injuries-hold-back-economic-
growth-in-developing-countries
A safer future
Better tech, from seat belts to air bags to driver-alert systems, has made cars safer. And increasing
vehicle automation could potentially reduce the killing power of speed, impairment, distraction, and
fatigue.
But automation can also be a crutch, and it is one that psychological scientists worry about. A car that
does most of the driving itself, requiring a driver to take over only in times of rare emergencies, would
be a very unsafe car indeed given the human inability to remain alert while not engaged. As cars do
more of the work, psychologists will need to be there to push back against automation that makes
roads more dangerous.
This is especially true when considering vulnerable road users, such as pedestrians, bikers, and
motorcyclists. These users have become an increasing share of motor vehicle deaths for a variety of
reasons, including the features of cars that make drivers safer, such as higher, heavier vehicles.
There is also an increasing share of older pedestrians on the road because of the aging of the
population, said CARRS-Q’s King: “Once you’re older, it’s actually quite easy for a knock that would
be just some bruising for a young person to be life-threatening.”
Many cities have committed to Vision Zero, an effort to eliminate all traffic deaths and severe injuries
by designing roads and policies to lessen the likelihood and severity of crashes. This focus on safety
may put psychologists in more demand than ever. Preliminary research by Wolfe and Kosovicheva
has found that when dangerous situations—such as a person walking into traffic—become rare,
drivers become less likely to react quickly and decisively. In other words, the safer roads get, the
harder it becomes, cognitively speaking, to prevent every accident. “We can do all of this work in
infrastructure and tech and potentially in training,” Wolfe said, “but we’ve got this little sliver that we
need to figure out how to address separately as a cognitive problem for drivers.”
https://www.apa.org/monitor/2022/06/feature-traffic-safety
EGYPT

Improving road safety in Egypt

Road traffic injuries are among the 10 leading causes of death and disability globally. In Egypt, road
traffic crashes claim the lives of about 8000 persons annually; thousands more are left with physical
disabilities. Half of all deaths occur among vehicle occupants, with pedestrians accounting for 20% of
these deaths. The highest rates occur among young adults.
The Global Status Report on Road Safety (2009) shows that the rate of road traffic fatalities in Egypt
is one of the highest rates globally – 41.6 per 100 000 population – and is expected to increase over
the next two decades.
The Road Safety in 10 Countries project is an international initiative that aims to raise road safety
awareness in 10 low- and middle-income countries, including Egypt. The project targets motorists,
cyclists and pedestrians, and aims to promote positive road safety behaviours and implement
appropriate interventions to eliminate the causes of poor road safety.
A community outreach campaign is being planned as a key activity of the project. The campaign was
designed following a community-based study which measured knowledge, behavioural trends, driving
speeds and seat belt practices of road users.
The project also seeks to improve data management to better document the number of fatalities,
injuries and disabilities resulting from road traffic accidents. Enhanced data collection, registration,
distribution and analysis will assist policy- and decision-makers in implementing effective evidence-
based interventions to improve road safety and reduce the number of injuries and fatalities.
Globally, the project is funded by Bloomberg Philanthropies and represents a consortium of partners,
including WHO, Johns Hopkins International School of Public Health, World Bank Global Road Safety
Facility, Association of Safe International Road Travel and the World Resources Institute. In Egypt,
the project is supported by the Ministries of Health and Population, Interior, Education, Higher
Education and Information, the Central Agency for Public Mobilization and Statistics (CAPMAS), and
other relevant agencies and civil society organizations.
As part of the Road Safety in 10 Countries project, the WHO Egypt country office, in collaboration
with the Ministry of Health and Population and other relevant ministries and agencies, conducted a
workshop on planning community outreach campaigns to raise road safety awareness from 20 to 21
June 2012 in Cairo, Egypt. Participants of the workshop included representatives of various
government ministries and community groups.
During the workshop, Dr Naeema Al-Gasseer, acting WHO Representative for Egypt, cited the need
for greater enforcement of traffic laws and legislation, the development of road infrastructure and the
mobilization of all sectors and groups to improve community awareness of road safety.
https://www.emro.who.int/media/news/improving-road-safety-egypt.html
"There are several solutions for this problem from a scientific standpoint, the most important of which is
education, road planning and amendments made to traffic law. We should rely on technology also, to help fix
the issue. Drivers should be trained to avoid road accidents, and reprimands should be made more serious. With
more focus on the issue, solutions could be outlined better," he says.
Meanwhile, General Alaa Abd al-Megeed, assistant director of the General Directorate of Transport and
Communications Police, says there are three main reasons for the high number of traffic accidents in Egypt: the
poor driving; the bad state of roads; and the bad state of vehicles.
"We should raise awareness about the various aspects of the phenomenon, and driving schools should be
developed and enrollment in them made compulsory before anyone else is allowed to be issued a license,”
Megeed says.
https://egyptindependent.com/egypt-top-10-road-traffic-deaths-officials-still-seeking-solutions/

Objective: Road traffic injuries (RTIs) are a major cause of global mortality and morbidity, killing
approximately 1.3 million people and injuring 20 to 50 million each year. The significance of this public health
threat is most pronounced in lowand middle-income countries where 90 percent of the world’s road traffic–
related fatalities take place. Current estimates for Egypt show a road traffic fatality rate of 42 deaths per
100,000 population—one of the highest in the Eastern Mediterranean Region. RTIs are also responsible for 1.8
percent of all deaths and 2.4 percent of all disability-adjusted life years (DALYs) lost in the country. Despite
this, studies surrounding this topic are scarce, and reliable data are limited. The overall goal of this article is to
define the health impact of RTIs in Egypt and to identify the strengths and weaknesses of each data source for
the purpose of improving the current RTI data systems.
Methods: A 2-pronged approach was undertaken to assess the burden of RTIs in Egypt. First, a thorough
literature review was performed using PubMed, Embase, ISIS Web of Knowledge, and Scopus databases.
Articles pertaining to Egypt and road traffic injuries were selected for screening. With assistance from Egyptian
colleagues, a comprehensive exploration of data sources pertaining to RTIs in Egypt was undertaken and
secondary data from these sources were procured for analysis.
Results: The literature review yielded a total of 20 studies, of which 6 were multi-country and 5 were hospital-
based studies. None examined risk factors such as speeding, alcohol, or seat belt use. Secondary data sources
were acquired from national hospital-based injury surveillance; a community-based health survey; pre-hospital
injury surveillance; the Ministry of Transport; the General Authority for Roads, Bridges and Land Transport;
death certificates; and the central agency for public motorization and statistics. Risk factor data are also limited
from these sources.
Conclusion: The results of this article clearly highlight the significant burden that road traffic injuries pose on
the health of the Egyptian population. The hospital-based injury surveillance system that has been established in
the country and the use of International Classification of Diseases (ICD-10) coding brings the system very
closely in line with international guidelines. There is, however, some considerable room for improvement,
including the need to extend the coverage of the surveillance system, the inclusion of injury severity scores and
disability indicators, and standardization of the sometimes rather disparate sources from various sectors in order
to maximally capture the true burden of RTIs.

Compared to other countries in the EMR, Egypt has one of the highest reported road traffic death rates per
100,000 population (Figure 1). According to the Global Status Report on Road Safety (WHO 2009a), road
traffic crashes resulted in 42 deaths per 100,000 population (1.8% of all deaths from all causes in Egypt) and, as
per the global burden of disease study 2004 update, 444 DALYs lost per 100,000 population (2.4% of all
DALYs lost in Egypt due to all causes).
Despite the alarming increases in the burden of injuries in Egypt, there is a significant scarcity of published
scientific articles surrounding the true burden of RTIs in Egypt, with the few that are available being limited to
small-scale, city-based, or facility-based studies. Limited public awareness of the issue coupled with diminished
emphasis on road safety policies at the national level results in reduced interest in this topic. One of the most
significant constraints of policymakers is the limited yet necessary reliable data pertaining to RTIs, and it is
therefore imperative that due attention be paid not only to the RTI data systems that already exist in Egypt but
also to the necessity to improve these systems.

 The majority of the respondents believed that road traffic crashes are hadthah (accidents/out of one’s
control) rather than esabah (injuries) Education, enforcement, and engineering were recommended as
intervention tactics
 Young Egyptians of medium to high socioeconomic status were found to be receptive toward injury
prevention programs. However, it is important to understand how these injury concepts are perceived
(hadthah or esabah)
 Compared to normal drivers, neurotic and accident-prone drivers received a significantly higher score
for neuroticism The neuroticism scores of accident-prone drivers were the highest amongst the three
groups
 Preemployment personality screenings were suggested
 11.2% of the participants used a seat belt regularly
 Need intervention programs to reduce behavioral risk factors among physicians and laws that mandate
seat belt use
 Elderly males were at higher risk for RTIs 57% of elderly RTI victims were pedestrians, 26% were car
drivers, 14% were car passengers, 2.7% were bicyclists, and 0.7% were motorcyclists
 Health and transport professionals must work together to prevent RTIs in vulnerable populations
Recommendations include improving motor vehicle and road designs as well as offering frequent
medical screenings
 The main cause of blunt traumatic diaphragmatic rupture was road traffic crashes (78.3%) Of the 46
patients, 2 (4.3%) died Blunt traumatic diaphragmatic rupture was more common in men in their 40s
 Blunt traumatic diaphragmatic rupture was most common in men who have been involved in road traffic
crashes
 Road traffic crashes were the most common cause of craniofacial injuries (54.12%) There were a higher
percentage of males involved in traffic crashes (45.88%) compared to females (7.06%)
 Engineering, enforcement, and education were recommended to decrease the number of craniofacial
injuries
 The main cause of mandibular fracture was road traffic crashes (39%) Among male patients, road traffic
crashes were the leading cause (42%). On the other hand, among female patients, road traffic crashes
were the second leading cause (36%) Among all road traffic crash patients, individuals between 21 and
30 years were at the highest risk (39%)
 The death per million vehicle kilometers in Egypt was 44.1. This was 34 times higher than G-7 countries
and 3 times higher than other Middle Eastern countries Over the past 5 years, there has been a decrease
in risk-based, causalities, and injury severity indicators but an increase in fatalities severity indicators
 Recommendations included increasing the awareness of drivers regarding the importance of inspecting
tires and observing speed limits. It is also necessary to implement tougher driver tests and ensure the
presence of road signs and road shoulders
 Of all accident-related deaths in United Arab Republic, 2.8% could be attributed to motor vehicle
crashes Urban areas experienced higher rates of motor vehicle related case-fatality compared to rural
regions Males were found to be at higher risks of motor vehicle related fatality than females at all ages
 Accident prevention program was recommended
 RTIs were the leading cause of injury-related deaths RTIs were responsible for 56% and 53% of all
injury related deaths in rural and urban areas, respectively Victims of RTIs included pedestrians (67%),
car occupants (14%), cyclists (7%), and motorcyclists (4%).
 Recommendations included improving death registration system; conducting population-based, case-
control, and cohort studies; and gaining endorsements from the national committee and safety council to
collect injury-related data
 Development of a surveillance database system. During the study period, there were 594 traffic crashes,
which resulted in 992 injured and 51 dead Road traffic injury rate per 100,000 population in Cairo was
52.9 and road traffic death rate per 100,000 population in Cairo was 2.7 Most victims were male
(82.2%) and 40 years or younger (73.6%) 52% of the victims were pedestrians
 Recommendations included standardizing data collection system, educating young drivers and child
pedestrians, improving road designs, adopting safety laws, creating a national road safety council,
increasing the number of ambulances during holidays, and improving EMS performance
 In 2007, there were 6345 accidents, of which 5403 or 85% were due to road traffic crashes Road traffic
crashes contributed to 29,855 injuries and 2416 deaths Giza, Cairo, and Elbehra governorates had the
highest percentages of road traffic crashes
 Recommendations included increasing the number of ambulances during holidays, forming mobile or
static ambulance squads, improving emergency medical service performance, introducing safety laws,
and standardizing data collection systems
 There were 1221 deaths, of which 48.89% were due to RTIs Among train, trucks, and car users, the
latter group experienced the highest percentage of RTI deaths (51.01%) The percentage of RTI deaths
compared to assault and drowning-related deaths is highest in the Red Sea governorate (92.86%)
 Egypt’s mortality registry can be enhanced with the use of public newspapers
 United Arab Republic (UAR)-specific results: The UAR experienced the highest rates of accidents in
general but the lowest rate of road traffic accidents Males were at greater risks for accidents The UAR
experienced high risk of accidents but the proportion of case-fatalities was low compared to all other
deaths
  Egypt-specific information: About 32% of the 1559 child patients were from Egypt Pooled results
showed that: 350 Children suffered road traffic injuries, of which 39% were pedestrians, 19% were
passengers of 4-wheelers, and 13% were passengers of 2-wheelers About 5% of the children wore seat
belts or helmets 20 Children needed emergency surgery and 2 died
 The authors concluded that it is feasible to assess childhood injuries and use standardized injury
surveillance in LMICs It was recommended that pedestrian safety be incorporated into interventions
 Pooled results show that: RTI-related fatality rates per vehicles were higher in developing countries
compared to developed countries RTIs cost about 1% of the annual gross national product of developing
countries RTIs were found to be a growing health and economic problem for developing countries
 Recommendations included improving education, training, and enforcement as well as implementing
cost-effective interventions
 Egypt-specific information: Crude case-fatality rate was 4 per 100,000 population in males and 2 per
100,000 population in females Pooled results showed that: In most of the developing world, motor
vehicle crashes were the leading cause of death from unintentional injuries Males were about 5 times
more likely than females to experience RTI-related deaths RTI-related fatality rates per population,
vehicles, and miles traveled have increased in the developing world
 Recommendations included prioritizing causal factors, using epidemiologic surveillance of injuries,
ensuring accurate recording, and conducting surveys as well as population-based prospective studies
 Egypt-specific information: In 1978, crude case-fatality rate per 100,000 persons was 2.1. The
proportional case-fatality rate for motor vehicle–related fatality to all deaths was 0.2, and the percentage
of all RTI-related deaths was 4.4 Pooled results showed that: The relationship between economic
development and RTI deaths was found to be weak if not nonexistent Income distribution in low-income
countries had a stronger relationship to RTI-related deaths
 RTI interventions were recommended to be country-specific because the determinants of RTI-related
case-fatality vary across countries
 Pooled results showed that: The relationship between economic development (GNP per capita) and RTI
deaths was found to be weak RTI fatality rates were increasing most quickly in low- and middle-income
countries. However, this relationship was not straightforward
 Future studies that focused on examining noneconomic determinants were recommended
file:///C:/Users/L.T.Tham%20Standard/Pictures/PuvachandraEgypt.pdf
Egypt's road network upgrade reduces deaths of traffic accidents

The upgrade of Egypt's national road network and the establishment of new roads and bridges have
largely contributed to the declining number of traffic accidents and consequent deaths in the most
populous Arab country.
In late October, Egyptian Ministry of Planning and Economic Development said that the deaths
caused by road traffic accidents decreased from 12,000 in 2019 to 7,000 in 2020, which marks over a
41.6-percent decline.
Planning Minister Hala al-Saeed noted that the country's spending on upgrading and building roads
and bridges doubled over the past couple of years.
Hassan Mahdy, professor of transport and roads at Cairo-based Ain Shams University, explained that
there are three factors for every road accident, namely the human factor, the vehicle and the road.
"Although the road is not much responsible for accidents, the improvement of Egypt's road network
reduced crashes because it is accompanied by monitoring and enforcement of traffic laws," Mahdy
pointed out.
The establishment of new cities and the expansion of existing roads helped reduce traffic crashes, he
continued, lamenting that Egypt loses more than 30 billion pounds (about 1.92 billion U.S. dollars)
annually because of traffic accidents.
In July 2014, Egyptian President Abdel-Fattah al-Sisi launched the national project for roads, which
targets establishment of tens of roads to link the country's provinces and ease traffic congestions,
with a total length of 4,400 km.
Many highways in Egypt now have separate lanes or special roads for heavy vehicles, which have
specific hours for running on certain bridges and roads.
The separate roads and schedules designed for heavy vehicles are behind the decline of traffic
crashes and resultant casualties, according to Magdy al-Shahed, a traffic expert and former traffic
police officer.
Shahed clarified that the traffic accidents involving trucks and trailer trucks result in larger numbers of
casualties.
The traffic expert also said that the country built about 250 new bridges from 2014 to 2019.
"The upgrade of Egypt's national road network is inevitable, for it goes in line with Egypt Vision 2030
with its economic and social dimensions, including the establishment of new cities,"