Road traffic accidents are the main cause of death for people between 5 and 20 years of age worldwide, with approximately 1.35 million road traffic deaths in 2016. While the global rate for road traffic deaths is around 18 per 100 000 population, there is great disparity by income, with rates more than three times higher in low and middle income countries and territories than in the world’s high income countries and territories (WHO, 2018[42]). South-East Asia is one of the most affected regions, with 20.7 road traffic deaths per 100 000 population. Western Pacific countries, however, have a rate of 16.9 road traffic deaths per 100 000 people, lower than the global average. Generally, speed contributes to about half of road deaths in high income countries and territories, whereas in middle and low income countries speeding accounts for 37% and 13% of the deaths respectively. The burden of road traffic deaths falls disproportionately on vulnerable road users as more than half of deaths are among pedestrians, cyclists and motorcyclists. The proportion of deaths among these vulnerable road users is higher in emerging economies where urbanisation and motorisation accompany rapid economic growth. In many of these countries, necessary infrastructural developments, policy changes and levels of policy enforcement have not kept pace with vehicle use (WHO, 2018[42]). The UN SDGs includes a target aiming to halve the number of global deaths and injuries from road traffic crashes by 2020 (SDG 3.6).
In 2016, Asia-Pacific countries and territories reported 20 deaths per 100 000 population aged 15 years and over due to road traffic accidents, three times the rate observed across OECD countries. Male deaths are higher than female deaths in all Asia-Pacific countries and territories. India, Thailand and Viet Nam have more than 50 male deaths per 100 000 population due to road traffic injuries, whereas the rate is less than 10 in Australia, Japan and Singapore. Cross-country variation is smaller among women. In Asia-Pacific, the average proportion of deaths due to road traffic accidents for both male and females in middle and low income countries and territories is more than three times higher than the average rate in high income countries and territories (Figure 4.26). Improvements have been made in several countries and territories in Asia-Pacific. For example, the Republic of Korea significantly reduced traffic fatalities with a national strategy for improved traffic behaviours around school zones; which decreased road traffic deaths of children age 14 by 95% between 1998 and 2012 (WHO, 2018[42]).
The five key risk factors for road traffic deaths and injuries are drink-driving, speeding, and failing to use motorcycle helmets, seat-belts and child restraints (Table 4.1).In addition, distracted driving – such as using mobile phones and other in-vehicle technologies while driving – is a growing threat to road safety. Texting causes cognitive manual and/or visual distraction. Even talking on mobile phones without holding or browsing a phone can reduce driving performance (WHO, 2018[42]). Since hands-free phone and hand-held phones are equally at risk of causing cognitive distraction, some national laws regulate both types of using mobile phones use (Table 4.1).
Drinking and driving, especially with a blood alcohol concentration (BAC) level of over 0.05g/dl (grammes per decilitre), greatly increases the risk of a crash and the likelihood of death or serious injury (see indicator “Alcohol” in Chapter 4). It is estimated that reducing BAC from 0.08% to 0.05% could reduce alcohol-related road injuries and deaths by between 5% and 18% (WHO, 2018[37]). Furthermore, setting a lower BAC limit (0.02 g/dl) for young people and novice drivers can reduce the risk of road crashes. Hence Australia, Fiji, New Zealand and Viet Nam have introduced additional national laws for young and novice drivers with the BAC level to 0 g/dl. Law enforcement through random breath testing checkpoints is considered highly cost effective (WHO, 2018[42]).
Speed limits are enforced by a national law in all Asia-Pacific countries. However, in several countries and territories speed limits are not able to be adapted at local level, creating potential barriers for a rapid response to local need (Table 4.1). Australia, New Zealand and Sri Lanka have introduced the WHO recommended speed limit less or equal to 50 km/h in urban areas. Several countries and territories in the region have implemented this suggested speed limit at the subnational level. For instance, as of 2017, the WHO recommended urban speed limit has been set in half of Thailand’s 76 provinces (WHO, 2018[42]). A number of initiatives aimed to reduce speeding are being implemented across the Asia-Pacific to decrease the risk of injuries and fatalities due to road traffic. For example, in 2019, the Philippines established a speed limit and enforcement management project funded by the UN Road Safety Fund (UNECE, 2020[43]).
Wearing a motorcycle helmet correctly can reduce the risk of death by more than 40% and the risk of severe injuries by almost 70%. When motorcycle helmet laws are enforced, helmet-wearing rates can increase to over 90%. Nonetheless, helmet-wearing enforcement is very low in a number of Asia-Pacific countries, such as China (20%), Pakistan (10%) and Mongolia (7%) (Table 4.1).
Wearing a seat-belt can reduce fatalities among front-seat passengers by up to 50% and among rear-seat car passengers by up to 25%. A national law on wearing seat belts has not been adopted in Bangladesh and the Solomon Islands yet (Table 4.1).
Child restraint systems, such as child seats for infants and booster seats for older children, decrease their risk of death in a crash by at least 60%. However, mandatory child restraint national laws exist only in seven Asia-Pacific countries– namely Australia, Cambodia, Fiji, Japan, Lao PDR, New Zealand and Singapore (WHO, 2018[42]).
