Peter Adamson:
"The victims of this tragedy are the poor and the powerless"

Peter Adamson is a senior UNICEF adviser. He was responsible for UNICEF's annual State of the World's Children report from 1980 to 1995 and worked closely with UNICEF executive director Jim Grant on UNICEF’s ground breaking child immunisation campaign. He also authored the Facts for Life report and the Progress of Nations report series. He was founding editor of New Internationalist magazine and a founder of Third World First in the 1970’s.

“The figures are very difficult to collect on road deaths for all sorts of reasons, but it looks as though we’ve got past a thousand child deaths every day on the world’s roads. Now that figure is horrific enough, but I honestly believe it doesn’t begin to capture what’s really meant by the dangers on the road. Because every single one of those deaths has to be multiplied by what it means for individuals. And in this case we are talking about every family, every parent’s very worse nightmare – someone coming to your door and telling you that your child’s been in an accident and is dead or is in hospital. It is grief and it is anguish that no one who has not been through it can imagine. And that’s what lies behind every single one of those thousand deaths a day of young people on the world’s roads.

Even that doesn’t really begin to capture the full extent of the problem because there are many, many injuries – some of them permanent and lifelong – disabilities, traumas, which multiply the effect many times over. The figures also don’t capture the full extent of the problem because they don’t look into the future and the time dimension on this is truly frightening, because for most of the world we are just at the very beginning of the great rise in vehicle ownership. Throughout the poor world, vehicle ownership is running at only about one tenth of the level of the world’s rich countries, yet the death rate on the road is already running four or five times as high as in the rich countries. And it’s bound to increase on a steep trajectory over the next two decades, and if things stay as they are now, if nothing drastic changes, we are going to see literally tens of millions of deaths on the roads, each one of which has to be multiplied and seen in the context of deep family tragedy, of unimaginable grief and anguish and of tremendous health and economic and disability costs.

Accidents on the roads have an unimaginable effect on individuals who are killed or injured, on families and sometimes on communities. But they also have a tremendous impact on countries’ development plans. They have a huge impact on health services for example, in diverting to expensive accident and emergency procedures, from ambulances to hospital wards, money that’s desperately needed for basic health measures, preventative health care, for clinics, for immunisation, for AIDS treatment, for all the pressing health needs in the developing world. They also have a tremendous impact on economies. A family may well lose an income earner for life and instead have someone who is a dependent and needing a lot of resources spending on them. But the same is true for communities and in the end for countries. There’s a huge economic toll being taken by road accidents. The sheer scale of today’s tragedy on the roads has this effect on families but it also affects virtually every single one of the millennium development goals and the aims that countries have set for themselves, for child survival, for improvements in health, for economic investment. You name any one of those development goals, they are affected by the sheer severity and scale of the carnage on the roads.

It is strange that a problem of this scale and severity is relatively ignored. The international community is not really engaged with it. Why? I’m afraid a large part of the reason is that the victims of this tragedy are by and large the poor and the powerless. It’s a crude oversimplification but there’s some truth in the fact that what we are talking about is the rich running over the poor.

Three quarters or more of all the deaths and injuries on the roads of the developing world are pedestrians and cyclists being hit by vehicles. That’s not the case in the rich world. In the rich world three quarters or more of deaths on the road are occupants of cars. The difference obviously is that although the developing world has only one tenth the rate of car or vehicle ownership, it has far, far more pedestrians and cyclists and the growth in the number of vehicles on the roads is racing ahead of the development of road safety infrastructure and a road safety culture and awareness. It’s running so far ahead of it that in the gap we’re seeing this unbelievable carnage on the roads. That’s one reason why I think the problem is being ignored.

I also think the problem is tending to be ignored because in the developed world we have the impression, and we are right, that the problem of road deaths is declining. For 20 or 30 years now in the world’s rich countries we have seen steady, sometimes spectacular overall declines in road deaths. And I think there’s an assumption that road deaths and road accidents are the kind of price that you pay for progress and that they will eventually come down as they have in the developed world, and you just have to carry on with the process. But it just isn’t true.

First of all in the developing world, road deaths are rising rapidly. In the developed world, the decline that’s been achieved, and it’s been a major achievement, let’s acknowledge that, but it’s been achieved not by some automatic process of progress and economic development. It’s been achieved by decades of research and lobbying and campaigning and legislating and educating and environmental change and improvement in accident and emergency services. It has been a long, conscious, sustained effort to bring those deaths down and many, many lessons have been learnt and it would be just unforgivable if those lessons that have been learnt are not made available and not acted on in those countries now witnessing a rapid rise in the number of vehicles on the roads.

Bringing down deaths and accidents on the roads isn’t going to happen by default, it isn’t going to just melt away in the heat of economic development. It is going to require a conscious, sustained effort to control those deaths and accidents, just as it has done in the rich world over the last 20, 30 years. Now the Make Roads Safe Campaign has made an extraordinary start with that – the impact has been extraordinary in the few years in which it has been campaigning. And critically it has got the support of some major political leaders and that’s essential. You need political mobilisation from the very top if anything is to happen on this. You need to have this problem recognised at the scale of a world summit, at least at ministerial level, to come to terms with the problem, to create an action plan, to build awareness, to get that plan funded.

I’m very worried by any suggestion of fatalism in the face of this issue of the carnage on the roads. It’s very worrying if the idea gets abroad that this is somehow inevitable or that somehow it’s the inevitable price you have to pay for progress. That’s just not true. There is a tremendous amount that can and should be done that could save many millions of lives. We know that it is not possible for many of the world’s poor countries to suddenly rush in and speed camera every road and bring in sophisticated breathalysers – that’s to come. But immediately there are low cost measures, from traffic calming near schools to legislation against selling alcohol in lorry parks and road side stalls. These things are affordable and they can make a huge difference.

So the fatalism is a real worry. It takes me back to the kind of fatalism that prevailed in 1980 about the huge question of child immunisation when maybe only 15 – 20% of the world’s children were immunised against the major killer diseases, the major vaccine preventable diseases of childhood. And the target was set, and a huge international effort made to reach a target of 80% child immunisation by 1990. And it was achieved. By 1990 virtually 80% of the world’s children were immunised and many millions of children’s lives were being saved and injuries prevented from polio, deaths from measles, tetanus, from whooping cough – millions of lives were saved, tens of millions over the whole of that period. And it was achieved by a conscious, determined effort that involved a great many people – not just governments but NGOs, people’s organisations, health professionals, legal professionals, the media, business, many millions of people involved in this and we need that kind of involvement now.

The World Summit for Children in 1990 brought together more than 70 Presidents and Prime Ministers to debate the issue and discuss the issue of child survival and what could be done. And that level of commitment is what’s required to get action on the necessary scale. And that’s what we need with road safety too. This problem can be solved, this problem can be cut down to size. We need at least a 10 year sustained effort to do it and it can be done.”

Peter Adamson was talking to Richard Stanley.