Is road safety being driven in the wrong direction?

BACKGROUND Road traffic crashes are a major cause of death and injury worldwide and are set to increase as low- and middle-income countries motorize. United Nations (UN)and World Health Organization (WHO) road traffic injury prevention efforts depend on support from external organizations, many of which have commercial interests in increasing car use. Because of concerns about conflict of interest, this study objectively assessed the activities of a key WHO collaborator, the Global Road Safety Partnership (GRSP). METHODS We conducted a quantitative content analysis comparing GRSP publications and the 2004 WHO World Report on Road Traffic Injury Prevention. Dictionaries of terms were constructed for each of the evidence-based interventions detailed in the World REPORT. Text analysis software was used to generate word frequency counts of those terms to compare the World Report and GRSP documents. RESULTS Education, information and publicity featured far more commonly in the GRSP publications than in the WHO World Report [word frequency ratios and 95% confidence intervals: GRSP Newsletter 3.09, 2.53 to 3.78; Around GRSPs World 4.69, 3.76 to 5.87;GRSP Project summaries 3.42, 2.59 to 4.51] On the other hand, compared with the World Report, reducing car use [GRSP Newsletter 0.36, 0.27 to 0.48], minimizing exposure to high-risk scenarios [GRSP Newsletter 0.04, 0.02 to 0.09] and encouraging the use of safer modes of travel [GRSP Newsletter 0.02, 0.01 to 0.08] rarely featured in GRSP publications. CONCLUSIONS The GRSP focuses on educational interventions, for which there is no evidence of effectiveness. Furthermore, the GRSP does not appear to consider the full range of WHO interventions. As motorization growth has serious negative implications for health, including those associated from physical inactivity, climate change and air and noise pollution, it is imperative that the UN and WHO do not allow business interests to dominate public health interests.

[1]  A. Zammit Development at risk : rethinking UN-business partnerships , 2003 .

[2]  Bernadette A. Thomas,et al.  Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 , 2012, The Lancet.

[3]  R. Aldred,et al.  Cars, corporations, and commodities: Consequences for the social determinants of health , 2008, Emerging themes in epidemiology.

[4]  G. Walt,et al.  Global public-private partnerships: Part I--A new development in health? , 2000, Bulletin of the World Health Organization.

[5]  D. Mohan,et al.  Global road safety and the contribution of big business , 2001, BMJ : British Medical Journal.

[6]  Margaret M. Peden,et al.  World Report on Road Traffic Injury Prevention , 2004 .

[7]  Katina Kardamanidis,et al.  Motorcycle rider training for the prevention of road traffic crashes. , 2010, The Cochrane database of systematic reviews.

[8]  Brian O'Neill,et al.  The World Bank's Global Road Safety Partnership , 2002 .

[9]  O. Kobusingye Injury prevention and safety promotion in Africa - local actors and global partners , 2006 .

[10]  K. Buse,et al.  Power to the Partners?: The politics of public-private health partnerships , 2004 .

[11]  J. Oosterhaven,et al.  Annual Report 2008 , 2009 .

[12]  G. Walt,et al.  Global public-private partnerships: Part II--What are the health issues for global governance? , 2000, Bulletin of the World Health Organization.

[13]  R Ian,et al.  School based driver education for the prevention of traffic crashes. , 2001, The Cochrane database of systematic reviews.

[14]  Wolfgang H. Reinicke,et al.  Business UNusual : facilitating United Nations reform through partnerships , 2005 .

[15]  I. Roberts,et al.  Safety education of pedestrians for injury prevention. , 2002, The Cochrane database of systematic reviews.

[16]  A. Aeron-Thomas,et al.  ESTIMATING GLOBAL ROAD FATALITIES , 2000 .

[17]  R Wentz,et al.  Car manufacturers and global road safety: a word frequency analysis of road safety documents , 2006, Injury Prevention.

[18]  F J Ingelfinger,et al.  International Journal of Epidemiology , 1973, The New England journal of medicine.

[19]  Tami Toroyan,et al.  Global Status Report on Road Safety: Time for Action , 2009 .

[20]  John P. Wann,et al.  Reduced Sensitivity to Visual Looming Inflates the Risk Posed by Speeding Vehicles When Children Try to Cross the Road , 2011, Psychological science.

[21]  I. Roberts,et al.  Climate change: the implications for policy on injury control and health promotion , 2005, Injury Prevention.

[22]  M Cameron,et al.  World Report on Road Traffic Injury Prevention. , 2004 .

[23]  Death on the road to international development , 2005, BMJ : British Medical Journal.

[24]  E. Krug,et al.  Decade of Action for Road Safety 2011-2020. , 2012, Injury.

[25]  Kamran Abbasi,et al.  War on the roads , 2002, BMJ : British Medical Journal.

[26]  P. Utting,et al.  United Nations-Business Partnerships: Good Intentions and Contradictory Agendas , 2009 .

[27]  P. Vignal [Traffic safety]. , 1952, Gazette medicale de France.

[28]  I. Roberts,et al.  Post-licence driver education for the prevention of road traffic crashes. , 2003, The Cochrane database of systematic reviews.

[29]  R. Laranjeira,et al.  THE INTERNATIONAL PUBLIC HEALTH COMMUNITY RESPONDS TO THE GLOBAL ALCOHOL PRODUCERS' ATTEMPTS TO IMPLEMENT THE WHO GLOBAL STRATEGY ON THE HARMFUL USE OF ALCOHOL , 2013 .

[30]  Mohan M. Kumaraswamy,et al.  An Overview of Public Private Partnership , 2016 .

[31]  Isaac CH Fung,et al.  Open access for the non-English-speaking world: overcoming the language barrier , 2008, Emerging themes in epidemiology.