DECADE OF ACTION FOR ROAD SAFETY 2011–2020
SAVING MILLIONS OF LIVES
Why this document? For many years road traffic crashes have been acknowledged by the United Nations and its Member States to be a considerable challenge to the achievement of health and development goals. It has only been during the past decade, however, that the issue has gained the prominence it deserves among the world’s most pressing international health and development concerns. Following the highly successful First Global Ministerial Conference on Road Safety hosted by the Government of the Russian Federation in November 2009, a Decade of Action for Road Safety 2011–2020 was officially proclaimed by the United Nations General Assembly in March 2010. This document offers some key information about the Decade and WHO’s role.
Acknowledgements WHO wishes to thank Bloomberg Philanthropies, FIA Foundation and the United States Centers for Disease Control and Prevention for their generous financial support for the development and publication of this document.
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Decade of Action for Road Safety 2011–2020 Saving millions of lives
Key facts • Road traffic crashes take the lives of nearly 1.3 million people every year, and injure 20–50 million more. • Road traffic injuries have become the leading cause of death for people aged 15–29 years. • Over 90% of road traffic deaths and injuries occur in low-income and middle-income countries, which have only 48% of the world’s registered vehicles. • Nearly half (46%) of those dying on the world’s roads are “vulnerable road users”: pedestrians, cyclists and motorcyclists. • In addition to the grief and suffering they cause, road traffic crashes result in considerable economic losses to victims, their families, and nations as a whole, costing most countries 1–3% of their gross national product. • Without action, road traffic crashes are predicted to result in the deaths of around 1.9 million people annually by 2020. • Only 15% of countries have comprehensive laws relating to five key risks: speeding, drinking and driving, and the non-use of helmets, seat-belts and child restraints.
Top 10 leading causes of death, 2004 and 2030 compared 2004 Rank 1 2 3 4 5 6 7 8 9 10 Disease or injury Ischaemic heart disease Cerebrovascular disease Lower respiratory infections Chronic obstructive pulmonary disease Diarrhoeal diseases HIV/AIDS Tuberculosis Trachea, bronchus, lung cancers Road traffic injuries Prematurity & low-birth weight Rank 1 2 3 4 5 6 7 8 9 10 Disease or injury Ischaemic heart disease Cerebrovascular disease Chronic obstructive pulmonary disease Lower respiratory infections Road traffic injuries Trachea, bronchus, lung cancers Diabetes mellitus Hypertensive heart disease Stomach cancer HIV/AIDS 2030
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Road traffic injury fatality ratesa per 100 000 population, by WHO region and income group WHO region African The Americas South-East Asia European Eastern Mediterranean Western Pacific Global a
High-income — 13.4 — 7.9 28.5 7.2 10.3
Middle-income 32.2 17.3 16.7 19.3 35.8 16.9 19.5
Low-income 32.3 — 16.5 12.2 27.5 15.6 21.5
Total 32.2 15.8 16.6 13.4 32.2 15.7 18.8
30-day definition of a road traffic death Source: Global Status Report on Road Safety, 2009
Population, road traffic deathsa, and registered motorized vehicles, by income group Population HIC Road traffic deathsa HIC Registered vehicles LIC
36.7% 47.8%
LIC
15.6%
8.5% 41.9%
9.2%
LIC
MIC
49.6%
MIC
38.7%
MIC
52.1%
HIC
a
30-day definition, modelled data. HIC = high-income countries; MIC = middle-income countries; LIC = low-income countries
For more key facts, visit: Global status report on road safety 2009 http:/ /www.who.int/violence_injury_prevention/road_safety_status/2009/en/index.html Global Health Observatory road safety http:/ /www.who.int/gho/road_safety/en/index.html
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Decade of Action for Road Safety 2011–2020 Saving millions of lives
Decade of Action for Road Safety 2011-2020 A Global Plan for the Decade of Action for Road Safety 2011–2020 has been drawn to guide efforts at national and local levels. If the Global Plan is successfully implemented, the Decade could achieve its goal to stabilize and then reduce the forecasted level of road traffic fatalities around the world. If this ambitious target is achieved, a cumulative total of 5 million lives, 50 million serious injuries and US$ 5 trillion could be saved over the Decade.
Decade of Action for Road Safety 2011-2020: saving millions of lives 2.0 1.8 1.6 Number of deaths (millions) 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0 2011 2012 2013 2014 2015 Year 2016 2017 2018 2019
Projected increase without action
5 million lives saved
Projected reduction if action taken
2020
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Global Plan for the Decade of Action for Road Safety 2011–2020 Pillar 1 Road safety management Pillar 2 Safer roads and mobility Pillar 3 Safer vehicles
This pillar focuses on the need to strengthen institutional capacity to further national road safety efforts. It includes activities such as putting into practice major United Nations road safety conventions; establishing a lead agency for road safety in the country involving partners from a range of sectors; developing a national road safety strategy; and setting realistic and long-term targets for related activities with sufficient funding for their implementation. It also calls for development of data systems to monitor and evaluate activities.
This pillar highlights the need to improve the safety of road networks for the benefit of all road users, especially the most vulnerable: pedestrians, bicyclists and motorcyclists. Activities include improving the safety-conscious planning, design, construction and operation of roads; making sure that roads are regularly assessed for safety; and encouraging relevant authorities to consider all forms of transport and types of safe infrastructure when they respond to the mobility needs of road users.
This pillar addresses the need for improved vehicle safety by encouraging harmonization of relevant global standards and mechanisms to accelerate the uptake of new technologies which impact on safety. It includes activities such as implementing new car assessment programmes so that consumers are aware of the safety performance of vehicles, and trying to ensure that all new motor vehicles are equipped with minimum safety features, such as seat-belts. Other activities covered include promoting more widespread use of crash avoidance technologies with proven effectiveness, such as electronic stability control and anti-lock braking systems. Managers of fleets are also encouraged to purchase, operate and maintain vehicles that offer high levels of occupant protection.
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Decade of Action for Road Safety 2011–2020 Saving millions of lives
The Global Plan for the Decade of Action for Road Safety 2011–2020 was developed by the United Nations Road Safety Collaboration (UNRSC) and stakeholders from around the world. To achieve its goal, the Global Plan features five categories or “pillars” of activities which are described below. Indicators have been developed to measure progress in each of these areas.
Pillar 4 Safer road users
Pillar 5 Post-crash response
Global Plan
For the full version of the Global Plan, visit: http://www.who.int/roadsafety/decade_of_action/plan/en/index.html
This pillar focuses on developing comprehensive programmes to improve road user behaviour. Activities include encouraging the development and adoption of model road safety legislation and sustained or increased enforcement of road safety laws and standards. These efforts are combined with public awareness and education to increase seatbelt and helmet wearing and to reduce drinking and driving, speeding and other risks. It also calls for activities to reduce work-related road traffic injuries and promotes the establishment of graduated driver licensing programmes for novice drivers.
This pillar promotes the improvement of health and other systems to provide appropriate emergency treatment and longer-term rehabilitation for crash victims. Activities include developing pre-hospital care systems, including implementation of a single nationwide telephone number for emergencies; providing early rehabilitation and support to injured patients and those bereaved by road traffic crashes; establishing insurance schemes to fund such initiatives; and encouraging a thorough investigation into crashes and an appropriate legal response.
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Implementing the Global Plan for the Decade of Action for Road Safety 2011-2020 There is strong evidence about what works to prevent road traffic deaths and injuries. The Global Plan is based on the best evidence of what works given successful experiences from a number of countries. Here are some examples below.
Australia
Reducing drinking and driving through random breath testing Consuming alcohol before driving increases the risk of a crash as well as the likelihood that death or serious injury will result. Passing a drinking and driving law and enforcing it can reduce the number of road deaths by around 20%. Random breath testing is the primary drinking and driving law enforcement tool used throughout Australia. The police can stop and perform a breath test on a driver at any time, irrespective of their driving behaviour. Highly visible “booze buses” are used to conduct testing while media campaigns support enforcement. The evaluation of random breath testing has shown long-term reductions in alcohol-related crashes. Effectiveness of random breath testing on alcohol-related crashes in Australia 50 % of fatally injured motorists with BAC ≥ 0.05 g/dl 45 40 35 30 25 20 15 10 5 0 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
Source: Department of Infrastructure, Transport, Regional Development & Local Government, 2009
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Decade of Action for Road Safety 2011–2020 Saving millions of lives
France
Charting progress over decades Since the early 1970s, France has made great strides in reducing fatalities on the nation’s roads. This has been the result of myriad factors, including adoption and enforcement of legislation on speeding, seat-belts and drinking and driving. Since 2002, a combination of factors including a stated commitment from the highest level of government, stricter enforcement of legislation especially through the use of speed cameras, and media campaigns explaining the traffic rules and risks has accelerated the decrease in annual fatalities. From the early 1970s to 2009, deaths have declined from more than 16000 annually to just over 4000 annually. Evolution of the number of annual road traffic deaths in metropolitan France, 1970–2009 Jun 1973 • Speed limits 110 km/h on roads with heavy traffic and 100 km/h on other roads • Seat-belts mandatory for front seat passengers outside urban areas • Helmet mandatory Jul 1978 Law on drinking and driving prevention
16 000 14 000 Annual number of road traffic deaths 12 000 10 000 8 000 6 000 4 000 2 000 0 Nov 1974 General speed limits: • 90 km/h on departmental roads • 110 km/h on dual carriageways • 130 km/h on motorways/ highways
Oct 1990 Random breath testing initiated by the police
Dec 1990 • Speed limit of 50 km/h in urban areas • Seat-belts mandatory for back seat passengers
Change of definition Since January 2005, the definition of a road traffic death has changed to include deaths for up to 30 days after the crash (instead of 6 days)
Oct 1979 Seat-belt mandatory for front seat passengers in urban areas
14 Jul 2002 Statement of the President of the Republic Dec 1983 Alcohol: • BAC limit set at 0.08 g/dl blood
Jul 1992 Introduction of the driver licensing point system
Sep 1995 Alcohol: • BAC limit set at 0.05 g/dl blood
Nov 2003 Introduction of speed cameras
Source: Graphique reproduit avec l’autorisation de l’Observatoire national interministériel de la sécurité routière (ONISR), France
Dec 1970 Dec 1971 Dec 1972 Dec 1973 Dec 1974 Dec 1975 Dec 1976 Dec 1977 Dec 1978 Dec 1979 Dec 1980 Dec 1981 Dec 1982 Dec 1983 Dec 1984 Dec 1985 Dec 1986 Dec 1987 Dec 1988 Dec 1989 Dec 1990 Dec 1991 Dec 1992 Dec 1993 Dec 1994 Dec 1995 Dec 1996 Dec 1997 Dec 1998 Dec 1999 Dec 2000 Dec 2001 Dec 2002 Dec 2003 Dec 2004 Dec 2005 Dec 2006 Dec 2007 Dec 2008 Dec 2009
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Ghana
Establishing a nation-wide ambulance service Until the early 2000s, emergency trauma care in Ghana was informal and extremely limited. Most patients injured in a road crash were taken by their relatives to a health facility where they would receive limited first aid. In 2001, efforts to address emergency trauma care gained political support. In 2004 the government established a nationwide ambulance and a dedicated An EMTservice checking the vital signs of a Patient inemergency the Ambulance as part of ongoing Assessment hotline. In less than four years: • the number of cases handled by the national ambulance system rose from 205 in 2004 to 8250 in 2008; • the average response time for ambulances decreased from 17 minutes in 2006 to 13 minutes in 2008; and • the average time spent at the scene decreased from 19 minutes in 2006 to 14 minutes in 2008. © AN Zakariah/GAS
Malaysia
Modifying road infrastructure to improve safety Separating different types of vehicles, for example, two and three wheeled vehicles from four or more wheeled vehicles is a proven intervention to reduce road traffic crashes. Exclusive motorcycle lanes are a means to do so. These lanes are dedicated solely for use by vehicles such as motorcycles, scooters and bicycles. They are becoming common in a number of Asian cities, where they have proven to dramatically reduce collisions and resultant injuries by creating safer driving environments for all road users. For example, evaluation of the Federal Highway Route 2 in Malaysia which includes an exclusive motorcycle lane revealed that crashes were reduced by 39% after this lane was built.
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© K Rajam/WPRO
Decade of Action for Road Safety 2011–2020 Saving millions of lives
United States of America Wearing a seat-belt reduces the risk of being ejected from a vehicle and suffering serious or fatal injury by between 40%– 65%. Click It or Ticket is the most successful seat-belt enforcement campaign ever conducted in the country. The cornerstone of the campaign is the national Click it or Ticket May Mobilization, during which law enforcement agencies join forces across the country. Their efforts are supported by national and local media campaigns. From 2000–2009, over 140 000 American’s lives were saved by seat-belts.
Increasing seat-belt wearing through the “Click It or Ticket” campaign Lives saved by seat-belts, USA, 2000–2009 18 000 16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0
Lives saved
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 Year
Source: http://www-nrd.nhtsa.dot.gov/
Viet Nam
Improving helmet-wearing rates through enforcement of legislation Research has shown that correctly wearing a motorcycle helmet can cut the risk of death by 40% and reduce the risk of serious head injuries by 70%. In 2007 the Government of Viet Nam passed a law requiring all motorcycle drivers and passengers to wear helmets. Strict enforcement of this law by police around the country led to a tripling in helmet wearing rates, reaching over 90% among both drivers and passengers. Within a year of the Government’s decision, police had intensified their enforcement and the fines for not wearing a helmet had increased substantially, while hospitals reported a 16% reduction in the risk of a head injury compared to the previous year. Police reports show that over 1500 lives were saved and over 2500 serious injuries prevented in the year after the helmet law was passed. Motorcycles comprise 95% of all registered vehicles in Viet Nam, and this policy on helmet use is therefore likely to have contributed significantly to these positive road safety benefits.
© WHO/M.Peden
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WHO’s contributions to the Decade of Action for Road Safety 2011-2020 WHO will support implementation of the Global Plan for the Decade of Action for Road Safety 2011–2020. Below are descriptions of some of the ways WHO plans to be involved in the coming years. Coordinating global efforts WHO, in collaboration with the United Nations regional commissions, is the coordinator of road safety across the United Nations system. In this regard WHO acts as the secretariat for the United Nations Road Safety Collaboration (UNRSC), a network of 60 governments, United Nations agencies, nongovernmental organizations, foundations and private companies. Across the Decade, the UNRSC will be instrumental in guiding global efforts by continuing as it has since 2004 to advocate for road safety at the highest political levels; compile and disseminate good practices in prevention; share information with the public on risks and ways to mitigate those; and draw attention to the need for increased funding. The UNRSC will coordinate and plan the key milestone events of the Decade.
Monitoring progress through global status reports While the UNRSC will be in charge of evaluating the overall impact of the Decade, WHO will provide one of the tools for doing so through its status reports. The Global status report on road safety, published in 2009, provided the first comprehensive assessment of the road safety situation globally. With data from 178 Member States, the report continues to be a reference for policy-makers, practitioners and the media and serves as a catalyst for change in many countries. These status reports collect information on the number and rates of fatalities; the existence of national strategies and targets; legislation and enforcement on a number of key risks; and the current state of post-crash care. The forthcoming Global status report on road safety, to be released on 2012, will serve as a baseline for monitoring activities relating to the Decade, with subsequent reports published every two years.
Supporting road safety programmes in countries In 2010, WHO and five other consortium partners received funding from Bloomberg Philanthropies to further road safety in ten countries. Dubbed the Road Safety in 10 Countries (RS10) Project, this initiative supports the governments of Brazil, Cambodia, China, Egypt, India, Kenya, Mexico, the Russian Federation, Turkey and Viet Nam. In all countries, the RS10 Project focuses on selected key risks for road traffic crashes. For example, the focus in Kenya is on helmets and speeding; in Mexico on seat-belts and drinking and driving; and in the Russian Federation on seat-belts and speeding. Efforts are focused on strengthening legislation and enforcement and
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Decade of Action for Road Safety 2011–2020 Saving millions of lives
educating the public through social marketing campaigns. WHO also supports road safety efforts in other countries such as Malawi and Mozambique to improve safety around schools. Over the Decade, WHO will continue to support these and other national road safety initiatives leading to sustainable government programmes.
Helping to improve emergency services Another important contribution to the Decade will be WHO’s support as part of the RS10 Project to pilot projects to improve emergency services in India and Kenya. In addition WHO is working with a number of partners to create the Global Alliance for the Care of the Injured. The partners involved in this nascent network have been instrumental in producing many of the guides released by WHO and others in recent years.
Building capacities Through the RS10 Project and other national road safety initiatives, WHO will support the building of capacities among WHO staff and its partners to design, implement and evaluate road safety programmes. As part of these broader capacity building efforts, doctors are trained to more accurately prepare death certificates, journalists are trained to better report on road traffic crashes, and staff from nongovernmental organizations are trained to strengthen their collaboration with the media. Road safety is also an important component of TEACH-VIP and MENTOR-VIP, two WHO-led capacity building efforts.
Supporting nongovernmental organizations In recent years, WHO has increasingly recognized the value of nongovernmental organizations, in particular in the area of advocacy. Such groups are key to increasing political will and generating a demand from the public for safer roads. Across the Decade WHO will support a strategic approach to advocacy by such groups. WHO will also support establishment of a more formal global network of nongovernmental organizations to support implementation of the Global Plan.
WHO global and regional focal points for the Decade To contact WHO headquarters and regional office focal points for the Decade, visit: http:/ /www.who.int/roadsafety/decade_of_action/focal/who_regional_offices/en/index.html
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What can you do to support the Decade of Action for Road Safety 2011-2020? The Decade of Action for Road Safety 2011–2020 is everybody’s Decade. We all have an interest in ensuring that the vision of the Decade becomes a reality. Below are some ideas for what you might do to support the Decade. Policy-makers: • release national or local plan in line with the Global Plan; • enact new legislation or improve enforcement of existing legislation; • ensure funds to support the national plan.
Nongovernmental organizations: • create awareness raising tools; • organize high-profile public events; • influence the creation or modification of legislation.
Private companies: • release a fleet safety policy; • support campaigns in the communities in which the company operates; • contribute financially to the Road Safety Fund.
Young people: • serve as “ambassador” for road safety; • join a youth assembly; • ensure the safety of roads around schools.
Victims and survivors: • share stories of the consequences of road crashes; • host an event on the annual World Day of Remembrance for Road Traffic Victims; • support nongovernmental organizations.
Media: • commit to reporting news and features on road safety; • report responsibly on road traffic crashes, using reports on crashes as an opportunity to address prevention; • serve as a conduit for social marketing and mass media campaigns.
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Decade of Action for Road Safety 2011–2020 Saving millions of lives
A symbol for all: the road safety “tag” The road safety “tag” is the new global symbol for road safety and the key visual for the Decade of Action for Road Safety. It will unite efforts which take place in the context of the Decade. A promotional web site for the tag encourages groups marking the launch of the Decade to “Wear. Believe. Act.” by wearing the road safety tag and displaying it on advocacy materials for Decade-related events; reflecting on the impact of road traffic crashes and the possibilities for prevention; and taking action to ensure greater safety on the roads. To purchase the tag as a wearable or decorative item, request the artwork for printed materials or contribute financially to the newly established Road Safety Fund, visit:
http://www.decadeofaction.org
Photo credits for title page: ©iStockphoto.com; ©WHO/M. Peden; ©WHO/K. Bartolomeos; ©WHO Russia; ©WHO/ K. Rajam. Page 13: © Pedro Costa/Lusa; © PAHO; © WHO/M. Peden; © PAHO. Back cover: ©Make Roads Safe campaign; ©WHO; ©Make Roads Safe campaign; ©Make Roads Safe campaign; ©Bloomberg Philanthropies
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Recognition is growing about the critical development and public health challenge posed by road traffic deaths and injuries. I call on Member States, international agencies, civil society organizations, businesses and community leaders to ensure that the Decade of Action for Road Safety leads to real improvements.
Mr Ban Ki-moon Secretary-General, United Nations The Decade of Action for Road Safety creates the political platform needed to scale up some well-defined measures. Evidence tells us that these measures work, and can save millions of lives.
Dr Margaret Chan Director-General, World Health Organization
It is time for those who can make a real difference to step up to meet this challenge and to commit to the Decade of Action for Road Safety.
The Most Reverend Desmond Tutu Archbishop Emeritus of Cape Town
By making road safety a priority over the Decade of Action for Road Safety, we have the potential to save millions of lives, and to prevent many millions of injuries and disabilities.
Ms Michelle Yeoh Actress and Global Ambassador for the Make Roads Safe Campaign
Too many people are killed or injured on the world’s roads. The World Health Organization predicts that road traffic injuries will rise to become the fifth leading cause of death by 2030. The time is now to commit to action. The Decade of Action for Road Safety has the potential to save millions of lives.
Mr Michael Bloomberg Mayor of the City of New York
DECADE OF ACTION FOR ROAD SAFETY 2011–2020
www.who.int/roadsafety/decade_of_action
WHO/NMH/VIP 11.07 © World Health Organization 2011. All rights reserved.
2011-2020 年道路安全 行动十年
拯救 百万 生命
本文件的目的 多年来，联合国及其成员国认识到道路交通车祸是对实现卫生和发 展目标提出的一项重大挑战。但是，该问题在过去十年期间才作为 世界上最紧迫的国际卫生和发展关注问题之一得到应有的重视。在 2009 年 11 月由俄罗斯联邦政府作为东道主召开的第一次道路安全 问题全球部长级会议获得巨大成功之后，联合国大会在 2010 年 3 月 正式宣布 2011-2020 年为道路安全行动十年。本文件为该行动十年 和世卫组织的作用提供了一些关键信息。
致谢 世卫组织希望感谢美国疾病预防控制中心和彭博慈善基金会为编写 和出版本文件提供的慷慨财政支持。
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2011-2020 年道路安全行动十年拯救百万生命
主要事实 • 道路交通车祸每年夺去近 130 万人的生命，并另外使 2000 万至 5000 万人受伤。 • 道路交通伤害已成为 15-29 岁年龄组人群的首要死亡原因。 • 90% 以上的道路交通死亡和伤害发生在低收入和中等收入国家，但这些国家注册的车 辆仅占全世界注册车辆的 48%。 • 全世界在道路上死亡者有近半数 (46%) 是“弱势道路使用者”：行人、骑自行车和摩托 车者。 • 除了引起悲伤和痛苦之外，道路交通车祸对受害者、其家人和整个国家造成相当大的 经济损失，在多数国家占其国民生产总值的 1-3%。 • 如不采取行动，到 2020 年道路交通车祸预计将每年造成约 1900 万人死亡。 • 仅 15% 的国家有涉及 5 项重点高危因素的综合性法律：超速驾驶、酒后驾车以及不使用 头盔、安全带和儿童约束装置。
2004 年和 2030 年相对比的十大死亡原因 2004 年 排名 1 2 3 4 5 6 7 8 9 10 疾病或受伤 缺血性心脏病 脑血管病 下呼吸道感染 慢性阻塞性肺病 腹泻病 艾滋病毒/艾滋病 结核病 气管、支气管、肺部癌症 道路交通伤害 早产和出生体重过低 排名 1 2 3 4 5 6 7 8 9 10 疾病或受伤 缺血性心脏病 脑血管病 慢性阻塞性肺病 下呼吸道感染 道路交通伤害 气管、支气管、肺部癌症 糖尿病 高血压性心脏病 胃癌 艾滋病毒/艾滋病 2030 年
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按世卫组织区域和收入分列的每 10万 人口道路交通伤害死亡比例 a 世卫组织区域 非洲 美洲 东南亚 欧洲 东地中海 西太平洋 全球 道路交通死亡的定义为 30 天内死亡。 来源：2009 年道路安全全球现状报告 a
高收入 — 13.4 — 7.9 28.5 7.2 10.3
中等收入 32.2 17.3 16.7 19.3 35.8 16.9 19.5
低收入 32.3 — 16.5 12.2 27.5 15.6 21.5
合计 32.2 15.8 16.6 13.4 32.2 15.7 18.8
按收入分列的人口、道路交通死亡a 以及注册的机动车辆 人口 道路交通死亡a HIC 注册车辆 LIC
36.7% 47.8%
LIC
15.6%
HIC
8.5% 41.9%
9.2%
LIC
MIC
49.6%
MIC
38.7%
MIC
52.1%
HIC
a
定义为 30 天内死亡，数据为模型式数据。HIC = 高收入国家；MIC = 中等收入国家；LIC = 低收入国家
更多的重要事实，请见： 2009 年道路安全全球现状报告 http:/ /www.who.int/violence_injury_prevention/road_safety_status/2009/en/index.html 全球卫生观察站：道路安全 http:/ /www.who.int/gho/road_safety/en/index.html
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2011-2020 年道路安全行动十年拯救百万生命
2011-2020 年道路安全 行动十年 制定了 2011-2020 年道路安全行动十年全球计划以便指导国家和地 方级作出努力。如果全球计划得到成功的实施，“行动十年”就可 实现其目标，即稳定并然后降低世界各地预计的道路交通死亡人数 水平。如果能实现这一雄心勃勃的目标，该十年期间就可拯救累积 总数达 500 万人的生命，避免 5000 万起严重伤害，并节省 5 万亿 美元。
2011-2020 年道路安全行动十年：拯救百万生命 2.0 1.8 1.6 1.4 死亡人数 (百万) 1.2 1.0 0.8 0.6 0.4 0.2 0 2011 2012 2013 2014 2015 年份 2016 2017 2018 2019
如不采取行动， 预计的增多
拯救 500 万人的生命
如采取行动， 预计的减少
2020
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全球计划 2011-2020 年道路安全 行动十年 第 1 支柱： 道路安全管理 第 2 支柱： 增强道路和机动安全 第 3 支柱： 车辆安全
本支柱侧重于加强机构 能力的必要性以便推进 国家道路安全工作。其 中包括的活动有：使联 合国的主要道路安全公 约付诸实践；在国家内 部建立一个道路安全领 导机构，由一系列部门 的合作伙伴参与；制定 一项全国道路安全战 略；以及为相关活动确 定现实和长期的指标并 为实施活动提供充裕的 资金。它还要求发展数 据系统以监测和评价各 项活动。
这一支柱强调需要为增 进所有道路使用者，尤 其是最易受伤害者 (如行 人以及骑自行车和摩托 车者) 的利益，提高道路 网络的安全性。活动包 括在考虑到安全的情况 下改进道路的计划、设 计、建设和运营；确保 对道路定期进行安全评 估；以及鼓励有关主管 部门在应对道路使用者 的交通需求时考虑所有 形式的交通和所有类型 的安全基础设施。
这一支柱涉及需要改进 车辆安全，具体措施为 鼓励协调相关的全球标 准和机制以加快采用对 安全性有影响的新技 术。其中包括的活动 有：实施新车评估规 划，使消费者注意到车 辆的安全性能，并力图 确保所有新的机动车辆 具有最低程度的安全特 征，例如安全带。涵盖 的其它活动包括促进更 广泛地使用经证实有效 的防撞技术，例如电子 稳定控制系统和防抱死 制动系统。还鼓励车队 管理人员购置、运营和 维持为驾乘人员提供高 水平防护的车辆。
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2011-2020 年道路安全行动十年拯救百万生命
联合国道路安全协作机制 (UNRSC) 和世界各地的利益攸关 方制定了 2011-2020 年道路安全行动十年全球计划。为了实 现其目标，全球计划把活动分成下文所述的五大类或“五 大支柱”。制定了指标以衡量每一领域内的进展。
第 4 支柱： 增强道路使用者安全
第 5 支柱： 碰撞后应对
全球计划
全球计划的全文，请参见： http://www.who.int/roadsafety/decade_of_action/plan/en/index.html
这一支柱侧重于制定改 进道路使用者行为的综 合规划。活动包括鼓励 制定和采用样板道路安 全法规并维持或加强执 行道路安全法规和标 准。作出这些努力的同 时应开展公众宣传教育 活动，提高座椅安全带 和头盔佩戴率，并减少 酒后驾车、超速驾驶以 及其它风险因素。它还 要求开展活动减少与工 作有关的道路交通伤害 并促进建立新驾驶员分 级驾驶执照制度。
这一支柱促进改善卫生 及其它系统，以便向车 祸受害者提供适当的急 救和较长期康复服务。 活动涉及发展到达医院 之前的救护系统，包括 采用全国统一的急救电 话号码；向道路交通车 祸的受伤者以及死者家 属提供早期康复服务和 支持；建立为此类行动 提供资金的保险计划； 以及鼓励彻底调查车祸 并采取适当的法律应对 措施。
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实施 2011-2020 年道路安全行动 十年全球计划 存在强有力的证据说明应如何预防道路交通死亡和伤害。根据若干 国家的成功经验，全球计划以有效措施的最佳证据作为基础。以下 为一些例子。
澳大利亚： 通过随机的呼吸测试减少酒后驾车 酒后驾车会加大车祸的风险以及造成死亡或严重受伤的可能性。酒后驾车法律的颁发和 执法可使道路死亡人数减少约 20% 。随机的呼吸测试是在整个澳大利亚采用的主要酒 后驾车执法工具。警察可在任何时候截住一名司机并进行呼吸测试，无论其驾车行为如 何。利用明显可见的“酒精测试车”进行测试，并同时开展媒体宣传运动支持执法。对 随机呼吸测试进行的评价显示在长期内减少了与饮酒相关的车祸。
澳大利亚随机呼吸测试对预防饮酒相关车祸的效果 50 血液酒精浓度 ≥ 0.05g/dl 的 机动车驾车者致命受伤的百分比 45 40 35 30 25 20 15 10 5 0 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
来源：基础设施、交通、地区发展和地方政府部，2009 年
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2011-2020 年道路安全行动十年拯救百万生命
法国： 数十年的进展图 自 1970 年代初以来，法国在减少全国道路死亡人数方面大踏步前进。这是众多因素的结 果，包括采用和执行关于超速驾驶、安全带和酒后驾车的法规。自 2002 年以来，包括 政府最高层的明确承诺、尤其通过使用测速摄像头的更严格执法以及解释交通规则和风 险的媒体宣传运动在内的一系列因素加快了每年死亡人数减少的速度。从 1970 年代初至 2009 年，死亡人数从每年 16,000 以上减少到每年略多于 4,000。
1970-2009 年法国大都市每年道路交通死亡人数演变情况 1973 年 6 月： • 速度限制交通繁忙的路上 为 110 公里/小时其他路上 为 100 公里/小时 • 在市区之外，前排座乘员 必须系安全带 • 必须戴头盔
16 000
1978 年 7 月： 预防酒后驾车法律
14 000
1990 年 10 月： 警察开始进 行随机呼吸 测试 1990 年 12 月： • 市区限速为 50 公里/小时 • 后排座乘员必须系安全带
改变定义： 自 2005 年 1 月起，以 车祸后 30 天内 (而不是 6 天内) 死亡为标准计算 死亡人数。
12 000 每年道路交通死亡人数 1974 年 11 月： 一般速度限制： • 省级公路为 90公里/小时 • 双程分隔车道 为 110 公里/小时 • 高速公路为 130 公里/小时 2002 年 7 月 14 日： 共和国总统的声明 共和国总统的声 1979 年 10 月: 在市区， 前排座乘 员必须系 安全带 1983 年 12 月： 酒精： • 血液酒精 浓度限量 定为 0.8g/l
10 000
8 000
6 000
1992 年 7 月 开始实 行驾照 积分制
4 000
1995 年 9 月： 酒精： • 血液酒精浓 度限量定为 0.5g/l
2 000
2003 年 11 月： 开始使用测速 摄像头
0 Dec 1970 Dec 1971 Dec 1972 Dec 1973 Dec 1974 Dec 1975 Dec 1976 Dec 1977 Dec 1978 Dec 1979 Dec 1980 Dec 1981 Dec 1982 Dec 1983 Dec 1984 Dec 1985 Dec 1986 Dec 1987 Dec 1988 Dec 1989 Dec 1990 Dec 1991 Dec 1992 Dec 1993 Dec 1994 Dec 1995 Dec 1996 Dec 1997 Dec 1998 Dec 1999 Dec 2000 Dec 2001 Dec 2002 Dec 2003 Dec 2004 Dec 2005 Dec 2006 Dec 2007 Dec 2008 Dec 2009 经法国国立跨部委公路安全观察署 (ONISR) 授权复制本图
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加纳： 建立全国性救护车服务机构 在 2000 年代初之前，加纳的应急外伤救治服务 是非正式的并极为有限。在道路车祸中受伤的多 数人由其亲属送往提供有限急救的卫生设施。在 2001 年，针对应急外伤救治的工作获得了政治 上的支持。在 2004 年，政府建立了全国性的救 护车服务机构以及专门的急救热线。在不到四年 的时间内： • 国家救护车系统处理的病例数从 2004 年的 205 例增加到 2008 年的 8250 例； • 救护车的平均反应时间从 2006 年的 17 分钟缩短到 2008 年的 13 分钟； • 现场所用的平均时间从 2006 年的 19 分钟减少到 2008 年的 14 分钟。 © AN Zakariah/GAS
马来西亚： 修正道路基础设施以提高安全性 不同类型车辆分道行驶，例如二轮和三轮车辆与 四轮或更多车轮的车辆分道行驶，已证实是减少 道路交通车祸的有效干预措施。摩托车专用道是 做到这一点的一种手段。这些专用道专供摩托 车、小型摩托车和自行车等车辆使用，在若干亚 洲城市中越来越常见，已证实可通过为所有道路 使用者创建更安全的出行环境，显著减少撞车和 造成的伤害。例如，对具有摩托车专用道的马来 西亚联邦二号高速公路进行的评价显示，车祸在 专用道建成之后减少了 39%。
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© K Rajam/WPRO
2011-2020 年道路安全行动十年拯救百万生命
美国： 通过“系上或罚款”运动提高安全带使用率 使用安全带可使从车中被甩出去和遭受 严重或致命伤害的风险减少 40%-65%。 “系上或罚款”是该国开展过的最成 功安全带执法运动。该次运动的基石 是全国性的“系上或罚款” 5 月动员行 动，全国各地的执法机构在此期间联 合采取行动。它们的努力得到国家和 地方媒体宣传运动的支持。从 2000 年 到 2009 年，安全带拯救了 140,000 多万 美国人的生命。 安全带拯救的生命 (美国，2000–2009 年) 18 000 16 000 14 000 12 000 10 000 8 000 6 000 4 000 2 000 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 年份 图表来源：http://www-nrd.nhtsa.dot.gov/
越南： 通过执法提高头盔佩戴率 研究表明，正确佩戴摩托车头盔可使死亡风险减 少 40% ，并使头部严重受伤的风险减少 70% 。 在 2007 年，越南政府通过一项法律，规定所有 摩托车驾车者和乘员必须佩戴头盔。全国各地警 察严格的执法使头盔佩戴率成倍上升，在驾车者 和乘员中各达到 90% 以上。在政府作出决定之 后不到一年，警方加强了执法工作，不戴头盔的 罚款额显著上升，而医院报告的头部受伤风险与 前一年相比降低了 16%。警方报告显示，在颁发头盔法律之后的一年内拯救了 1500 多人 的生命并预防了 2500 多起严重受伤。摩托车占越南所有注册车辆的 95%，因此关于使用 头盔的政策很可能对这些积极的道路安全效益作出了显著的贡献。
拯救的生命
© WHO/M.Peden
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世卫组织对 2011-2020 年 道路安全行动十年的贡献 世卫组织将支持实施 2011-2020 年道路安全行动十年全球计划。 以下介绍世卫组织计划在未来数年参与活动的一些方面。
协调全球努力 世卫组织与联合国各地区委员会合作，是整个联合国系统的道路安全协调机构。在这方 面，世卫组织作为联合国道路安全协作机制 (UNRSC) (由 60 个国家政府、联合国机构、非 政府组织、基金会和私营公司组成的网络) 的秘书处。在“行动十年”中，联合国道路安 全协作机制将致力于指导全球作出努力，继续其自 2004 年以来在最高政治层面倡导道路 安全的工作，汇集和传播有关预防的良好做法，与公众分享关于风险和如何减轻风险的 信息，并提请注意增加资金供应的必要性。联合国道路安全协作机制将协调和计划“行 动十年”的重要里程碑活动。
通过全球现状报告监测进展情况 联合国道路安全协作机制将负责评价“行动十年”的整体影响，而世卫组织将通过其现 状报告提供这方面的工具之一。2009 年出版的《道路安全全球现状报告》是对道路安全 情况的第一次全球综合评估。报告包括来自 178 个会员国的数据，仍然在为决策者、从 业人员和媒体提供参照，并在许多国家起到促进变革的所用。这些现状报告收集的信息 涉及死亡人数和比率、国家战略和指标的情况、关于若干主要风险的法规和执法情况以 及车祸后救治的现状。定于 2012 年发表的下一份《道路安全全球现状报告》将作为监测 与“行动十年”相关活动的基线。随后将每两年发表一份报告。
支持各国的道路安全规划 在 2010 年，世卫组织及其它五个联盟伙伴获得了彭博慈善基金会提供的资金，用于在 10 个国家推进道路安全。该行动被称为 10 国道路安全项目 (RS10) ，对巴西、柬埔寨、中 国、埃及、印度、肯尼亚、墨西哥、俄罗斯联邦、土耳其和越南等国政府提供支持。在 所有国家中，RS10 项目侧重于选定的道路交通车祸重点风险。例如，肯尼亚的侧重点是 头盔和超速驾驶；在墨西哥是安全带和酒后驾车；在俄罗斯联邦是安全带和超速驾驶。 作出的努力注重于加强立法和执法以及通过社会营销运动开展大众教育。世卫组织还在 马拉维和莫桑比克等其它国家支持改进学校周边安全的道路安全工作。在“行动十年” 期间，世卫组织将继续支持这些和其它国家道路安全行动，从而导致可持久的政府规划。
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2011-2020 年道路安全行动十年拯救百万生命
帮助改进急救服务 对“行动十年”的另一项重要贡献将是世卫组织作为 RS10 项目一部分对改进印度和肯 尼亚急救服务的试点项目提供的支持。此外，世卫组织正在与若干合作伙伴一起开展工 作，创建伤员救治全球联盟。参与这一新生网络的合作伙伴对世卫组织及其它各方在近 几年许多指导手册的出版工作中发挥了作用。
能力建设 通过 RS10 项目及其它国家道路安全行动，世卫组织将支持世卫组织工作人员及其伙伴在 制定、实施和评价道路安全规划方面的能力建设。作为这种更广泛能力建设工作的一部 分，将训练医生更准确地填写死亡证明，训练记者更充分地报道道路交通车祸，并训练 非政府组织的工作人员加强与媒体的合作。道路安全也是 TEACH-VIP 和 MENTOR-VIP (世 卫组织领导的两项能力建设活动) 的一个重要组成部分。
支持非政府组织 在最近几年，世卫组织越来越重视非政府组织的价值，尤其是在宣传倡导领域内。此类 团体对加强政治意愿和使公众产生对更安全道路的要求是至关重要的。在整个“行动十 年”期间，世卫组织将支持此类团体以战略性的方法开展倡导工作。世卫组织还将支持 建立更加正式的非政府组织全球网络以支持实施全球计划。
世卫组织“行动十年”全球和区域归口单位 与世卫组织总部和区域办事处的“行动十年”归口单位联系，请访问： http:/ /www.who.int/roadsafety/decade_of_action/focal/who_regional_offices/en/index.html
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你可为支持 2011-2020 年 道路安全行动十年做什么？ 2011-2020 年道路安全行动十年是每个人的“行动十年”。我们都 希望确保“行动十年”的理想成为现实。以下是一些主意，说明你 可为支持“行动十年”做什么。
决策者： • 按照全球计划发布国家或地方的计划； • 发布新的法规或改进现有法规的执行情况； • 确保支持国家计划的资金。
非政府组织： • 创建提高认识的工具； • 组织引人注目的公开活动； • 施加压力创建或修订法规。
私营公司： • 制定车队安全政策； • 在本公司运作的社区中支持开展活动； • 为道路安全基金提供财政捐助。
青少年： • 作为道路安全“大使”； • 参加青少年集会； • 确保学校周边的道路安全。
受害者和存活者： • 宣传关于道路车祸后果的故事； • 在每年一度的世界道路交通事故受害者纪念日主办活动； • 支持非政府组织。
媒体： • 致力于报道关于道路安全的新闻和专题； • 负责地报道道路交通车祸，并利用关于车祸的报道作为处理预防问题的机会； • 作为社会营销和大众媒体宣传运动的渠道。
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2011-2020 年道路安全行动十年拯救百万生命
所有人注意的标志：道路安全“标签” 道路安全“标签”是新的全球道路安全标志，也 是道路安全行动十年的重要视觉资料。它将把 “行动十年”背景下作出的各方努力联合起来。 标签的促销网站鼓励庆祝“行动十年”启动仪式 的人群“佩戴，相信，行动”，即佩戴道路安全 标签并在“行动十年”相关活动的宣传材料上显 示该标签，考虑道路交通车祸的影响以及预防的 可能性，并采取行动确保道路上更高程度的安全 性。要购买标签作为可佩戴或装饰性物件，要求 把艺术作品用于印刷材料或者对新建立的道路安 全基金提供财政资助，请访问：
http://www.decadeofaction.org
Photo credits for title page: ©iStockphoto.com; ©WHO/M. Peden; ©WHO/K. Bartolomeos; ©WHO Russia; ©WHO/ K. Rajam. Page 13: © Pedro Costa/Lusa; © PAHO; © WHO/M. Peden; © PAHO. Back cover: ©Make Roads Safe campaign; ©WHO; ©Make Roads Safe campaign; ©Make Roads Safe campaign; ©Bloomberg Philanthropies
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道路交通死亡和伤害对发展和大众健康造成的巨大挑战正 在获得越来越高程度的重视。我呼吁各成员国、国际机 构、民间社会组织、企业和社区领袖确保使道路安全行动 十年导致真正的改进。
潘基文先生 联合国秘书长
道路安全行动十年创建了必要的政治平台以加强一些明确 的措施。证据告诉我们，这些措施具有效果并可拯救成百 万人的生命。
陈冯富珍博士 世界卫生组织总干事
那些可真正发挥作用的人现在必须站出来应对这一挑战并 致力于道路安全行动十年。
戴斯蒙德·图图 最尊贵的开普敦荣誉大主教
通过在道路安全行动十年期间使道路安全成为一项优先重 点，我们有潜力拯救数百万人的生命并预防数百万起伤害 和残疾的发生。
杨紫琼女士 演员兼道路安全宣传运动全球大使
太多的人在世界各地的道路上死亡或受伤。据世界卫生组 织预计，到 2030 年，道路交通伤害将成为第五大死亡原 因。时机已到，必须致力于行动。道路安全行动十年有潜 力拯救成百万人的生命。
迈克尔·彭博先生 纽约市长
2011–2020 年道路安全 行动十年 www.who.int/roadsafety/decade_of_action
WHO/NMH/VIP 11.07 © 世界卫生组织，2011年 版权所有。