1. Addressing road injuries in Western Asia: A public health perspective Adnan A. Hyder, MD MPH PhD International Injury Research Unit, Department of International Health, Johns Hopkins University, Bloomberg School of Public Health, USA

2. Road traffic injury improvements in the 20 th Century in high income countries: A Public Health Success Story!

4. What accounts such a decline in RTI fatalities? Speed control Roadway designs MV safety standards Visibility Seat belt use Car seat use Drinking and driving Helmets

5. Impact of Seat Belts:

6. Traffic injuries – what works? Interventions for RTI: Newly recognized needs… Visibility AidsHelmets for Kids

7. Evidence based interventions for further consideration Child safety seat laws with distribution and education programs Primary seat belt laws with active enforcement Graduated driver’s licensing programs Sobriety checkpoints, minimum drinking age laws,.08 BAC legislation

8. Cost Effective Interventions Exist InterventionCost per Disability Adjusted Life Year Improved enforcement (LMIC average) $5.25 Speed bumps at top 25%ile dangerous junctions (LMIC average) $8.89 Bicycle helmets (China) $107 Motorcycle helmets (Thailand) $467 (Bishai and Hyder, 2006)

9. For Child Road Traffic Injuries: Investment of US$ 1 in… Reaps savings/benefits of US$ Child restraints29 Bicycle helmets29

10. How did these changes occur?

11. Comprehensive, multi-disciplinary approaches Government leadership Sustained commitment to research Advocacy and public support IOM, 1999; MMWR, 1999

12. The Focus of Road Safety… On protecting people On the pursuit of “efficiency” and “effectiveness” Such a systems approach will deliver interventions which provide the largest reduction of injuries and deaths

13. Identify a lead agency in government to guide the national road traffic safety effort. Assess the problem, policies and institutional settings. Prepare a national road safety strategy and plan of action. Allocate financial and human resources to address the problem. Implement specific actions to prevent crashes, minimize injuries and their consequences and evaluate the impact of these actions. Support the development of national capacity and international cooperation. Recommendations World Report 2004:

14. Institutional Base Interventions Results A Systems-Based Public Health Approach To Road Injury Prevention

15. Such crashes are unacceptable in Western Asia in the 21 st Century

16. Thank you! Dr. Adnan Hyder (ahyder@jhsph.edu)ahyder@jhsph.edu International Injury Research Unit www.jhsph.edu/IIRU