Road traffic accidents are the main cause of death for people between 5 and 29 years of age worldwide. Globally, road traffic accounts for approximately 1.19 million deaths in 2021, a reduction of 5% compared to 2010 (1.25 million road traffic deaths) (WHO, 2023[1]) The global rate for road traffic deaths is 15 per 100 000 population, with a 1 to 3, female‑to-male ratio (WHO, 2023[1]). South-East Asia is one of the most affected regions, with 16 road traffic deaths per 100 000 population. Western Pacific countries, have a slightly lower rate with 15 road traffic deaths per 100 000 people equal to the global average. Globally, more than 70% of road traffic deaths occur in lower-middle (44%) and upper-middle (35%) countries combined. The burden of road traffic deaths falls disproportionately on vulnerable road users as 38% and 27% of deaths are among pedestrians and cyclists in Western Pacific Region and South-East Asia Region respectively. 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[2]). The UN SDGs includes a target aiming to halve the number of global deaths and injuries from road traffic crashes by 2030 (SDG 3.6). Road traffic injuries are estimated to have a global cost of USD 1.8 trillion (Chen et al., 2019[3]).
In 2021, Asia-Pacific countries and territories reported between 15 and 16 deaths per 100 000 population due to road traffic accidents, three times the rate observed across OECD countries in the region (WHO, 2023[1]). In Asia-Pacific, the average proportion of deaths due to road traffic accidents in lower-middle- and low-income countries and territories is more than four times higher than the average rate in high-income countries. Improvements have been made in several countries in Asia-Pacific. In general, from 2010 to 2021 there has been a reduction in road traffic deaths of 2% and 16% in the South-East Asia and Western Pacific regions, respectively. From the Asia Pacific Region, two countries reached the target of at least 50% reduction in their fatality numbers, Brunei Darussalam and Japan (WHO, 2023[1]).
Road user behaviours are important risk factors for road traffic deaths; drink-driving alone account for 10% of road traffic deaths (WHO, 2023[1]). Legislation governing road user behaviours are key to reduce road traffic fatalities. For example, legislations on drink-driving, seat-belt use, child restraint, speed limit, helmet use, and mobile phone use (Table 4.1). Distracted driving – such as using mobile phones and other in-vehicle technologies while driving – is a growing threat to road safety; although most countries have implemented a national law to govern mobile use, there are still 4 countries in the latest report that do not have such law, Bangladesh, Indonesia, Myanmar and Nepal (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). Therefore, the WHO Best Practice Criteria includes national laws setting a BAC limit of 0.05/dl for the general driving population and a lower BAC limit (0.02 g/dl) for novice drivers (WHO, 2023[1]). All Asia Pacific countries, here presented, have reported presence of a national law prohibiting drink-driving (Table 4.1). Law enforcement through random breath testing checkpoints is considered highly cost effective (WHO, 2018[2]).
Speed limits are enforced by a national law in all Asia-Pacific countries here reported (Table 4.1). However, in several countries speed limits are above the WHO Best Practice Criteria recommended urban limit of 50km/h (Table 4.1). 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, from 2019 to 2021, Indonesia implemented the Safe School Zone project which included installation of speed limit and safe school zone signs within 100‑metre radius from the schools (WHO, 2023[1]).
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%. Although all Asia Pacific countries reported having a national law to enforce the use of motorcycle helmets, the wearing rate is relatively low in countries such as Thailand (52%) and China (62%), compared to Sri Lanka (96%) and Nepal (98%) (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%. Compared to the 2022 report, a national law on wearing seat belts has now been adopted in all Asia Pacific countries reported (Table 4.1). Likewise, 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 has not been adopted in Bangladesh, Indonesia, Korea, Nepal, Pakistan and Viet Nam (Table 4.1) (WHO, 2023[1]).
