Despite the bleak outlook, there are examples of effective measures being taken to reduce mortality and morbidity from RTIs in less developed countries. A low-income country that has implemented an effective intervention to decrease speeding and resulting crashes is Ghana. Rumble strips were installed at intervals at the Suhum Junction, a frequent crash site on the Accra-Kumasi highway. This simple intervention contributed to a decrease in crashes of 35% and fatalities by 55% in a 16-month period. The total cost of the installation was less than $21,000, a bargain when compared to estimates of $104,610 to redesign the junction or $184,600 to construct a walkway and guardrails to separate pedestrians.

Another successful program has been conducted in Colombia, a middle-income country, which saw a 50% drop in traffic fatalities from 1995 to 2002 as a result of a series of interventions implemented at national and local levels. In 1995, the Traffic Accident Mandatory Insurance Law was introduced, requiring all vehicles to have insurance policies. A levy on insurance generates revenue to fund mass media prevention campaigns, road safety education and support of other activities carried out by state road safety entities. This law also guarantees that the insurer pays for any hospital care received by victims of traffic crashes and has led to improvements in the recording of information on road traffic crashes. The Ministry of Transportation (MoT) also has several initiatives, including a national road safety plan, which will be used to provide policy frameworks and issue general guidelines to local authorities. Another is a national monitoring system, which would allow authorities to track vehicle locations via geographic sensing devices installed in public transport vehicles. Sumatriptan tablets

In Bogota, several policies have been implemented to mandate that all drinking establishments close by 1:00 a.m., to restrict driving in the city during certain hours two days each week and to restrict private vehicles in the city. Last has been the introduction of Bogota’s mass transit system, which transports an average of 800,000 people per day. It has improved mobility in the city in addition to reducing the number of injuries along its routes by building infrastructure that ensures the safety of pedestrians and other road users. The drivers are under contract, and their salaries are established by law. This differs from most public transportation systems where drivers are paid based on the fares they collect—a situation that leads to vehicles being massively overloaded with passengers and driven at high speeds to reach new passengers before the competition. Don’t be left without your medication get celecoxib 200 cheaper online.

Conclusion and the Way Forward

Much remains to be done to reduce mortality and morbidity associated with road traffic crashes in developing countries. Many are just beginning to take action and programs are in their infancy. Others have still not recognized the true extent of the problem; deaths and injuries will continue to rise in those countries. The adoption of a systems approach to road safety is crucial to stemming the loss of life. However, it is presumptuous to assume an intervention designed in the west will be effective in a less developed country without first understanding the local context and unique social determinants. Research is needed to further uncover factors that distinguish road traffic crashes from those occurring in developed countries. Information gathered can be used to develop novel interventions as well as identify ways to adapt western interventions to meet local needs. Indigenous solutions should be sought and encouraged to promote sustainability and decrease reliance upon international “experts”. These actions will also increase community participation and can foster a sense of ownership, thus improving the likelihood of success and compliance. In addition, rigorous evaluation is desperately needed to determine effectiveness of programs and transferability of interventions to less developed countries as well as prevent the wasteful use of scarce resources. Regulating informal public transportation systems and enforcing safety legislation could go a long way in reducing the burden of RTIs. It is imperative that governments of developing countries make this issue a top priority alongside HIV/AIDS and other pressing public health problems. Public investment and funding for road safety must be increased— both by governments and donors—to curb the substantial loss of human capital. The time for action has come.