We use a comprehensive approach to designing our projects, tailoring our work to the needs of the specific locale.
Surveillance and Data: Strengthening the Systems that Save Lives
When city agencies in Bandung started working on road safety interventions in 2015, they realized they didn’t have good local road injury data to help them. There was a national police crash reporting system (IRSMS), but only police had access to it and the reports were incomplete. Hospital and death certificate data were not available, nor records from the national road victims’ insurance agency, Jasa Raharja. It was a common scenario: lots of data stored in different places, but not integrated in a way to get a clear picture of the road injury situation. Vital Strategies and local embedded staff rolled up their sleeves to develop systems and turn data into useful information.
The first task was to get official city government access to the police crash record and insurance data and set up a linkage system. Next, they partnered with the city Health Department and hospitals to develop a simple monthly road injury reporting format and conducted training on the standard global International Classification of Diseases (ICD-10) system for coding causes of injury, so that cases could be easily identified for reporting. The one-year evaluation for this system was so positive that additional hospitals were invited to participate, and the Health Department, with BIGRS funding, developed an App to streamline the reporting further. After all the data were linked up, it appeared there were about 64 percent more deaths than were recorded in the routine police crash data system: a critical finding to advocate for road safety as an urgent public health issue locally.
The team prepared comprehensive annual reports providing important new insights for decision makers. It was already well known that motorcyclists, especially young men, were at high risk. The reports highlighted the vulnerability of pedestrians (a quarter of deaths) and the elderly (with the highest road death rates per 100,000 among all age groups). They also showed that half the deaths were on national or provincial roads, indicating that multiple levels of government must work collaboratively to reduce the death toll within Bandung. The report also showed hotspots requiring urgent prioritization.
As the culture of data use is established among Bandung’s road safety stakeholders, the BIGRS initiative will leave a legacy of strong systems to support effective, evidence-based decision-making.
Addis Ababa, Ethiopia
Mass Media Campaigns: Moving Hearts and Minds
It is a stark call to action: A mother flips through a photo album, talking about her teenage daughter killed on an Addis Ababa road by a driver who had been drinking alcohol. Her pain and grief are palpable as she tells viewers, “I cannot find solace.” The television PSA ends with a clear message: Never drink and drive.
This ad was the centerpiece of “Never Drink and Drive,” a hard-hitting and emotional anti-drink driving campaign deployed in the Ethiopian capital in October 2016, part of a $250 million global initiative administered by Vital Strategies called the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS). In Addis Ababa, citywide social marketing campaigns are the tip of the iceberg—the most visible part of intensive work with the local government to improve the complicated web of elements needed to reduce road safety deaths in the long term. These include upgrading reporting of traffic deaths, surveillance of road user’s risky behaviors, and advertising campaigns tightly coordinated with increased enforcement.
Interventions like these are desperately needed. The WHO estimates that 23,837 people died on Ethiopia’s roads in 2015, with a fatality rate of 25.3 per 100,000 people, compared to 17.4 worldwide and 24.2 in low-income countries.
Globally, 1.35 million people are killed in road traffic crashes annually—over 90 percent in low- and middle-income countries. Half of these deaths are “vulnerable road users”: pedestrians, cyclists and drivers of motorized two-wheelers. Under current trends, road traffic crashes will become the world’s 5th leading cause of death by 2030.
Creating sustained reduction will require building strong systems, instilling expertise and coordinating different sectors of government. For the “Never Drink and Drive” campaign, at the same time that Addis Ababa residents were seeing and hearing the PSAs, police were out on the streets in a high-visibility enforcement effort using breathalyzers for the first time.
Vital Strategies has taken an integrated approach in all ten of the program’s cities, bringing together global and local experts, city officials and advocates on the ground to implement innovative and effective public health interventions. Our hope is that with each intervention, and each campaign, we can spare at least one more mother from grieving the needless loss of a child.
“Never Drink and Drive”
BIGRS City Exchange and Third Safer Streets Meeting, Rome
Coordinating a Response: What Cities Can Teach Each Other
Bringing together experts, leaders, and advocates provides the opportunity to share evidence-based tactics to improve road safety that can be used across the globe. In collaboration with the World Resources Institute, Vital Strategies organized and conducted an extended program of the 2018 OECD’s International Transport Forum (ITF)in Rome, Italy.
The session discussed strategies and reviewed current progress of the development of sustainable plans for road safety and the Safe System Approach, which provides a framework to examine road traffic injury risk factors and interventions from a holistic perspective. The Safe System Approach emphasizes tested city planning and policy actions like improved pedestrian crossings, building roundabouts at dangerous intersections and better public transportation and bike lanes.
With the participation of the 10 BIGRS cities, and representatives from other OECD cities and international safer streets networks, this city exchange provided an opportunity to learn and build capacity on city-wide initiatives aiming to adopt a comprehensive approach and raise the profile of road safety.
BIGRS cities’ representatives heard experiences from Zurich, Lisbon, Belgrade and Rome. During the ITF session, Vital Strategies sought to provide exposure to city staff on long term implementation and to explore further connections within the ITF Safer Streets network.
Bringing it all Together: How One Mayor Is Working Toward Zero Traffic Fatalities
With high-level political will and dedication to evidence-based action, Fortazela, Brazil, is saving lives on its roads. In February 2018, Fortaleza Mayor Roberto Cláudio announced that the city had experienced a 40 percent reduction in road deaths since 2014: from 377 to 226 in 2018.
“Deaths and injuries caused by road crashes are not mere coincidences. We will continue to work tirelessly to reduce these numbers more and more. No death in traffic is acceptable!” the mayor said during a press conference.
Key interventions within the city have included reduced speed limits from 60 to 50 km/h at major avenues, increased drink driving checkpoints by the traffic authority, multiple hard-hitting mass media campaigns, conducted in partnership with Vital Strategies, that show the dire consequences of risky road behaviour, and the “Cidade da Gente” program, which aims to reclaim public space with data-backed infrastructure improvements.
Fortaleza is also a participant in the Bloomberg Philanthropies Partnership for Healthy Cities. Within this initiative, Fortaleza has redoubled efforts to improve road safety by enhancing bicycling infrastructure.