Bloomberg Global Road Safety Program November 10,

ROAD TRAFFIC INJURIES 2 Road Traffic Injuries RANK Heart Attack 2 Stroke 3 Chronic Lower Respiratory Disease 4 Lower Respiratory Infections 5 Trachea, Bronchus, Lung Cancers Road Traffic Injuries 6 HIV/AIDS Trachea, Bronchus, Lung Cancers 7 Diarrheal DiseasesDiabetes 8Road Traffic Injuries Hypertensive Heart Disease 9 DiabetesStomach Cancer 10 TuberculosisHIV/AIDS cause 1.24 million deaths worldwide every year Without intervention, Road Traffic Injuries will become the 5 th leading cause of death globally by 2030 ROAD TRAFFIC INJURIES

FOCUS AND INTERVENTIONS MEXICO BRAZIL TURKEY EGYPT KENYA CAMBODIA VIETNAM CHINA RUSSIAN FEDERATION 1.Helmets 2.Seat-Belts 3.Drinking & Driving Prevention 4.Speed Reduction 5.Infrastructure Improvements 6.Sustainable Urban Transport INDIA 10 FOCUS COUNTRIES: ACCOUNT FOR MORE THAN HALF OF ROAD TRAFFIC DEATHS ANNUALLY 6 PROVEN INTERVENTIONS: 3

4 BLOOMBERG GLOBAL ROAD SAFETY PROGRAM Countries and Interventions HelmetsSpeedSeat-belts Drinking and Driving Infrastructure Sustainable Urban Transport Brazil Cambodia China Egypt India Kenya Mexico Russia Turkey Vietnam

5 BLOOMBERG GLOBAL ROAD SAFETY PROGRAM STRATEGIES AND PARTNERS World Health Organization World Resources Institute/EMBARQ Johns Hopkins Bloomberg School of Public Health Global Road Safety Partnership World Bank Global Road Safety Facility Association for Safe International Road Travel

6 BLOOMBERG GLOBAL ROAD SAFETY PROGRAM STRATEGIES AND PARTNER ROLES InterventionsProgram InitiativesPartner Organizations Surveillance & Evaluation Policy level Measurement of fatalities and injuries WHO Hopkins Environment Reducing road crashes through transport and land-use policies Incorporating safety into road design EMBARQ World Bank Global Road Safety Facility Road Safety Behavior Legislation and best practices: helmets, speed, drinking and driving, seat-belt and child restraints Training and compliance WHO, GRSP, ASIRT WHO, GRSP Post-Crash Care Pilot program to show feasibility of delivering effective post-crash care Hopkins Optimizing Interventions Public education/mass media Training of public health professionals ASIRT, WHO, GRSP, EMBARQ Hopkins NGO Development Capacity building ASIRT, GRSP, WHO

7 BLOOMBERG GLOBAL ROAD SAFETY PROGRAM Inputs Outcomes Training Paid/Earned Media Capacity Reviews Road Safety Audits Legislative Review Political Economy ± Improved legislation/regulation Improved enforcement/compliance Increased seatbelt, helmet, child seat Reduced drunk driving and speeding Improved, safer infrastructure Improved trauma care Advocacy Measurement and Evaluation Goal: Reduction in serious traffic injuries and traffic-related mortality

STATUS OF NATIONAL LEGISLATION Country Drinking and DrivingHelmetsSeat-beltsSpeed National Legislation Enforcement National Legislation Enforcement National Legislation Enforcement National Legislation Enforcement BrazilGoodFair CambodiaPoor China*Good Egypt PoorFair IndiaFairPoor Set subnationall y NA Kenya Poor FairPoor MexicoFairPoor GoodPoor Russia GoodFairPoorFair Turkey* Good VietnamFairPoor Source: GSRRS 2009 Reported for Bloomberg Intervention Focus Areas Only * Official government reports of legislation status for China and Turkey may not reflect on-the-ground reality.

STATUS OF NATIONAL LEGISLATION NOVEMBER Source: GSRRS 2009 & 2013 and RS10 updates November 2013 Country Drinking and DrivingHelmetsSeat-beltsSpeed National Legislation Enforcement National Legislation Enforcement National Legislation Enforcement National Legislation Enforcement BrazilGoodFair GoodFair CambodiaFairPoorFairPoor ChinaGood Fair Egypt Fair IndiaFairPoorFairPoor Set sub- nationally NA Kenya GoodPoor FairPoor MexicoFair GoodFair Russia GoodFairPoorFair Turkey FairGood VietnamGoodPoorGood

10 SPEED REDUCTION Brazil, China, Egypt, Kenya, Russia, Turkey Brazil –National law allows speed camera installation without public announcement China –Speeding in Dalian from 32% (2011) to 9% (2012) Egypt –Police installed 24 speed cameras along the Cairo Ring Road Russia –Speeding reduced in Lipetsk from 47% (2011) to 26% (2013) & in Ivanovo 55% (2011) to 40% (2013) Turkey –Local decrees mandating all drivers obey speed limits in Afyon and Ankara; reduction in Afyon from 43% to 29% (2012)

11 DRINKING AND DRIVING Brazil, Cambodia, China, India, Mexico, Vietnam Brazil –Advocating for new national zero tolerance law Cambodia –Phnom Penh from 10% (2011) to nearly 0% (2012) China –Criminalized drinking & driving; passage of a National zero tolerance law India –Significant police enforcement in Hyderabad; earned media Mexico –New law in Guadalajara in 2010 reduced legal BAC from.15% to.05%. Vietnam –Ninh Binh from 23% (2010) to 8% (2011)

12 SEAT-BELT USE Egypt, Mexico, Russia, Turkey Egypt –awareness raising Mexico –Guadalajara progress: prevalence 41% (2010) to 51.2% (2013) Russia –Ivanovo progress: prevalence 48% (2011) to 90 % (2013) –Lipetsk progress: prevalence 52% (2010) to 74% (2013) Turkey –Local decrees by governors of Afyon and Ankara  Afyon prevalence 4% (2012) to 73% (2013)

HELMET USE Cambodia, India, Kenya, Vietnam Cambodia –Phnom Penh increased from 32% (2010) to 57% (2013) & Kandal 18% (2010) to 45% (2013) India –Completed political mapping on helmet use in Hyderabad Kenya –International standards adopted by Kenya Bureau of Standards Vietnam –National level 40% pre-law in 2007 to 90% today; loop holes addressed 13

SOCIAL MARKETING CAMPAIGNS & ENFORCEMENT IN RUSSIA INCREASED SEAT-BELT USE IN IVANOVO AND LIPETSK, RUSSIA SOCIAL MARKETING + ENFORCEMENT 14

INTERVENTIONS IN RUSSIA SEAT BELT USE 15

CHALLENGES Minimal civil society capacity Lack of access to decision makers / politicians Ministry of Health often not best entry point Ineffective social marketing campaigns Low road safety capacity at country level Police commitment to enforce Lack of access and poor quality surveillance data – hospital and police 16

BLOOMBERG GLOBAL ROAD SAFETY PROGRAM 17