Gearing up for the next decade: India needs a "Safe Systems Approach" to reduce road traffic injuries and deaths
By Samina Parveen
On October 28, 2021, the Global Plan for the Decade of Action on Road Safety 2021-2030 was launched. This global plan was developed by the World Health Organization (WHO) and the United Nations (UN) Regional Commissions in cooperation with partners in the UN Road Safety Collaboration. As we gear up for the next decade of action on road safety, it is an ideal time to reflect on current status of road safety in India, the lessons learned from the past and the plan for the next decade.
In March 2010, the National Road Safety Policy was approved by the Union Cabinet of India to improve road safety in the country. India being the 4th largest vehicle producer, has also launched the Bharat National Car Assessment Programme (NCAP) for testing the safety of the cars available, and introduced Anti-lock braking system (ABS) in all new two-wheeler motorcycles. As per the Global Status Report on Road Safety 2018, except for child-restraint and bicycle helmet law, India has national laws for speed limits, driving under the influence (alcohol or drugs), motorcycle-helmet use, seat belt use, and mobile phone use while driving. Furthermore, the government amended the Motor Vehicle Act in 2019 to increase fines for road traffic violations like drunk driving, speeding and non-usage of helmets. In 2021, the government has notified the constitution of the National Road Safety Board as the lead agency, which is still in progress.
Despite the aforementioned initiatives, in 2019 alone 151,113 people were killed and 451,361 were injured. There has also been an increase in the severity of road crashes by 1.3% from 2018. This makes one wonder, what can be done or what should be done differently to improve road safety in India?
In answering this critical question which has an impact on saving lives and minimizing injuries there are four points we need to consider.
First, we need to shift our lens of intervention from an approach centred towards road users to a safe systems approach by investing in other pillars of road safety. The safe systems pillars for road safety are as follows: road safety management, safe roads, safe speeds, safe vehicles, safe road users and post-crash care. Though at the global level the field has moved towards safe systems approach, in India still needs to do more to implement a safe systems approach. While we have the commitment and the policies towards the reduction of road deaths, our major focus remains on changing the behaviours of road users. For instance, the laws on road safety as mentioned above are on violations by road users but there are no strict laws tailored towards mandating vehicle manufacturers with appropriate levels of safety performance or laws on the manufacture and sale of standard helmets. The quality standard for helmets in India is decided by the Bureau of Indian Standards (BIS) through standard tests for helmets before they are sold in the market. However, there is no evidence to confirm that all helmets that are sold in the market pass the standard quality tests. We still observe several helmet vendors along the roads of the National Capital Region Delhi selling helmets without any data on their quality standards. Pedestrians are one of the most vulnerable road users, yet the road design and infrastructure are focused on vehicle users without proper walkable pavements and road crossings. Also, there is no evidence whether the roads built are as per the standards given by the Unified Traffic and Transportation Infrastructure (Planning & Engineering) Centre (UTTIPEC) and the Indian Road Congress (IRC).
Second, we need to improve the implementation and enforcement of existing laws and policies. For example, as per the seat belt law, the driver, front passenger and rear passengers are mandated to use seatbelts, but in practice very few rear passengers wear seatbelts. In fact, in some taxis, one might find that the seatbelt at the back has been removed by the owner or driver. Similarly, for motor bikes, low helmet usage is observed especially among pillion riders (passenger riders generally seated behind the driver on motorbikes), despite the law mandating both the driver and pillion rider to wear helmets. Furthermore, while some tier-I cities like Delhi and Chennai have introduced e-challan and installed over-speed violation detection (OSVD) camera systems and traffic cameras, other states continue with previous measures lacking enforcement strategies.
Thirdly, we need to implement road safety plans focused on rural areas. A report by World Bank in 2020 called Delivering Road Safety in India states that rural areas account for more than 66% of road deaths, yet our interventions are focused on urban areas. For instance, the amendment in the Motor Vehicle Act 2019 increased the fines 5 to 10 times to address the high burden of road traffic deaths, but there is no evidence from low, middle or high-income countries that shows that increasing financial penalties alone reduces road traffic deaths. Such interventions while not being evidence-based also ignore the impact it has on the vulnerable, thus disproportionately affecting those with low-income levels, low education, or limited access to legal services. We also do not have context-relevant road safety interventions specifically for rural areas on timely emergency care, road infrastructure and strict enforcement to name a few.
Finally, the campaigns on public awareness of road safety are not tailored to all sections of society. In a recent example, the Delhi Transport Department organized the very first Road Safety Summit on October 1, 2021 to improve road safety awareness among the public. However, the social media campaign ‘Sadak Surakshit Dilli Surakshit’ ignored the lack of mobile phone usage or internet availability in rural areas. Although, the campaign itself was developed based on WHO guidelines and addressed four important areas of speeding, drunk driving, helmet wearing and seatbelts, lack of access to such campaigns outside urban areas makes them ineffective. Additionally, the ineffectiveness of isolated knowledge-based interventions like education campaigns in reducing road injuries is well documented.
In conclusion, for India to achieve the goal of reducing deaths due to road traffic injuries by 50% by 2030, there is a need for holistic evidence-informed safe systems approaches.. Lessons from countries such as Sweden and Vietnam, where applicable, can be incorporated to improve road safety. Some key strategies which can be implemented are:
Drafting and implementing evidence-informed legislations on vehicle safety, helmet quality standards and road standards.
Investing government funds in research projects, comprising of primary and interventional studies, on all pillars of road safety (safe roads, safe vehicles, safe speeds, post-crash care, safe road users) in urban and rural areas.
Monitoring and evaluating existing interventions using interrupted time-series studies or other appropriate study designs.
Convergence and creating a system for the exchange of dialogue between different stakeholders and departments to work towards road safety. A good example and first step towards this was the Road Safety Summit in 2021.
Capacity building of the police personnel on enforcement of the existing road safety laws both equitably and effectively.
Prioritizing and advertising vehicle safety features while marketing for vehicles rather than speed and other luxurious features.
Using context-relevant media interventions, rather than a “one-size” fits all approach for rural areas.
These strategies can be a good starting point to ensure a safe and sustainable effort towards improving road safety by creating safer systems and by reaching all communities.
While policy changes are vital, it is also important to remember that it takes everyone, especially the public to reduce road traffic deaths and injuries.
About the Author
Samina Parveen is a Public Health Researcher, currently working as a Research Fellow at the George Institute for Global Health, New Delhi, India. Her area of work has been diverse ranging from maternal and child health to injuries. Her research interests in injury prevention is particularly in road traffic injuries, health systems and policy research. She is passionate about bridging the gap between evidence-based research and policies pertaining to injury prevention in India and other LMICs. All opinions are personal. She tweets @SaminaParveen19