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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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In 2009, Bloomberg Philanthropies launched the Road Safety in 10 Countries project, a five-year, $125 million effort to reverse global deaths and injuries from road traffic crashes.  The initiative is implementing 12 different road safety interventions in specific sites within 10 low- and middle-income countries.  As part of the project, which is the largest international road safety initiative undertaken to date, JH-IIRU has been tasked with monitoring and evaluating the interventions in all participating countries. Part of this responsibility includes examining the economic impact of the project, because, while it’s well-established that road traffic injuries (RTIs) are one of the leading causes of death and disability in the developing world, what is often overlooked is the economic cost of such a high burden of injury.

“Projecting the Health and Economic Impact of Road Safety Initiatives: A Case Study of a Multi-Country Project,” JH-IIRU senior technical advisor, David Bishai, along with colleagues from the Johns Hopkins Bloomberg School of Public Health, examined how many lives RS-10 can potentially save in selected sites, using two different economic approaches: Investment per life-years saved ($/LYS) and value of statistical life (VSL). $LYS calculations reflect traditional cost-effectiveness estimates. VSL calculations estimate how much society would be willing to pay to achieve the risk reductions promised by the RS-10 interventions.

The results of the study indicate that RS-10 benefits would have to be 20-fold less than those projected for its costs to outweigh the benefits and given such a high margin, it is very likely that RS-10 will be worth the money invested.

To read the full article and learn more about the methods used, click here:

As part of the Road Safety in 10 Countries project (RS-10), in 2012, JH-IIRU published “Public Health Burden of Road Traffic Injuries: An Assessment from Ten Low- and Middle-Income Countries,” a special issue of Traffic Injury Prevention. This landmark publication includes 11 scientific papers jointly authored with 50 colleagues from JH-IIRU and their in-country collaborators that contribute much-needed new knowledge to the burgeoning issue of road traffic injuries in low- and middle- income countries.

The burden of road traffic crashes is significant in Brazil, which has one of the highest road traffic mortality rates of any country in the Americas.
In a recent publication, “Impact of Road Traffic Deaths on Expected Years of Life Lost and Reduction in Life Expectancy in Brazil,” JH-IIRU faculty, including associate director, Aruna Chandran, and senior technical advisor, David Bishai, as well as colleagues from Universidade Federal do Rio Grand do Sul, calculate years of life lost and the resulting reduction in life expectancy as a result of road traffic deaths in order to better characterize the full extent of the burden of road traffic deaths.

The research indicates that road traffic deaths in Brazil account for more than 1.5 million life-years lost, with 80% occurring among males. The team also discovered that road traffic crashes reduce at-birth life expectancy in Brazilians by approximately 9 months for males and 2 months for females.  The authors also show how the years of life lost could be reduced if the different geographic regions in Brazil improved their road safety statistics to match those of the best-performing region.

With road traffic crashes responsible for nearly 1.3 million deaths globally each year (a number that is expected to increase by 65% by 2020 if no interventions are made), illustrating the years of life lost and the resulting reduction in life expectancy, as well as the potential for reducing the road mortality rate, is vital to support for the need for the continued implementation of evidence-based road safety interventions in Brazil.

“Impact of Road Traffic Deaths on Expected Years of Life Lost and Reduction in Life Expectancy in Brazil” will appear in the upcoming edition of Demography.

To read the entire article, click here.

For more information on the Road Safety in 10 Countries Project (RS-10) click here.

In July, the Johns Hopkins International Injury Research Unit (JH-IIRU) team members, Senior Technical Advisor, David Bishai, and Research Program Coordinator, Ekaterina Slyunkina, attended the International Conference on Road Safety in 10 Countries that was held in Lipetsk, Russian Federation.

While at the two-day conference, which was organized by the Lipetsk government, JH-IIRU presented an assessment of the first two years of the RS-10 project in the Russian Federation. Team members discussed the successes and challenges of implementation in the intervention sites of Lipetskaya and Ivanovskaya Oblast, as well as opportunities for the future to enable both regions to achieve greater results and to bring success to the RS-10 project in Russian Federation.  For example, conference participants discussed the need to expand and intensify collaborations with consortium partners and between key stakeholders and the desire to engage various federal and regional departments in road safety measures, as well as the possibility of declaring 2013 a “Road Safety Year.”

The conference provided an excellent opportunity to enhance collaboration between JH-IIRU and other RS-10 consortium partners as well as key stakeholders at the central and regional level.

As a result of the conference, the Lipetsk government issued a resolution to endorse mutual collaboration in order to overcome challenges of RS-10 project and reduce road traffic fatalites and injuries in the region. The resolution also calls on federal departments involved in road safety activities to improve the enforcement and surveillance at the national level.  Additionally, conference participants called for discussions with the regional departments involved in road safety activities to develop and implement additional activities that will be eventually linked to the planned political and budgetary initiatives, to expand and intensify collaboration with consortium partners, to use the international experience of other countries, and to a develop a complex and systematic approach to the road safety culture on Lipetsk roads through by  establishing a special fund that will ensure various federal and regional departments will be engaged in road safety initiatives.

Group at RF Conference
International Road Safety Conference participants.

E Slyunkina at RF conference
JH-IIRU research program coordinator, Ekaterina Slyunkina, at the conference.

To see examples of media coverage in the Russian Federation of the conference, follow these links:

For additional information on the RS-10 Project, click here, or contact us at

Recently, JH-IIRU team members, Senior Technical Advisor David Bishai and Associate Director, Abdulgafoor Bachani, contributed a chapter to Injury Research: Theories, Methods, and Approaches, edited by Guohua Li from Columbia University Mailman School of Public Health and Susan P. Baker, from the Johns Hopkins Bloomberg School of Public Health.  
In the chapter, “Injury Costing Frameworks,” Drs. Bishai and Bachani examine three approaches to measuring the costs of injuries: the human capital, willingness to pay and general equilibrium framework and offer a guide to how one would go about costing injuries.  Cost information is vital to the decision-making process when developing preventive strategies because it allows for a comparison of the costs that can be prevented once an intervention is chosen versus the cost of the implementation of that intervention.
Injury Research: Theories, Methods and Approaches is a comprehensive, multidisciplinary look into the field of injury and violence prevention with contributions from leaders in the field of injury research.
Additional information on the book can be found here:
To find out more about the Johns Hopkins International Injury Research Unit, contact us at

Approximately half a million people die of drowning every year around the globe. More than 97 percent of these deaths occur in low and middle-income countries. In Matlab, Bangladesh, for example, drowning is the most common cause of death for children aged 1 to 4. To help address this problem, a team of researchers led in part by Dr. Adnan Hyder, director of the Johns Hopkins International Injury Research Unit, and David Bishai, senior technical advisor for the Unit, examined verbal autopsy data in Matlab, Bangladesh.

The recently released study, entitled "Childhood drowning and traditional rescue measures: case study from Matlab, Bangladesh," analyzed 10 years of data around drowning deaths in Matlab, including household characteristics, age, gender, time, and also rescue methods attempted. The study is one of the first to publish data on traditional rescue practices performed on drowning children in rural Bangladesh. The findings suggest that interventions should be designed using local information so that we can most effectively reduce childhood drowning. Additionally, community-based resuscitation techniques and emergency medical systems are needed to improve chances for recovery.

To read the full study, please visit this link. If you have any questions about our work in drowning research, please contact the Johns Hopkins International Injury Research Unit.

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