Road traffic crashes contribute to more than 1.3 million annual deaths worldwide, with many more suffering from disability. The burden of these deaths and disabilities disproportionately impacts those living in low- and middle-income countries (LMICs). In 2015, an ambitious goal of reducing deaths from crashes by 50% by 2020 was set under the Sustainable Development Goal target 3.6. While significant progress has been made, unfortunately, the world wasn’t able to meet this goal, because of both its aggressive vision and the rapid motorization and urbanization patterns seen across the globe. It thus remains imperative that the work in road safety and injury prevention continues unremittingly from prevention of crashes to adequate post-crash care provision of services. It is encouraging, therefore, that the UN adopted resolution 74/299 to improve global road safety and proclaim a second decade of action to prevent at least 50% of road traffic deaths and injuries by 2030.

The Johns Hopkins International Injury Research Unit is proud to join the United Nations in acknowledging the UN Road Safety Week 2021 and its theme “Streets for Life,” and lending support for lowering speed limits (30km/h or 20mph) in urban areas to improve the safety for all road users.

Why focus on speed?

In short, reducing speeds saves lives. Lower speeds decrease the probability of a crash and its severity. Speed management is not only paramount to improving road safety, but also for sustainable mobility by creating inclusive environments for non-motorized modes of transport, and to help mitigate the impact of climate change from road transport.

Putting most vulnerable users first

Higher speeds in urban areas disproportionately affect vulnerable road users – motorcyclists, bicyclists, pedestrians, and children. Globally, there has been a shift in the major cause of death of children and young adults from infectious diseases to road traffic injuries now being the main cause for persons between age 5 and 29 years. Hence, enacting and enforcing lower speed limits on roads where vulnerable road users are exposed to high-speed traffic and in the vicinity of schools and communities will help to limit the number of young pedestrians who are impacted by crashes. The JH-IIRU team is proud to contribute to global efforts to improve road safety through multiple avenues including the Bloomberg Philanthropies Initiative for Global Road Safety. Since its inception in 2008, the JH-IIRU team has been involved in activities ranging from evidence generation and intervention evaluation to capacity development and translation of evidence into effective policies and programs across the globe.

Going beyond injury prevention: post-crash scenarios

While speed control measures can be taken to prevent crashes from happening in the first place, they are also effective in reducing the severity of crashes when they happen. In addition to these measures, efforts are also needed to focus on post-crash care to avail appropriate and timely care to affected individuals. These efforts ought to go beyond just the acute phase and include medium to long-term rehabilitation, which is key to restoring functioning and improve the overall well-being of individuals. Increasing focus on the post-crash scenario is important to not only save lives but also to restore the lives of the injured as close as possible to their pre-crash states.

Considering rehabilitation as part of continuum of care

Lack of availability, affordability and accessibility to rehabilitation services is a limiting factor for many who need rehabilitation care. These key population- and systems-level limitations have social and economic consequences for countries if not addressed in a timely manner. Even with limited resources available, enhancing availability of and access to rehabilitation services worldwide provide an opportunity for improving quality of lives of individuals. For road traffic injuries, which disproportionately impact vulnerable road users and younger populations across the globe, rehabilitation services are especially useful in preventing complications from injuries and long-term consequences – health, societal, and economic.

Through the newly launched Learning, Acting, and Building for Rehabilitation in Health Systems (ReLAB-HS), JH-IIRU leads a multidisciplinary consortium that seeks to bridge this gap, and address the growing rehabilitation needs of populations across the globe. We are working to co-develop systems-based solutions to efficiently and effectively respond to rehabilitation needs of individuals, and develop capacity of providers, leaders and health systems to provide rehabilitation care.

Rehabilitation needs a multisectoral person-centered approach that engages local stakeholders and develops approaches that are demand-driven and contextually relevant to ensure their integration and sustainability. By understanding and addressing the rehabilitation needs of individuals after a crash event, and processes involved, ReLAB-HS will generate empirical evidence that will contribute to strengthened health systems that integrate rehabilitation services as a core service.