close
close

Revitalizing road safety regulations in Africa

On February 24, 2024, o collision of a truck with three smaller vehicles caused the death of 25 people on the Arusha-Namanga highway in northern Tanzania. In the days that followed, disturbing footage of the wreckage and crowds searching for survivors quickly spread on social media. President Samia Suluhu Hassan reacted to the tragedy offering her condolences the families of the victims and to recommend that the security authorities intensify their efforts to ensure compliance with road safety regulations.

However, this outage is not an isolated event. The rapid motorization of African countries has outpaced the development of infrastructure, regulation and law enforcement to support it, leading to a growing trend of road accidents across the continent. Increasing road safety and reducing road fatalities in Africa should be an urgent priority, starting with the need to improve driver and motorcyclist education. According to the FIA ​​Foundation, as many as 70% of road accidents in Africa are caused by motorcycles, and by 2030 the number of motorcyclists is expected to increase from 22 to 80 million.

Road accidents in Africa affect all walks of life. Another collision in February this year, this time in western Kenya, it claimed the life of marathon world record holder Kelvin Kiptum; in November 2023, An overloaded truck lost control in northern Nigeria, killing 25 people. In 2021 almost a quarter of a million—225,482—drivers and pedestrians killed on African roads. Africa had a road accident fatality rate of 19 per 100,000 inhabitants compared to 7 per 100,000 in Europe, despite having less than 3% of the world’s vehicle fleet. As of 2019, road accidents were the ninth leading cause of death on the continent and are likely to continue to rise unless efforts are made to promote road safety standards for drivers and vehicles.

The rapid motorization of African countries has outpaced the development of infrastructure, regulation and law enforcement that supported it

There is access to driver education and training in Africa currently limited, which partially contributes to the occurrence of road accidents. Efforts should focus on expanding access to high-quality driver education programs that include tutorials on driving, understanding road signs and signals, and responding to emergencies. The Motorcycle Safety Institute has initiated such an educational initiative in South Africa, for example, since November 2015 it has successfully trained over 4,100 motorcycle operators in safe riding practices.

However, education alone is not enough. Laws must also be developed, passed and enforced to promote safe driving practices.

Risk factors

Alcohol consumption is another important risk factor for car accidents all over the continent, but only eight African countries has adopted national drink-driving laws that impose a blood alcohol limit on drivers of less than 0.05 grams per deciliter – a level recommended by the World Health Organization.

Even in countries with drinking-driving laws, enforcement of sobriety laws is still insufficient. This was shown by a 2021 study in Tanzania 66% of car drivers and 52% of motorcyclists those involved in the accidents were under the influence of alcohol. Another study found that a fivefold increase risk of injury from any alcohol consumption, especially among motorcyclists. In addition to expanding drink-driving laws, investing in police will be essential for law enforcement, along with penalties such as jail time and driver’s license suspension for violations.

A strengthened traffic police force could also improve enforcement of other road safety laws, including ensuring that all drivers have a valid driving license and obey speed limits, make it compulsory for motorcycle drivers to wear helmets, and prevent overloading of passengers and cargo in buses and trucks – a factor known to contribute to accidents such as the one that occurred last year in Nigeria.

A car is transferred to a truck after a fire accident involving an oil tanker on the Lagos-Ibadan Expressway in Lagos, Nigeria, June 29, 2018.
REUTERS/Akintunde Akinleye

Development of infrastructure

The next important step is to prioritize infrastructure investments. Currently only some 30% of the road network in Africa is paved, and pedestrian-safe infrastructure remains underdeveloped, contributing to unsafe driving conditions. Development in Africa is hampered by resource constraints, including: an investment gap exceeding USD 100 billion per year. Last decade, donations from Bloomberg Philanthropies and investments under China’s Belt and Road initiative have facilitated infrastructure development on the continent. One example of such an investment is the construction of the six-lane Nairobi Expressway, which cuts through the heart of Kenya, but the development of safe infrastructure requires further financial resources.

Other high-income countries could fund initiatives to develop paved roads, traffic lights, designated motorcycle lanes and intersections to increase vehicle safety and improve pedestrian amenities such as well-lit sidewalks to improve mobility. Policy interventions can also be made to ensure safety features in African vehicles, including active braking systems, automatic collision avoidance technology and the installation of airbags. To establish safety standards and criteria for vehicles imported to the continent, the United Nations launched a project Safer and Cleaner Vehicles for Africa project. The project, launched in 2020, is expected to prevent road accidents and reduce air pollution associated with used vehicles in African countries.

Health systems also need to be strengthened to provide better care for the injured. Historic core service priorities for infectious diseases including HIV/AIDS, tuberculosis and malaria, have caused significant impacts poorly developed pre-hospital and emergency care, especially in rural areas of the continent.

As with infrastructure development, healthcare systems also face limited financial resources

As with infrastructure development, health systems also struggle with limited funding, and many African countries cannot afford to expand their emergency care capacity. However, this challenge can be met strengthening national healthcare financing systems with the support of high-income countries. This may include adopting effective financing models such as Community health insurance program in Rwanda, which raises funds from a variety of stakeholders, including citizens, government and international organizations. The increased funds will be allocated to ensuring effective post-injury care, pre-hospital treatment of injuries and expanding emergency services for victims of road accidents. Improving access to high-quality emergency and trauma surgery will require the construction of trauma centers providing services in the field of neurosurgery, orthopedics, general surgery, advanced diagnostic imaging and comprehensive rehabilitation.

The recent and tragic road fatalities in Tanzania and other countries in sub-Saharan Africa are a reminder of the urgent need for comprehensive and sustained efforts to prevent and treat road traffic accidents and injuries in Africa. Through education, legislation, strategic investment in infrastructure and emergency care, tangible progress can be made to create safer roads and save lives across the continent.

Vehicles are stuck in a traffic jam at dusk in Abidjan, Ivory Coast, October 15, 2021.
REUTERS/Luc Gnago

Faraan Rahim is a global health researcher and incoming medical student at Harvard Medical School.

Alice Andongolile is a physician and researcher at the Kilimanjaro Clinical Research Institute.

Francis Sakita is an emergency medicine physician and head of the emergency department at Kilimanjaro Christian Medical Center in Moshi, Tanzania.

Julian Hertz is an associate professor of emergency medicine and global health at Duke University.

Catherine Staton is a National Institutes of Health-funded trauma implementation scientist, director of the Global Center for Emergency Medicine Innovation and Implementation Research, and an emergency medicine physician at Duke University’s Department of Emergency Medicine.