• Heather E Rosen, Imran Bari, Nino Paichadze, Margaret Peden, Meleckidzedeck Khayesi, Jesús Monclús, and Adnan A Hyder.
• Center on Commercial Determinants of Health and Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States of America. Electronic address: hrosen@gwu.edu.
• Injury. 2022 Jul 20.

BackgroundRoad traffic injuries (RTIs) pose a significant health burden with 1.35 million individuals dying on the world's roads annually. Nearly a decade ago, based on agreed road safety indicators, global commitments were encouraged to dramatically reduce this burden as part of the United Nation's Decade of Action for Road Safety 2011-2020.MethodsThe analysis was based on global level data from three Global Status Reports on Road Safety published by the World Health Organization in 2013, 2015, and 2018. A total of 161 countries that consistently reported statistics for all three reports were included in the analysis. Descriptive analyses, t-test, Wilcoxon rank-sum test, and Spearman's rank correlation were performed to evaluate past and current trends in road traffic deaths and countries' progress in achieving key road safety indicators.ResultsWe found no significant decline in global road traffic death rates from 2010 to 2016 and in fact, death rates increased in low-income countries (LICs) and the African Region. Death rates were highly dependent on income level of the country, with deaths higher in low- and middle-income countries (LMICs) when compared to high-income countries (HICs). We found that the strength of enforcement of speed laws and child restraint laws increased from 2011 to 2017. However, we did not find a correlation between enforcement of the five key prevention policies (speeding, drink-driving, seatbelts, helmets, and child restraints) and death rate. In terms of advancement in achieving key road safety indicators, there was slow progress in adopting most of the recommended policies and practices based on the five pillars (road safety management, safer roads and mobility, safer vehicles, safer road users, and post-crash response).ConclusionDespite global efforts during the past decade, road traffic deaths remain disproportionally high in LMICs and African countries as shown by global reports, and progress in achieving global road safety indicators is slow. Countries need to greatly accelerate the implementation of interventions proven to reduce RTIs in order to meet the goals of the second Decade of Action for Road Safety.Copyright © 2022. Published by Elsevier Ltd.

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