2004, Year of Europe
Europe, a common ideal
May 1 2004 will be an historic date for
Europe. The addition of ten new member states to the European family, to be followed
shortly by Bulgaria and Romania in 2007, will establish the unification of the continent
of Europe. France is delighted at this - it extends a warm welcome and friendship to its
new partners and intends to weave close and trusting bonds of cooperation with each of
them.
Noëlle Lenoir, Minister of State for
European Affairs
With this enlargement Europe enters a new
era, one of rediscovered unity. But this prospect also requires us – and this is an
opportunity – to take up four big challenges.
First, the institutional challenge - the
ability of the Union to make decisions must not only be preserved, it must be increased.
Twenty-five or twenty-seven of us cannot take decisions as efficiently as we did when we
were fifteen. What is at stake in the draft European constitution currently under
discussion is giving an enlarged Europe the new rules that will permit member states to
carry out projects together that are both practical and ambitious in the service of
European citizens. I hope that such a constitutional text, full and approved by all the
governments, can be quickly presented to the people of the Union. A stable president of
the Council, a strong Commission, capable of representing and defending the general
interest of Europeans, a European Minister of Foreign Affairs, a European Parliament in
step with public opinion, extension of the range of decisions taken by qualified majority
voting are the principal elements that should consolidate the architecture of Europe and
give it the resilience it needs.
The second requirement is economic and
financial. If the enlargement of the Union is to succeed, the emergence within it of a gap
between a rich West and a less developed East has to be avoided. Indeed, this solidarity
is Europe’s primary purpose, which must now lead us to organise the "economic
catching-up process" of the acceding countries and candidate countries. This process
has, of course, in many ways already begun, through the solidarity initiatives of western
Europe and the investment of private economic players, but it must be continued. Here we
have one of the main challenges for the negotiations on the financing of the Union for the
period 2007-2013 - to strengthen the economic and social cohesion of the whole of Europe,
in the interest of all its members, whilst controlling the burden for European taxpayers.
A centre of influence and prosperity
The third imperative is to develop a common
culture in the area of diplomacy and defence policy. We are well aware that Europe offers
a unique model of democracy and progress and that it carries its values beyond its
borders. By contributing to peace, stability and justice in the world, it must establish
itself as a true centre of influence and prosperity. Its common foreign and security
policy already plays a considerable role in several regions of the world and in many
domains - it is the architect of stabilisation in the Balkans, it is active in the Near
East and has been a strong supporter of the creation and implementation of the
International Criminal Court. These achievements are precious; they should allow us to go
further - a European strategy on security is in the process of being drawn up; we are
looking together into the establishment of close partnerships with our "new
neighbours" in the East and South; new proposals are being made to strengthen
European defence, an indispensable tool for a strong, respected and independent foreign
policy.
Last but not least, we must renew and extend
the efforts that are put into bringing people together. Too long separated by the Iron
Curtain, our societies of East and West do not know each other well enough. Involving
civil societies through the development of town twinning projects is a promising way
forward; but I would also like to see the creation of a genuine educational arena in
Europe, allowing young people to enrich their knowledge of the diversity of European
cultures.
I am confident that together we will be able
to meet these various challenges. Already Europe is asserting, as never before since its
creation half a century ago, its values of liberty, respect for the law, justice and
tolerance. It has to be a voice that is heard in the world. The enlargement of the
European Union, to which France continues to be fully committed, will, I am sure, rekindle
European enthusiasm and give new impetus to our common ideal. (Label France, magazine N°
53 – January 2004)
Road Safety is No Accident
Road traffic injuries are a major but
neglected public health challenge that requires concerted efforts for effective and
sustainable prevention. Of all the systems with which people have to deal every day, road
traffic systems are the most complex and the most dangerous. Worldwide, an estimated 1.2
million people are killed in road crashes each year and as many as 50 million are injured.
Projections indicate that these figures will increase by about 65% over the next 20 years
unless there is new commitment to prevention. Nevertheless, the tragedy behind these
figures attracts less mass media attention than other, less frequent types of tragedy.
A public health concern
Every day around the world, more than 3000 people die from
road traffic injury. Low-income and middle-income countries account for about 85% of the
deaths and for 90% of the annual disability-adjusted life years (DALYs) lost because of
road traffic injury.
Projections show that, between 2000 and 2020, road traffic
deaths will decline by about 30% in high-income countries but increase substantially in
low-income and middle-income countries. Without appropriate action, by 2020, road traffic
injuries are predicted to be the third leading contributor to the global burden of disease
and injury.
The social and economic costs of road traffic
injuries
Everyone killed, injured or disabled by a road traffic crash
has a network of others, including family and friends, who are deeply affected.
Globally, millions of people are coping with the death or
disability of family members from road traffic injury. It would be impossible to attach a
value to each case of human sacrifice and suffering, add up the values and produce a
figure that captures the global social cost of road crashes and injuries. The economic
cost of road crashes and injuries is estimated to be 1% of gross national product (GNP) in
low-income countries, 1.5% in middle-income countries and 2% in high-income countries. The
global cost is estimated to be US$ 518 billion per year. Low-income and middle-income
countries account for US$ 65 billion, more than they receive in development assistance.
Road traf.c injuries place a heavy burden, not only on global
and national economies but also household finances. Many families are driven deeply into
poverty by the loss of breadwinners and the added burden of caring for members disabled by
road traffic injuries. By contrast, very little money is invested in preventing road
crashes and injuries.
Comparatively little is spent on
implementation, even though many interventions that would prevent crashes and injuries are
well known, well tested, cost-effective and publicly acceptable.
Changing fundamental perceptions
Since the last major WHO world report on road safety issued
over 40 years ago there has been a major change in the perception, understanding and
practice of road injury prevention among traffic safety professionals around the world.
The predictability and preventability of road crash
injury
Historically, motor vehicle
"accidents" have been viewed as random events that happen to others and as an
inevitable outcome of road transport. The term "accident", in particular, can
give the impression of inevitability and unpredictability – an event that cannot be
managed. This is not the case. Road traffic crashes are events that are amenable to
rational analysis and remedial action. In the 1960s and early 1970s many highly-motorized
countries began to achieve large reductions in casualties through outcome-oriented and
science-based approaches. This response was stimulated by campaigners including Ralph
Nader in the United States of America and given intellectual strength by scientists such
as William Haddon Jr.
The need for good data and a scientific approach
Data on the incidence and types of crashes as
well as a detailed understanding of the circumstances that lead to crashes is required to
guide safety policy. Knowledge of how injuries are caused and of what type they are is a
valuable instrument for identifying interventions and monitoring the effectiveness of
interventions. However, in many low-income and middle-income countries, systematic efforts
to collect road traffic data are not well developed
and underreporting of deaths and serious
injuries is common. The health sector has an important role to play in establishing data
systems on injuries and the effectiveness of interventions, and the communication of these
data to a wider audience.
Road safety as a public health issue
Traditionally, road safety has been assumed
to be the responsibility of the transport sector. In the early 1960s many developed
countries set up traffic safety agencies, usually located within a government’s
transport department. In general, however, the public health sector was slow to become
involved. But road traffic injuries are indeed a major public health issue, and not just
an offshoot of vehicular mobility. The health sector would greatly benefit from better
road injury prevention in terms of fewer hospital admissions and a reduced severity of
injuries. It would also be to the health sector’s gain if – with safer
conditions on the roads guaranteed for pedestrians and cyclists – more people were to
adopt the healthier lifestyle of walking or cycling, without fearing for their safety. The
public health approach to road traffic injury prevention is based on science. It draws on
knowledge from medicine, biomechanics, epidemiology, sociology, behavioral science,
criminology, education, economics, engineering and other disciplines. While the health
sector is only one of many bodies involved in road safety, it has important roles to play.
These include: • discovering, through
injury surveillance and surveys, as much as possible about all aspects of road crash
injury – by systematically collecting data on the magnitude, scope, characteristics
and consequences of road traf.c crashes; • researching the causes of traffic crashes
and injuries, and in doing so trying to determine: — causes and correlates of road
crash injury, — factors that increase or decrease risk, factors that might be
modi.able through interventions; • exploring ways to prevent and reduce the severity
of injuries in road crashes by designing, implementing, monitoring and evaluating
appropriate interventions; • helping to implement, across a range of settings,
interventions that appear promising, especially in the area of human behaviour,
disseminating information on the outcomes, and evaluating the cost-effectiveness of these
programmes; • working to persuade policy-makers and decision- makers of the necessity
to address injuries in general as a major issue, and of the importance of adopting
improved approaches to road traf.c safety; • translating effective science-based
information into policies and practices that protect pedestrians, cyclists and the
occupants of vehicles; • promoting capacity building in all these areas, particularly
in the gathering of information and in research.
Cross-sectoral collaboration is essential here, and this is
something the public health sector is in a good position to promote.
Road safety as a social equity issue
Studies show that motor vehicle crashes have a
disproportionate impact on the poor and vulnerable in society. Poorer people comprise the
majority of casualties and lack ongoing support in the event of long-term injury. They
also have limited access to post-crash emergency care. In addition, in many developing
countries, the costs of prolonged medical care, the loss of the family bread winner, the
cost of a funeral, and the loss of income due to disability can push families into
poverty. A large proportion of the road crash victims in low-income and middle-income
countries are vulnerable road users such as pedestrians and cyclists. They bene.t least
from policies designed for motorized travel, but bear a disproportionate share of the
disadvantages of motorization in terms of injury, pollution and the separation of
communities. Equal protection for all road users should be a guiding principle to avoid an
unfair burden of injury and death for poorer people and vulnerable road users. This issue
of equity is a central one for reducing the global burden of road crash death and injury. |
