Table of Contents
Every day, more than 3,000 people die on the world’s roads. Some 90 percent of these deaths occur in low- and middle-income countries. Many involve young people in the prime of their lives — workers, students, young parents, and entrepreneurs whose futures are cut short in an instant. The burden of non-fatal outcomes from road traffic crashes is equally staggering — up to 50 million people are injured each year, often with debilitating and lifelong consequences.
These human tragedies also mean devastating losses for economies. And many could be avoided.
To date, efforts to reduce road traffic deaths and injuries have primarily focused on crash prevention: safer roads, safer vehicles, better driver behavior. Prevention strategies remain essential. But when road crashes happen, the strength of a country’s emergency care system often determines whether an injured person survives, whether they recover fully, and whether households fall into long-term economic hardship.
Life-saving systems
When a crash happens, every minute matters. The difference between life and death often depends on how quickly help arrives; whether critical crash-site interventions like bleeding control are delivered skillfully and in time; whether injured people are efficiently transported to a health facility; and whether that facility is equipped to provide the care they need.
Too often, links in this chain of survival are missing.
Emergency care systems in many countries remain fragmented, under-resourced, and inaccessible to large parts of the population. Ambulances may not arrive in time — or may not be available at all. Emergency call numbers may not function reliably. Hospitals may lack the staff, tools, and organization needed to provide rapid, effective care. Rural communities are often especially underserved. This means injuries that should be survivable become fatal. This includes not just road injuries, but other acute health conditions like heart attacks, workplace injuries, and obstetric complications.
In a growing number of settings, though, we’ve seen barriers to good emergency care begin to fall. Proven, cost-effective actions exist that virtually all countries can take to strengthen their emergency care systems. Investing in emergency care saves lives, reduces disability, creates new jobs at multiple skill levels, and energizes local economies. These are core messages of a new report,Saving Lives On Roads Through Emergency Care Systems, a collaborative output of the World Bank Group’s Health and Transport units.
Change on the ground
Saving Lives On Roads contributes new knowledge through its roots in country experience and its focus on implementation.
The report introduces an original operational typology that groups emergency care systems into three broad categories — nascent, maturing, and mature. The purpose is not to rank countries. Instead, the typology helps governments and implementers understand where they stand today; identify “no-regret” priority interventions for their specific context; and strategically sequence emergency care reforms.
Countries don’t need to wait for perfect systems to start saving many more lives. Progress can begin with straightforward actions that are high-impact and relatively low-cost. Train community first aid responders, as South Africa has done. Create a single universal access number for all emergency calls, as is the goal of ongoing work in Peru. Improve dispatch with digital tools, as in Uzbekistan. Expand ambulance networks through public-private partnerships, as in India’s collaboration with the non-profit GVK-EMRI.
The World Bank Group is committed to supporting countries in these efforts. We know that doing so is crucial to advance key development goals, including the Bank Group target of supporting countries to reach 1.5 billion people with quality, affordable health services by 2030.
An investment in health and development
Saving Lives On Roads delivers a compelling health and economic case for investment in emergency care systems. It recalls that, in many low- and middle-income countries, the economic burden associated with road traffic injuries is estimated at between 2 and 6 percent of GDP. That’s a heavy drag on development — and a powerful entry point for change.
Evidence shows that many emergency care interventions are highly cost-effective. Beyond their direct health benefits, they help people return to work, reduce long-term disability, and strengthen society’s resilience to crises — from mass casualty events and disease outbreaks to climate-related disasters. Countries with stronger emergency response capabilities are better equipped to protect lives and keep economies running when a crisis hits.
The economic benefits extend even further.
Expanding ambulance services, emergency response networks, referral systems, and digital health platforms creates jobs. It provides opportunities for local know-how and innovation. And it opens space for productive partnerships with the private sector in areas such as transport, logistics, medical technology, and digital solutions.
Through our work across multiple sectors — including health, transport, governance, digital development, and social protection — the World Bank Group sees emergency care systems as an essential foundation for safer roads, stronger health systems, and more resilient economies.
