6 QUESTIONS TO – Etienne Krug, Director of the Department of Management of NCD, Disability, Violence & Injury Prevention at WHO | May 10, 2017

From 8 to 14th of May will be held the Fourth UN Global Road Safety Week. On this occasion, the Director of the Department of Management of NCD, Disability, Violence and Injury Prevention at the World Health Organization, to share his insights on the major progresses and challenges of the Decade of action for road […]

From 8 to 14th of May will be held the Fourth UN Global Road Safety Week. On this occasion, the Director of the Department of Management of NCD, Disability, Violence and Injury Prevention at the World Health Organization, to share his insights on the major progresses and challenges of the Decade of action for road safety.


Dr Krug is Director of the Department of Management of Noncommunicable Diseases, Disability and Violence and Injury Prevention at the World Health Organization in Geneva, Switzerland. In this position he has overseen the development of major intergovernmental resolutions and ground breaking world reports, the implementation of major innovative development projects, and preparations for large global events. He chairs the International Organizing Committee for World Conferences on Injury Prevention and Safety Promotion and the United Nations Road Safety Collaboration and is member of the Editorial Board of several scientific journals.

Before joining WHO, Dr Krug was an epidemiologist at the Centers for Disease Control and Prevention in Atlanta, USA. Prior to that he worked in war torn countries for Médecins sans Frontières and the United Nations High Commissioner for Refugees. Dr Krug holds a degree as Medical Doctor from the University of Louvain in Brussels, Belgium and a Masters Degree in Public Health from Harvard University and has received many awards.


Question: We are half way through the UN Decade for Action for Road Safety, what are the main progresses you have seen since 2011?
Dr Krug: Collectively, I would say that our greatest achievement at global level has been to get road safety included in the Sustainable Development Goals. That for me was a pivotal success, because it means that Member States around the world have agreed that without road safety, people cannot be healthy and cities cannot be sustainable. Milestone events such as ministerial conferences and UN global road safety weeks have also contributed to global momentum to address this major health and development challenge. At national level, it is of course the steady, albeit often slow, progress that countries are making towards updating their legislation, improving enforcement, building safer roads and vehicles, and enhancing the emergency trauma systems which care for road traffic victims.

Question: What remain for you the biggest and emerging challenges ahead?
Dr Krug: For me, our greatest challenge remains the lack of political will in some countries to address road safety. We have the knowledge needed to tackle the problem, but the leadership is lacking to put in place the measures which would most make a difference, such as developing good legislation on key risks like speeding and drinking and driving, ensuring that those laws are fully enforced, building roads and manufacturing vehicles up to the highest safety standards, and improving our care of the injured. While it is understandable that many countries are trying to decide among a number of critical health issues often with limited resources, the responses needed to ensure greater safety on the roads are no mystery. We know what needs to be done, and governments need simply to do what’s needed!

Question: Today starts the Fourth UN Global Road Safety Week, the focus of this week is on speed management. Can you tell us what led the United Nations Road Safety Collaboration to emphasize this aspect of road safety?
Dr Krug: Globally around 1.25 million people die every year on the world’s roads and as many as 50 million people are injured. Speed is a major contributor to road traffic crashes in every country of the world. Typically 40-50% of drivers go over posted speed limits. Excessive or inappropriate speed contributes to at least one in every three road traffic fatalities in high-income countries. This percentage is probably higher in low- and middle income countries where pedestrians and cyclists – who are more vulnerable to the adverse consequences of speed – make up a greater percentage of those who use the roads. This is why the United Nations Road Safety Collaboration decided to emphasize this particular risk, because if countries address just this issue alone, there is an enormous potential to save lives.

Question: How can the different countries prioritize road safety when dealing with speed management?
Dr Krug: Countries that have had the most success in drastically reducing rates of road traffic death and injury in recent decades – Netherlands, Sweden, and the United Kingdom among them – are those that have addressed the issue holistically. They have prioritized safe speed as one of four components of the “safe system approach”, along with safe roads, safe vehicles, and safe road users. While these are the components needed to ensure that the system is safe, safe speed is elevated among these four important areas for action, because it touches on all components. For example, to ensure safe roads, you must introduce the building of roundabouts and speed bumps, thereby slowing speed; with vehicles, you ensure that cars are manufactured with technologies such as autonomous emergency braking, again slowing speed; and with road users, drivers in particular, you convince them by enforcing laws and exposing them to mass media campaigns to slow down. In this regard managing speed is central to what must be done to ensure safety on the roads.

Question: How can other stakeholders, such as international and local NGOs, support concrete changes regarding speed management?
Dr Krug: NGOs have a very important role to play in road safety in terms of their advocacy efforts including those directed towards the media, because these efforts help to generate a demand for road safety from the public. Both as the voice of road traffic victims and as managers of projects aimed at preventing road traffic crashes, NGOs help the public to understand that road traffic crashes are not inevitable, that the action needed to prevent them is imminently doable, and that they have the right to enjoy the streets of their communities in safety. With that understanding comes a demand for improved safety. In this respect the role of NGOs is crucial if we are to hold governments accountable for achieving the Sustainable Development Goal targets linked to road safety.

Question: Handicap International has developed road safety programs in various countries, working on capacity building for local stakeholders, data collection & analyses, awareness raising on main risk factors with a strong focus on vulnerable users. What is for you the added value of this work on this aspect of road safety and what are your recommendation for our organization ? Where do you think our real added value is at country level?”.
Dr Krug: Handicap International has a wonderful reputation globally. Its voice speaks with authority in the countries where it operates. Its programmes are evidence-based and have led to significant results in many countries such as Cambodia, where I had the opportunity to visit its road safety programmes. If the organization could use its power of persuasion to convince more policy-makers to address their road traffic injury problem, by making them understand that the solutions are feasible, that would be a great service. Highlighting in particular the plight of those who are most vulnerable – pedestrians, cyclists, and users of public transport among them – is of particular value as the world looks to creating cities and towns which are more liveable and sustainable, so the organization should certainly continue to focus on those who most need to be protected.



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