EVERY THREE minutes and a half, according to the calculations of the Indian government, one of its citizens is killed in a traffic accident. This represents 150,000 people per year. But in all likelihood the carnage is much worse: the World Health Organization (WHO) estimates that there are 300,000 road deaths in India each year, more than there are people in Barbados. It is not just a function of India’s huge population. China has roughly the same number of people, but its authorities only count 58,000 deaths each year. In fact, India, home to just 10% of the world’s registered vehicles, accounts for 22% of road deaths, the World Bank estimates, using WHO data. It is a daily massacre, which takes place in full view of the public but which causes little consternation.
It’s no secret that the roads of India are chaotic. Drivers ignore lane markings; traffic lights are considered purely indicative; pedestrians weave through fast-paced traffic and the main safety measure is the incessant sound of the horn. It’s not just cars. Overloaded trucks, rickety auto rickshaws, scooters and roaring motorcycles jostle for space, as do various forms of ranching. On many city streets, vendors take up half the road space while on some older highways it is not uncommon for people to drive on the wrong side of the road.
The chaos reflects a structural problem. In the poorest countries, there are few vehicles, which drive slowly on bad roads. This means relatively few deaths relative to the population, although safety standards may be low. Wealthy places can afford to invest in security and have the administrative capacity to enforce strict traffic rules, with well-equipped (and well-paid) police and the latest technology. Poor but fast-growing countries, on the other hand, have plenty of vehicles, and even some decent roads, but don’t spend much money or attention on safety. It is in these places that road deaths are the highest.
The lack of investment in security has three main aspects. The first is the basic infrastructure of roads and cars. Many vehicles are old and lack essentials such as seat belts, let alone airbags. Many roads do not have proper markings or safety barriers. Sidewalks, to keep pedestrians away from traffic, are rare.
The “fundamental problem”, says Madhav Pai of the World Resources Institute, an American research group, is that road design in many poor countries is modeled after the rich world, where cars and trucks make up the vast majority of traffic . But in India, motorcycles and scooters account for 70% of vehicles in many cities. They are 30 times more likely to be in an accident than a car. Yet Indian roads make no effort to accommodate two-wheelers, such as designating separate lanes for them.
A second flaw is education. A 2017 survey suggested that six out of ten Indian drivers had failed to pass a driving test to obtain their licence. It has since become more difficult to reimburse transport authorities, but that still leaves millions of drivers who obtained their papers through corruption. In any case, driving tests are often a charade. Worse still, 37% of truckers, who are supposed to have specialized skills to operate their large vehicles, admit to not having received any formal training before obtaining a license.
The third big gap concerns health care. Once an accident occurs, the injured are much more likely to die than in a wealthy country. Official estimates suggest that half of those killed could have been saved had they received medical assistance in time. But emergency services are scarce outside cities. Hospitals are running out of beds for trauma patients. The doctor/population ratio, less than one per 1,000 people, is lower than neighboring Sri Lanka and Pakistan, let alone Germany or Japan.
Poor men of working age are most at risk. They are more likely to be injured and tend not to have health insurance. The quality of care in public hospitals is low, but the bills for even basic private care can plunge poor households into shortages. In 2019, the World Bank estimated the annual cost of traffic crashes to the economy, including lost future production from those killed, at $172 billion, or 7.5% of GDP at the time.
The Indian government is not blind to the scale of the problem. It has set itself the target of halving the number of road accidents between 2020 and 2030. It has introduced heavy fines and prison sentences for common traffic violations, including driving in a state intoxicated, underage or without proper license plate. Drivers of scooters or motorbikes now risk having their licenses suspended if they are caught without a helmet. A Good Samaritan law ensures passers-by won’t be harassed by police or asked to pay hospital bills if they help accident victims.
Unfortunately, these changes have yet to yield results. Two years after the introduction of the new protections for those who offer help, a study has found that almost 60% of these people say they are still being questioned by the police. Bareheaded scooter riders remain legion, often accompanied by equally unprotected spouses and children.
Improving roads, health care and driver training will take a generation. But there are much faster fixes that can start reducing deaths immediately. A little over a decade ago, Tamil Nadu, a state at the southern tip of the country, created a road accident database. This has allowed local authorities to set up emergency care centers near the most dangerous locations, drastically reducing response times after accidents. Thanks in part to these changes, annual road deaths in the state fell by a quarter in the five years before the pandemic.
Civil society groups have pioneered similar approaches. Piyush Tewari started SaveLife Foundation, a nonprofit focused on road safety in New Delhi, after his teenage cousin was killed in a hit-and-run accident. The group identified the most dangerous sections of road and set about collecting detailed information on the causes of accidents. Investigators employed by the foundation go to the site of an accident to speak to the families of the victims and get their hands on CCTV footage.
On a 100km stretch between Mumbai and Pune, the two largest cities in the wealthy western state of Maharashtra, SaveLife researchers identified 3,500 security gaps and worked with authorities to address them. Some changes were as simple as replacing faulty guardrails or moving decorative flower pots from the sidewalk. Others were more complicated. Ambulances were put on standby on the riskiest stretches of road. Road signs have been put up on tight bends. Sections of road have been resurfaced to make cars rumble if drivers doze off and start veering into the pavement. Highway fatalities fell from 151 in 2016 to just 66 in 2020, a number that would have been only slightly higher without the pandemic. The whole effort cost between $18 and $20 million. Comprehensive improvements in driver training, infrastructure and health care can take time, but focusing attention on the deadliest places can quickly save many lives. ■
