Undoubtedly, the road transport system is one of the largest contributors to health problems in global society. Pollution and crash injuries are the largest problems, and fatalities due to crashes account for the ninth most common cause of death in all categories. Within 15 to 20 years, the WHO predicts that road crash casualties will be the third or the fourth most common cause of premature death.1 It is therefore obvious that the way the current road transport system operates is neither acceptable nor sustainable. Without doubt, the road transport system also offers benefits to society, but to a price that is unacceptable to all of us. Most people would not at all be willing to trade a person’s life for some kind of benefit. The road transport system is an open system with a large number of stakeholders, loosely connected to each other. There has not been any clear and shared idea of how the system should develop in safety terms. Instead, individual countermeasures have been implemented on an ad hoc basis and isolated from each other. Its components are not in alignment. While large parts of the system do not tolerate speeds higher than, say, 50 or 60 km/h, road users are allowed to drive at 100 km/h, and modern vehicles can easily do 200 km/h. The magnitude of the mismatch is one key factor explaining a low safety level. The road transport system also seems to lack responsibility. While the individual user has a clear legal responsibility, other important actors of the system do not. Furthermore, the possibilities for the individual to take on these responsibilities have also been marginal. The fact that it has been illegal to crash in most countries since the 1920s has probably resulted in the legal and moral blame being put on the road user. Also, prevention of crashes and injuries has the individual user as the main target. To do so with a high-energy system with large gaps between human capability and the requirements to travel safely within the system is in itself a sign of lack of responsibility from the providers of the road transport system. On the other hand, there is no one to blame among the stakeholders in the road transport system for deliberately making it unsafe. There is no winner when it comes to action or lack of action. It is however clear that there is no basic safety philosophy underlying the design and use of the road transport system that can guide all the actors to do what is necessary. There has not even been a definition of what a safe road transport system is, only what is safer. The driving mechanism for change of the safety of the road transport system has also been weak and slow. While stakeholders’ time to act in epidemics, aviation, workplace safety and other areas has been relatively fast, the time gap between identifying a problem, theoretically solving the problem and then implementing the solution in the road transport system has been extremely long. In the case of an epidemic, the time to act is sometimes less than 24 hours. In the road transport system it can take 24 years or more. One reason might be that the actions that should be made require a complicated decision process. Here the mindset sometimes has been that society should not invest in prevention unless there is a gain and at the same time those citizens and stakeholders that have not seen themselves as a part of the problem should escape unaffected by the action. Given the situation that road crashes are caused by a small minority of the population that is acting irresponsibly, the willingness to act has been weak. Understanding that we are all at risk, to a varying degree, and cannot fully control this risk, has not been a favourite subject in the past. In general, the road transport system and its stakeholders have been given the task of providing the citizen with mobility but have at the same time unintentionally generated one of the largest health catastrophes ever seen in the history of mankind. In a moral and legal sense, there has always been a citizen to blame. (Author/publisher)
Abstract