Following the publication of the World Health Organisation's 'World Report on Road Traffic Injury Prevention' in 2004, this document presents guidelines to help low- and middle-income countries develop measures to reduce the economic and social costs associated with road accidents. The guidelines promote a 'Safe System' approach to road safety which can be applied to any country but are particularly related here to low- and middle-income countries. The six main World Report recommendations, which identified the strategic initiatives necessary to improve country road safety performance, are first set out. It is suggested that in order to implement the recommendations, capacity building at the global, regional and country levels is required to create the resources and tools necessary. At the country level institutional management functions are considered to be particularly important with a focus on results. The conduct of a safety managementcapacity review is seen as a necessary first step and procedures for carrying this out are outlined. From the capacity review the development of a long-term investment strategy, Safe System projects and lead agency strengthening are then described. Detailed case studies from countries with examples of good practice (New Zealand, Great Britain, the Netherlands, Sweden and the two Australian states of Victoria and Western Australia) and from transitional countries (Malaysia and Poland) are presented in annexes.