Low- and Middle-Income Countries suffer the large majority (93%) of global road crash deaths and face particular challenges in managing this crisis. This paper presents global data and trends revealing underlying features of the problem for LMICs. LMICs are commonly grouped and described together in road safety commentaries, yet appreciation of the substantial differences between LICs and MICs is vital. While global deaths per 100,000 people have stabilized during the UN Decade of Road Safety, the population rate has increased in LICs (by 8.2%), while decreasing in HIC and MIC. LICs have less resources to address road safety and younger populations adding to risk. Wide variations on road safety performance exist within country income groups, with some of this variance occurring systematically between regions. Absolute numbers of
deaths are increasing due to increasing population and increasing vehicle fleets in LMICs compared with HICs. The capacity of MICs, and especially LICs, to manage road safety is hampered by poor crash data to guide action as well less available funding and resources to achieve safer road engineering, safer vehicles, and protect the large
proportions of vulnerable road users. Road crash deaths and injuries are retarding the economic growth of LMICs and investing road safety is a costeffective means by which LMICs can move towards becoming HICs. Vital opportunities for cost-effective savings of lives and debilitating injuries in LMICs include better management of speed (especially through infrastructure), improving safety infrastructure for pedestrians, increasing seatbelt use, and shifting travel from motorcycles to buses through provision of Bus Rapid Transit systems.
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