Introduction In 2008 the World Health Organization undertook a global survey to assess the road safety situation in all Member States.

Aims and Methods To assess the status of road safety in the WHO European Region and provide a baseline assessment of how far countries have come in implementing the recommendations of the World report on road traffic injury prevention. The survey used a standardised questionnaire administered to multisectoral respondents.

Results 49 out of 53 States belonging to the WHO European Region took part in the survey, representing 99% of the population. In the Region, road crashes result annually in 120 000 deaths, 2.4 million injuries and a great economic burden. Vulnerable road users such as pedestrians, cyclists and users of motorised two-wheelers constitute 50 000 (or 39%) of all road traffic injury fatalities, with pedestrians being twice at risk in the eastern part of the Region compared to the western. Countries differ greatly in mortalities for road traffic injuries; the average in low- and middle-income countries is twice that in high-income countries.

Conclusions Despite the dramatic achievements in some countries, safety on the roads still remains critical in certain areas of the Region. The following actions are proposed: narrow the gap between countries with the lowest and highest mortalities; provide better protection for vulnerable road users; develop a well resourced multisectoral road safety strategy in each country; design and enforce comprehensive legislation and develop and implement healthier transport policies.