How it was developed

The development of this package was based on a framework by Justen and colleagues published in 2014, which involves six interrelated stages, namely, defining objectives and targets, creating an inventory of measures, assessing the package, modifying the package and implementing and evaluating the package.5 A meeting of 24 external experts and 5 WHO technical staff was held on 9–10 February 2016 to discuss whether there was a need to develop a road safety technical package of interventions to assist countries implement quick wins as expected in the SDG target. Consensus was reached, and the group went on to agree that the Global Plan for the Decade of Action for Road Safety 2011– 2020 should be used as a basis from which to focus messages around a smaller set of priority interventions.6 There was also consensus on the need to prioritise speed management within this package as it is considered a unifying component across all the five pillars in the global plan. The need to include quick wins in infrastructure and to ensure that the package addressed the high burden among vulnerable road users was also emphasised. A small working group of experts was constituted to develop the package. A preliminary list of over 50 ‘good practices’ was identified by WHO technical staff and reviewed by the small working group. This initial list was examined against published evidence on effective measures, in particular through systematic reviews and summary reports that have been compiled7–11 and trimmed to 44 specific interventions.

The 44 specific interventions were further reviewed by researchers and practitioners against a set of criteria on effectiveness, cost, acceptability, capacity and institutional complexity to implement, technical complexity, timescale of implementation and time from implementation of the measure to the time its effect is realised.

The effectiveness of the interventions was also examined with respect to their contribution to reducing road traffic fatalities and serious injuries and changing behaviour. Each intervention was assessed for effectiveness as follows:

• Proven: evidence from robust studies such as randomised controlled trials, systematic reviews or case–control studies shows that these interventions are effective in reducing road traffic fatalities and injuries or in bringing about desired change in behaviour.

• Promising: evidence from robust studies shows that some road safety benefits have resulted from these interventions, but further evaluation from diverse settings is required and caution is needed when implementing them.

• Insufficient: evaluation of an intervention has not reached a firm conclusion about its effectiveness because of a lack of evidence.

Feedback from the review and intense discussion within the small working group led to the list of 44 specific interventions being revised, merged and consolidated into 22 measures, which are presented in table 1.

Core components and interventions

The core components of the Save LIVES technical package are Speed management, Leadership, Infrastructure design and improvement, Vehicle safety standards, Enforcement of traffic laws and postcrash Survival (table 1). Each component of Save LIVES is associated with priority interventions that will assist road safety decision makers and practitioners in making tangible and sustained progress in reducing road traffic injuries in the next 5 years and beyond. These 6 components and 22 interventions are inter-related and need to be implemented in an integrated manner, following the Safe System approach, to effectively address the problem of road traffic deaths and injuries.