Background Many Low-Income Countries (LICs) are currently turning towards the Safe Systems Approach (SSA) in their road safety efforts. The SSA, in principle, requires the road systems to be designed in such a way that the physical and cognitive limitations of road users are taken into account. Although this approach provides a universally applicable strategy, it is, however, inadequate to address the inherent inequities and injustices in road safety. The health, and socio-economic impacts of road safety problems in LICs primarily affects low income groups, women and vulnerable groups such as children, and the youth. Unlike fatalities and injuries in the road system, road safety inequities have causes that go beyond the mere transfer of kinetic energy. Addressing current inequities, therefore, primarily requires understanding the social, economic, cultural, and political factors and processes that have historically contributed the inequitable and unfair exposure of vulnerable groups of road users.

Objective The objective of this study is to explore the socio-economic, cultural and political factors and process that create and perpetuate inequity and injustice in road transport and safety work, with a particular emphasis on the case of Ethiopia.

Methods The study uses a triangulation of different methods ranging from literature review analysis, policy content analysis, and argumentation analysis.

Results Road safety problem in Ethiopia primarily affects the poor and vulnerable who are neither direct beneficiaries from car transport nor major decision makers in transport policy planning. There are major gaps related to interventions, funding and legal frameworks that mitigate the risks these groups face. There is also a strong social and cultural value associated with car ownership, even when the health and socio-economic costs are born disproportionately by the poor and the vulnerable. There is low social activism and public demand for better safety. Road safety is not a key concern for political activists and parties competing for political power.

Conclusion Addressing inherent inequities in road safety in LICs requires identifying and correcting cultural, socio-economic and political systems and values that have historically tolerated the unfair and inequitable exposure of the poor and vulnerable to road crash risks.