Bloomberg Philanthropies Releases Midway Status Report; Evaluates Global Road Safety Program Interventions.  To view the complete report from Bloomberg Philanthropies, please click here.

A groundbreaking Global Road Safety Program in ten countries funded by Bloomberg Philanthropies produced results showing that 1.6 billion people are now covered by strengthened road safety laws, Mayor and philanthropist Michael R. Bloomberg announced today. The initiatives include increased seat-belt and helmet usage, reduced speed limits, drinking and driving enforcement, and improvements in road infrastructure and sustainable transport.

Bloomberg Philanthropies released its first progress report on its Global Road Safety Program, a five-year, $125 million investment to reduce preventable road traffic deaths and injuries. It is projected that at least 12,670 lives will be saved in five years based on the program’s early accomplishments in target countries: Brazil, Cambodia, China, Egypt, India, Kenya, Mexico, Russia, Turkey and Vietnam.

The Association for Safe International Road Safety (ASIRT), EMBARQ, Global Road Safety Partnership (GRSP), Johns Hopkins Bloomberg School of Public Health (JHBSPH), World Bank Global Road Safety Facility (GRSF), and World Health Organization (WHO) are all partners in the Global Road Safety Program.

Each year, road traffic crashes kill 1.3 million people and between 20-50 million suffer severe injuries. By 2030, the World Health Organization estimates that road traffic fatalities will be the fifth leading cause of death globally.

“The success we have had through our road safety program is saving lives around the world, but there is still more work to be done,” said Michael R. Bloomberg. “We look forward to spreading our efforts and contributing to the Decade of Action to reduce preventable road traffic deaths and injuries.”

In 2010, the UN General Assembly proclaimed the UN Decade of Action for Road Safety 2011-2020 in a landmark Resolution co-sponsored by 100 countries to “stabilize and then reduce” global road traffic fatalities. The Bloomberg Global Road Safety Program strives to accelerate progress on the Decade of Action. Results suggest the program initiatives are a major step forward toward global progress on road safety.

2010-2012 Bloomberg Program Highlights from 10 focus countries:

1. 1.6 billion people now covered by new or strengthened road safety laws

2. 13,300 police and public health officials trained on road safety interventions

• Police officers are trained on enforcement of road safety laws and how to set up safe checkpoints
• Health professionals are trained on trauma response
• Police forces and hospital staff are trained on proper data collection

3. $440 million committed by governments to make road improvements

4. 5,500 miles of high-risk roads have been assessed with improvements recommended to governments

5. 12 media campaigns were initiated reaching 65 million people

Examples of early successes include:

Seat-Belts: Wearing a seat-belt reduces the risk of fatality among passengers in the front seat by 40-50% and 25-75% for those in the back seat. One target country where Bloomberg has been working to increase seat-belt usage is Turkey, where federal law does not require commercial or government vehicle drivers to wear seat-belts.

However, the Governor of Afyon, Turkey issued a local decree in 2012 mandating all drivers to wear seat-belts. Seat-belt usage in Afyon jumped from 4% in 2011 to 49% in 2012.

Speed: Higher speeds lead to an increased risk of a crash and greater probability that someone will be killed or seriously injured.

Following a strong social marketing campaign and increased police enforcement, speeding rates decreased from 32% in 2011 to 9% in 2012 in Dalian, China, and from 47% in 2011 to 33% in 2012 in Lipetsk, Russia.

Drinking and Driving Enforcement: Drinking and driving increases both the risk of a crash and the likelihood that a death or serious injury will occur. The risk of involvement in a crash increases significantly with a blood alcohol concentration above .04%.

In Phnom Penh, Cambodia, following a strong social media campaign and increased police enforcement, drinking and driving rates dropped from 10% in 2010 to nearly 0% in 2012.

Helmets: Wearing a helmet is the single most effective way of reducing head injuries and fatalities resulting from motorcycle crashes, as it decreases the risk of injuries by 70% and deaths by 40%.

The Kenya Bureau of Standards has recently adopted internationally recognized motorcycle helmet quality standards, another critical component of helmet wearing laws.

Bloomberg Philanthropies is committed to creating healthier, safer lives across the globe, and the road safety program focuses on 10 low-and middle-income countries that account for close to half of the 1.3 million road traffic deaths each year. Ninety percent of road traffic deaths occur in low- and middle-income countries and globally half of all deaths are among pedestrians, bicyclists and motorcyclists.

Bloomberg’s program is rooted in the belief that road traffic deaths are preventable with effective, evidence-based interventions, such as increased seat-belt and helmet use, speed reduction, and decreased drinking and driving. The program also focuses on safe sustainable urban transport – achieved by reducing car travel and moving people through safely designed mass transportation and improving high-risk roads through infrastructure improvements including widening shoulder lanes, installing medians, crosswalks and lane markings. Strategies also include support for public efforts to implement effective road safety laws, enhance professional training to enforce laws, create resources for advocacy and hard-hitting mass media campaigns.

Today, Bloomberg Philanthropies announced a new investment in an innovative maternal health program in Tanzania that is projected to impact at least 50,000 mothers and their children over the next three years.  Today’s investment brings the total commitment to $15.5 million since late 2006.  The program is a partnership with Geneva-based H&B Agerup Foundation and operates in close consultation with the Tanzanian Ministry of Health and Social Welfare. It is implemented by the World Lung Foundation and is evaluated by the Centers for Disease Control and Prevention (CDC), in partnership with the CDC Foundation.

More than 100 local non-physician clinicians including assistant medical officers and nurse midwives in Tanzania’s most isolated areas have been trained to perform life-saving procedures including caesarean sections since the program began. The number of maternal deaths from bleeding and other complications in Tanzania have been reduced; in one district alone, maternal deaths declined by 32% in less than 2 years due to the project.

To date, more than one thousand babies have been delivered by c-section in villages where women previously had to travel several hours to receive care – often when it was too late. Women in Tanzania deliver an average of 5.5 children in their lifetime, meaning every mother’s life saved not only impacts her and her newborn but also the well-being of her other children.

Tanzania has the eighth highest number of maternal deaths in the world; a woman dies from complications of pregnancy and childbirth almost every hour in Tanzania.

According to the United Nations, almost 300,000 women die globally from pregnancy and childbirth every year. For every woman that dies, another 20 suffer an injury, illness or disability, often with life-long consequences.  

99% of maternal deaths occur in developing countries with over half of these in Sub-Saharan Africa.  Tanzania has the fifth highest number of maternal deaths in Sub-Saharan Africa.

Access to comprehensive emergency obstetric services can prevent most maternal deaths, yet women continue to die because there are few facilities with skilled personnel and the distances are long. The crux of the Bloomberg Philanthropies Maternal Health Program is the decentralization of life-saving health care services to the level of the village, where it is needed the most. The approach has two components:

1) Upgrading Infrastructure
Almost every community in Tanzania has access to a health care center that can provide basic health care services. The Bloomberg Maternal Health Program has upgraded these health centers by constructing operating rooms and other critical infrastructure needed for comprehensive emergency obstetric care.

2) Training healthcare workers
Most remote communities of Tanzania do not have a medical doctor, and obstetricians are almost non-existent in rural areas. Tanzania was an early adopter of a practical solution known as “task-shifting” which allows non-physician clinicians to provide health care services. Non-physician clinicians are much more likely to work in isolated communities than doctors. Recognizing this, our program trains non-physician clinicians - called Assistant Medical Officers (AMO) - to manage complicated deliveries, including caesarian sections, and nurse midwives to administer anesthesia.

The United Nations’ Millennium Development Goal (MDG) 5 calls for a 75% reduction in maternal mortality rates by 2015. At the current rate of progress, Tanzania is not on track to reach MDG 5. Our program strives to accelerate progress and early results suggest we are headed in the right direction. We are showing that women will use life-saving medical treatments and facilities when they are easily accessible and provide high-quality care.

So far:

1. Nine extremely remote heath centers have been upgraded. Prior to the program, patients had to travel 3-4 hours to the nearest hospital.  Now, emergency obstetric care is available in the community.
2. More than 100 non-physician clinicians have been trained in comprehensive emergency obstetric care or anesthesia.
3. Health center utilization for delivery care has increased substantially, from about 3,500 deliveries per year in all 9 health centers prior to the program to about 9,000 in 2011 after the intervention.
4. More than 1,000 c-sections have been performed.
5. The Ulanga district, one of 7 districts where the program is operating, saw a 32% decline in maternal deaths after the program was implemented.
6. Conservative projections show that at least 50,000 women and children will be impacted by our work.