Saving Lives on Asia’s Roads

Every day, across Asia’s bustling highways and rural backroads, road crashes shatter lives in an instant. In 2021, the region bore the brunt of a staggering global toll: over 694,000 deaths due to road traffic incidents, representing nearly 60% of global road fatalities. More distressingly, road crashes are now the leading cause of death for young people aged 15 to 29 across Asia. It’s not just a safety issue—it’s a public health emergency and a long-term economic challenge.

As transport networks expand and motorisation accelerates, the cost of inaction grows steeper. Road traffic injuries now eat into national GDPs by as much as 5%, draining resources from development priorities. Despite these alarming figures, the lion’s share of attention continues to fall on prevention—better roads, stricter regulations, safer vehicles. While essential, prevention alone doesn’t address the urgent need for swift, efficient, and integrated post-crash care.

Why Response Matters

Timely post-crash intervention is the line between survival and tragedy. According to Johns Hopkins research, reducing pre-hospital response times from 25 to 15 minutes can cut fatalities by a third. But in many parts of Asia, emergency services are under-resourced and overstretched. Ambulance shortages, long distances, traffic congestion, and limited trauma facilities hamper effective care.

“Our health systems bear the brunt of road injuries, yet they remain under-equipped to handle the scale and complexity of trauma cases,” said Associate Professor Abdulgafoor M. Bachani from the Johns Hopkins International Injury Research Unit.

Improving post-crash care isn’t only about better ambulances or faster response times. It’s about building a robust system—from first aid at the crash site to comprehensive rehabilitation services—that supports survivors at every stage of recovery.

Building Resilience from the Ground Up

To ensure a comprehensive safety net, several key areas must be strengthened:

1. First Aid Management

In far-flung communities where emergency services might be hours away, bystanders are often the first responders. Investing in basic first aid training and health literacy programmes at the community level can save lives. Equipping local schools, village leaders, and public transport operators with emergency response know-how is a cost-effective, grassroots solution.

“When trained bystanders provide immediate assistance, survival rates increase significantly,” said Nishit Patel, co-author of the ADB Working Paper.

2. Integrated Emergency and Long-Term Care

Post-crash response should be seamless, not stopgap. Victims need an integrated system that begins with ambulance services and continues through to hospital care, rehabilitation, and social reintegration. However, gaps in coordination between pre-hospital and hospital care often leave patients stranded in transition.

Too often, long-term rehabilitation is either overlooked or underfunded. Yet physical therapy, psychological support, and vocational retraining are essential for a full recovery. Without this, survivors risk falling into chronic disability or poverty.

3. Surveillance Systems

Data is a powerful ally in the fight against road trauma. Comprehensive injury surveillance systems help pinpoint high-risk locations, track patient outcomes, and identify gaps in emergency care. Transport and health authorities must share data and jointly analyse trends to craft targeted, data-driven interventions.

Polin Dy Ly, a contributing researcher to the ADB paper, emphasised: “Good data enables smarter decisions. It’s how we move from reaction to prevention.”

4. Multi-Agency Collaboration

A truly effective response requires all hands on deck. Transport authorities need to design and maintain emergency access routes, especially in congested urban areas or remote rural zones. Health ministries must ensure medical infrastructure is fit for purpose, including adequate trauma centres and trained professionals.

Cross-sector collaboration also means aligning budgets, pooling resources, and creating shared action plans. Fragmented efforts waste time, money, and ultimately, lives.

“Road safety is not the sole responsibility of transport agencies. Health, law enforcement, and local governments must be equally invested in the outcome,” said Diana Marie Hernandez-Louis, one of the lead researchers.

Economic Impact and the Cost of Inaction

The financial burden of road traffic injuries is immense. Between 3% and 5% of Asia-Pacific countries’ GDPs are lost to road crashes annually. These losses stem not just from healthcare costs, but also from lost productivity, long-term disability, and the devastating ripple effects on families.

In low-income households, out-of-pocket medical expenses can push families into poverty. Without social support systems or accessible rehabilitation services, victims and their caregivers are left to fend for themselves.

Improved post-crash care isn’t just a moral imperative—it’s economic common sense.

Regional Coordination and the Road Ahead

The Asian Development Bank (ADB) has been championing a regional approach to post-crash care. The 16th Regional Environmentally Sustainable Transport (EST) Forum brought together experts, policymakers, and academics to discuss sustainable transport and health system integration.

The findings from the ADB Working Paper No. 104, led by Johns Hopkins University researchers, formed a cornerstone of these discussions. They also fed directly into the ADB’s 1st INSPIRE Health Forum, focused on building inclusive, sustainable, and resilient health systems across Asia and the Pacific.

Peter Sbirakos, one of the authors of the study, noted: “We need to embed health resilience into our broader development goals. Post-crash care is the linchpin that connects transport, health, and sustainability.”

Stronger Systems for a Safer Future

By improving post-crash response, we do more than just save lives. We create a safety net that strengthens the entire healthcare ecosystem. These systems also serve victims of natural disasters, workplace accidents, and public violence. In essence, a resilient trauma care infrastructure benefits everyone.

That means prioritising:

• Multi-level trauma systems
• Public education campaigns on road safety and first aid
• Better coordination between urban planning and emergency services
• Digital health tools for faster triage and treatment decisions

As cities across Asia continue to urbanise and motorise at breakneck speed, integrating health and transport planning is no longer optional—it’s essential.

Towards Safer, Smarter, Stronger Communities

Investing in post-crash care isn’t just about reacting better when tragedy strikes. It’s about creating a society where people feel safer on the roads, where systems are in place to catch them when things go wrong, and where recovery doesn’t come at the cost of livelihood.

Asia’s road safety crisis demands more than piecemeal reforms. It calls for a bold, coordinated movement that bridges sectors, scales solutions, and places human wellbeing at the heart of infrastructure development.

“Every minute counts. Every life matters. By aligning transport and health, we can rewrite the story of road safety in Asia,” concluded Michelle Apostol, one of the contributing researchers.