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David Sugerman, MD MPH, Emergency Medicine, Johns Hopkins Medical Institution, 600 N. Wolfe St, Marburg B-186, Baltimore, MD 21287, 443-854-9470, dsugerm1@jhmi.edu, Adnan A. Hyder, MD, MPH, PhD, Department of International Health, Division of Community Health and Health Systems, Johns Hopkins University, 615 N. Wolfe Street, Suite E-8132, Baltimore, MD 21205, Abdul Ghaffar, MD, MPH, MHA, Global Forum for Health Research, WHO, 20 avenue Appia, 1211 27, Geneva, Switzerland, and Tayyeb I. Masud, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Suite E-8132, Baltimore, MD 21205.
Objective: The 1998 Global Burden of Disease Study estimated that road traffic injuries (RTI) will become the third overall leading cause of lost DALYs (disability adjusted life years), with two-thirds of the deaths occurring in least developed nations. Moreover, automobile based transport systems are associated with air pollution (with lead toxicity, asthma, and greenhouse gas accumulation), noise disturbances, as well as physical inactivity and obesity. This study reviews road transport policies in Pakistan and their potential impacts on health outcomes; examines health policies to assess their focus on transport related health problems; reviews implemented road transport specific interventions; and identifies policy for future research.
Methods: A methodological review of the literature on direct and indirect effects of road transportation in Pakistan. This review includes government documents, memos, statements, and draft policies as well as relevant articles indexed in MEDLINE.
Findings: A systematic review revealed no approved transport policy in Pakistan, despite three national health policy documents. The Health Chapter of the 9th Five Year Plan appreciates the grave threat of unchecked RTI, but fails to offer specific policy interventions. Despite ambitious plans by the Pakistan Environmental Protection Agency, actual projects and their implementation remain scarce- resulting in ever increasing air pollution. The health impact of lead toxicity, noise pollution, and RTI remain high, while obesity is on the rise.
Conclusion: The increasing health impact of road transport on 140 million people is a call for immediate policy action. Government agencies must intervene effectively to establish monitoring and decentralized enforcement nationwide, while at the same time supporting alternative modes of transportation.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.