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Death on the road to international development

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  • Anna Cronin (PCT North West)
    For info Anna BMJ 2005;330:972 (23 April), http://bmj.bmjjournals.com/cgi/content/full/330/7497/972?etoc reviews PERSONAL VIEWS Death on the road to
    Message 1 of 1 , Apr 22, 2005
      For info


      BMJ 2005;330:972 (23 April),

      Death on the road to international development

      We don't know much about her. All we know is that in 2003 a small Tanzanian
      girl died after having been run over by a truck, a truck belonging to a
      company managed by CDC (formerly the Commonwealth Development Corporation,
      and now wholly owned by the Department for International Development of the
      UK government). According to CDC records the girl did not die at the scene,
      but "following poor care she died in the hospital 3dayslater."

      CDC's mission is to create wealth in emerging markets, particularly poorer
      countries, by investing in "sustainable" private sector businesses. In 2003
      CDC made a pretax profit of £45m ($85m; 65m), some £15.6m of which was made
      from its investment in Africa.

      Last year I gave a lunchtime seminar on road safety to CDC managers. Before
      the seminar I was given a summary of the fatal "accidents" attributable to
      CDC managed businesses in 2003. The Tanzanian girl was not the only child to
      have died on the road to international development in 2003. The same year a
      two year old Tanzanian child was crushed to death by a tractor, and in
      Swaziland, a contractor's truck struck and killed a child on his way to

      CDC records show that there were 13 fatal injuries "directly attributable to
      the work activities of the CDC group," about half of which were traffic
      related injuries. But these are just the deaths that we know about. Road
      deaths are notoriously under-reported in low and middle income countries.
      Studies have found that the actual numbers of road deaths can be four times
      as high as the figures shown in police statistics, and the number of serious
      injuries is almost 75 times higher. Moreover, death is just the tip of the
      injury iceberg. For each death there are about 15 injuries requiring
      hospitalisation and 70 minor injuries.

      According to Richard Laing, chief executive of CDC, only fatal injuries are
      reported to head office in London. Nevertheless, none of the deaths were
      mentioned in the 2003 annual report. All the report says is that CDC
      requires the companies in which it invests to observe "minimum standards in
      relation to health, safety and social issues." For some children these
      minimum standards were not enough.

      It is immoral for the Department for International Development to continue
      to pay insufficient heed to the human cost of transport

      Captains of industry are excited about international trade because of its
      potential to increase profits. It is more profitable to run businesses in
      poor countries, where wages are low, than in rich countries, where workers
      enjoy decent wages and reasonable standards of health and safety. All that
      is required is cheap transport-which means adequate roads, preferably paid
      for by the public, cheap fuel, and victims who pay the human cost of road
      death and injury. If businesses had to pay the full social and environmental
      costs of transport then trade would be much less efficient and they would
      show little enthusiasm for it. Fortunately for business, ordinary people pay
      much of the costs, so that business in Africa is lucrative. For CDC this
      means a "positive fund performance" of around 20%. But what has all this got
      to do with international development? According to the World Health
      Organisation the economic losses associated with traffic injuries in
      developing countries is close to 2% of their combined gross domestic
      product, nearly $100bn, twice as much as all overseas development
      assistance. Every year in Africa 200 000 people are killed on the roads and
      millions seriously injured. These losses only serve to inhibit development
      and perpetuate poverty.

      So what is the Department for International Development doing about all
      this? According to the secretary of state for international development, the
      department's response to the global road safety crisis is to provide funding
      for the Global Road Safety Partnership. This partnership, the brain child of
      the World Bank, brings together over 70 private sector and governmental
      organisations to improve road safety around the world. The partnership
      includes corporate giants such as the car makers Ford, DaimlerChrysler, and
      Volvo, and the drinks multinationals Bacardi-Martini and United Distillers.
      Are these the socially responsible, philanthropic organisations that will
      bring road safety to Africa, or has the department put the fox in charge of
      the chickens?

      According to Joseph Stiglitz, former chief economist at the World Bank,
      globalisation has been brought about "by the enormous reduction of costs of
      transportation and communication." But have the costs of transportation
      really fallen or have they merely been externalised? The human cost of
      transport is not paid by global business but by Africans. And the cost is
      staggering. A recent report by the World Health Organization and World Bank
      shows that the WHO African region had the highest road traffic death rate in
      2002, estimated at 28.3 per 100 000 population ( World Report on Road
      Traffic Injury Prevention. Geneva: World Health Organization, 2004) and it
      is projected that the number of road traffic fatalities in sub-Saharan
      Africa will increase by 80% between 2000 and 2020. Creating wealth in poorer
      countries is a noble aim but it is immoral for the Department for
      International Development to continue to pay insufficient heed to the human
      cost of transport.

      Ian Roberts, professor of epidemiology and population health
      London School of Hygiene and Tropical Medicine Ian.Roberts@...
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