Road traffic accident related deaths now claim more young African lives than malaria or HIV, yet the crisis remains ignored. Experts say it’s time to treat road safety as a development emergency, not an afterthought.
A hidden epidemic looms in plain sight. For more than three decades, children and young people across Africa have fallen victim to something far deadlier than most assume: road traffic crashes. This persistent scourge threatens both the health and wealth of the continent, yet remains neglected in global health and development discussions. Without urgent action, it risks undercutting Africa’s greatest asset, her youth, and her future.
Globally, road crashes now kill more people than HIV, tuberculosis, or malaria, amounting to 1.3 million deaths each year. They are the leading cause of death for people aged 5 to 29. Yet progress is uneven. While many regions have reduced fatalities, Africa stands out as the only continent where road deaths have risen sharply over the past decade. According to the WHO’s Global Status Report on Road Safety, between 2010 and 2021, road traffic death rates in Africa increased by roughly 17 percent, even as global rates declined.
This is deeply alarming for Africa’s development trajectory. The United Nations projects that Africa will remain the world’s youngest region, and the only one where population growth will continue strongly through 2050, even as other continents age. Nearly half of Africans are under 20, a youthful population that could power the continent’s long-awaited “demographic dividend” – a window in which a growing share of citizens enter productive working ages, fueling economic growth and prosperity. But road crashes threaten to derail that promise. Protecting this generation on the roads is not only a health or transport concern; it is a development imperative central to Africa’s future prosperity and stability.
At the household and community level, road crashes trigger catastrophic health costs, take breadwinners out of work, and often force families to sell assets. They interrupt children’s education and overwhelm already strained health systems. On a macroeconomic scale, road crashes are projected to cost the global economy $1.8 trillion between 2015 and 2030. Conversely, by investing in safer roads in line with UN targets, countries could see GDP per capita rise by between 7 and 22% over 24 years.
Beyond the harrowing human and financial toll lies a broader development crisis. Road safety cuts across the heart of the Sustainable Development Goals. At least five of the 17 SDGs, from ending poverty and ensuring healthy lives (SDGs 1 and 3) to providing quality education (SDG 4), building resilient infrastructure (SDG 9), and making cities safe and inclusive (SDG 11) depend on safer roads. Crashes directly undermine progress in all these areas by pushing families into poverty, disrupting education, and limiting mobility for work and opportunity.
The global community pledged under SDG 3.6 to halve road traffic deaths and injuries by 2030. Yet at the current pace, there is less than a five percent chance of achieving that target. Failing to act decisively on road safety means failing on development itself. For every life lost on Africa’s roads, a piece of its future potential is lost too.
This month marks International Walk to School Month, a global campaign promoting “active mobility,” such as walking, cycling, and other non-motorised travel, for its health and environmental benefits. In many high-income, car-dependent countries, it encourages children to walk again in the face of rising motorisation and urban sprawl. But in much of Africa, walking to school is not a lifestyle choice; it is a necessity, shaped by limited access to school transport or private vehicles. While walking is healthy, it exposes children to deadly traffic and other hazards that often outweigh its benefits.
To make walking truly “active by design” – and not by default, it must be made safe. That requires thoughtful urban planning, protective infrastructure, and environments built for safety, not speed.
The good news is that we already know what works. The “Safe System” approach, developed in the late 1990s, designs roads, vehicles, and speeds around human vulnerability rather than human error. While older approaches focused on policing, fines, and driver education, the Safe System model asserts that no loss of life on the road is acceptable, and that safety responsibility lies not only with road users but also with those who design and manage road systems.
This places a duty on governments and municipalities to provide leadership, investment, and accountability, to design entire systems for safety. Practical, low-cost measures such as traffic calming around schools, protected walkways, upgraded intersections, and improved post-crash care have proven effective worldwide. Crucially, these interventions must be adapted to African contexts, integrating local knowledge and community resources.
The recently launched ROADKids Study is an encouraging example of African and international collaboration in action. This partnership, between the University of Zimbabwe, the University of Oxford, Muhimbili University of Health and Allied Sciences, and the London School of Economics and Political Science, seeks to operationalise the Safe System model in Zimbabwe and Tanzania. The study aims to strengthen injury data, assess the economic impact of crashes, and identify practical ways to build safer roads and improve emergency response.
Similar initiatives are emerging across the continent and must be supported and scaled through national budgets and regional financing, ensuring that every child can travel to school and return home safely.
If neglected, Africa faces a new and terrifying epidemic of injury and violence that will stunt growth and deepen poverty. But the opposite is also true: by investing in safer roads, Africa invests in her people, her productivity, and her promise. Every road made safe is a pathway to opportunity, and every life saved is a step closer to the Africa we all hope to see.
Written by Dr Dennis Mazingi
Dr Dennis Mazingi is a medical doctor and general surgeon specialising in paediatric injury prevention and global surgery. He is a postdoctoral researcher at the University of Oxford’s Nuffield Department of Surgical Sciences, focusing on improving surgical and injury care for children in low- and middle-income countries.
