Reflectors could reduce road deaths ninefold, says Global Forum for Health Research

4500 secondary school pupils in Arusha, United Republic of Tanzania, a small tourist town in sight of Mounts Meru and Kilimanjaro, are to receive 5 cm-square plastic yellow reflectors to tie on their arms or pin on the backs of their clothes. These will help reduce accidents in which they are injured or killed by walking on the roads in the dark.

The independent Global Forum for Health Research, which works to increase research on developing country issues, bought the US 60-cent reflectors "as a gesture" from the Danish makers "C you" — to coincide with Forum's annual meeting in Arusha this November. "The children will get two reflectors each, one themselves and one for a sibling," said a Forum spokesman.

The Forum will seek investigators, and funding, to study their effect on deaths and injuries. In Denmark, studies have shown that reflectors reduce users' risk of fatal accidents ninefold, according to the Forum but their effects in developing country situations is unknown.

Every year, more than US$ 70 billion is spent worldwide on health research by the public and private sectors, but only about 10% of this is devoted to 90% of the world's health problems. The Global Forum refers to this as the "10/90 gap."

Samwell Nungu, consultant orthopaedic surgeon at Muhimbili Orthopaedic Institute, Dar es Salaam, is one African researcher who might be able to undertake work on the reflectors, given funding. He studies traffic accidents in Dar es Salaam, the capital of United Republic of Tanzania. He told the Bulletin that he sees 50 seriously injured under 12-year-old victims of road accidents victims every month. "The peak injury hours are in the evening, coming home from school, and in the late evening" said Nungu. Few streets have lights, and those are only in the city centre.

"Reflectors will definitely contribute to the fight against accidents" said Nungu. But no comprehensive study had been done so far in United Republic of Tanzania on this age group of victims, looking carefully at the circumstances of the accident, said Nungu. "High-risk victims have to be identified and then targeted if we want to evaluate the results of any intervention measure". The reflectors should be made available to all children, Nungu believes — "not just schoolchildren, but also street kids from the town and the outskirts".

According to WHO estimates road traffic injuries accounted for over 1.2 million deaths worldwide in the year 2000, amounting to 2.3% of all deaths. Many of the deaths occur in young adults, and 90% of the deaths occurred in the middle and low income countries, where death rates (21 and 24 deaths per 100 000 population, respectively) are approximately double the rates in high income countries (12 per 100 000 population).

The objectives of The Global Forum's meeting in Arusha, where it was to donate the reflectors, were much wider than traffic accidents, however. An independent, international foundation, established in 1998, and funded by the Rockefeller Foundation, WHO, the World Bank, and the governments of Canada, Denmark, Netherlands, Norway, Sweden and Switzerland, the Forum planned to "celebrate African Health research", showcasing the development of interventions by African institutions, their impact on the health of the African populations, particularly the poor, and their impact outside Africa.

The Global Forum's host partner for the meeting was the National Institute for Medical Research of Tanzania (NIMR).

Robert Walgate, Bulletin