 Rising Death Toll on Asia's Roads
Accidents kill, injure 27,000 everyday
An estimated 10 million people are either killed or injured on Asia-Pacific roads each year, making it a major health problem for the region. The region accounts for about 60 percent of global road deaths despite having only 16 percent of the world's vehicles, according to the World Health Organization (WHO).
Road deaths jumped by nearly 40 percent in Asia between 1987 and 1995 while in developed nations, they fell by about 10 percent because of better safety measures. WHO estimates that if current trends continue, road accidents will be the third global cause of disease or injury by 2020, after heart disease and depression, with the numbers of those killed and disabled up by 60 percent.
Said Dr. Shigeru Omi, WHO regional director for the Western Pacific: "Roads have been the gateway for the development in the region. But tragically, roads are where many people are injured, disabled, or killed. Road deaths are needless, brutal, and devastating for victims' families. This is a public health crisis that demands our attention."
While motorization and urbanization are escalating, road infrastructure, safety measures and trauma care lag behind, he said.
Drivers often have poor safety awareness and violate traffic regulations. Many vehicles are not roadworthy.
"We tend to be fatalistic about road crashes, but these 'accidents' are rarely random, uncontrollable events," said Dr. Hisashi Ogawa, WHO regional adviser in healthy settings and environment for the Western Pacific Region. "Much can be done to prevent injuries and save lives."
Key preventive measures include the use of seat belts, restrictions on speed and alcohol intake, and enhanced vehicle standards and road design and conditions. In many Asian countries, these essential measures are lacking, although a number of programs to promote seat belts or traffic regulations are ongoing.
Most injuries among motorcycle riders are to the head, so helmets could significantly reduce deaths and injuries.
Road accidents are a huge economic drain. In the recently released World Report on Road Traffic Injury Prevention, it was shown that up to US$517.8 billion are lost every year because of vehicular accidents. In Asia alone, nearly US$25 billion are lost every year. In Bangladesh, for example, traffic injuries cost US$745 million in 2000, and it accounted for about 1.4 percent of the gross domestic product. In addition, research indicates that the direct costs of road crashes in Thailand are as high as three percent of the annual GDP. This does not even include costs from lost productivity, the WHO said.
Also, the bulk of fatalities-more than 50 percent-in road traffic accidents are made up of men between 15 and 44 years. This group also registered 60 percent of all losses in disability-adjusted life years (DALYs) resulting from road traffic injury.
What is important to note is that while in high-income countries the 15 to 29 age group registered the highest death rate for every 100,000 population, the 60 and above group has the highest fatality rate in middle-income and low-income countries.
"When involved in a motor vehicle crash, elderly people are more likely to be killed or seriously disabled than younger people because they are generally less resilient," the Report says. And with the expected increase in the above-60 populations in these countries in the next 30 years, the "vulnerability of elderly people to road traffic death and serious injury will be of increasing concern globally."
The Report concludes: "While there are many interventions that can save lives and limbs, political will and commitment are essential, and without them little can be achieved. The time to act is now. Road users everywhere deserve better and safer road travel."
J. P. de Guzman, with AFP report
Young Asians Now More Sexually Active, Face Higher HIV/AIDS Risk
Changing norms may fuel spread of the disease
SINGAPORE
Asia's youth are becoming increasingly susceptible to HIV through "boyfriend-girlfriend" relations as many become sexually active at a younger age.
Teenagers are increasingly shirking their parents' "Asian values" by having premarital sex, often with multiple partners, regional health authorities in nations including Singapore, Cambodia, Vietnam, and Malaysia said. And although some governments have begun to react by implementing education programs and launching school and community campaigns, the WHO says existing initiatives are not enough.
"There needs to be bigger political commitment, more education and information, and more resources for care and treatment," WHO Western Pacific adviser on HIV/AIDS, Bernard Fabre-Teste, said.
He said many governments in Asia were just beginning to pay attention to the problem and highlighted China as an important nation that is still in its infancy in educating its youth about HIV/AIDS. His comments followed a WHO report in January that warned Asian youths lacked the knowledge to avoid risky behavior that could lead to HIV infection.
"Social norms regarding sexual activity and sexual behavior have changed, but the environment to support the adolescents to face these changes has not," WHO Western Pacific director Shigeru Omi said in the report. The report cited studies showing 23 percent of Filipinos between 15 and 24 years had engaged in premarital sex, 70 percent of them without the use of contraceptives.
In Vietnam, a separate report in 2003 by the UN Joint Program on HIV/AIDS (UNAIDS) said a survey among youths aged 15 to 24 showed only 26.3 percent had basic knowledge of HIV transmission and prevention. The survey found only half of the males and a third of the females used a condom in their last sexual intercourse with a nonregular sexual partner.
Despite the concerns of the WHO about a lack of education, there are many positive examples of health organizations and governments around the region working to improve awareness about HIV and AIDS.
In Cambodia, for example, nongovernment organizations such as World Education are working with the Ministry of Education to implement sex education programs in most of the country's middle and high schools. The program focuses on responsible behavior, such as using condoms, respecting one's partner and resisting peer pressure, UNAIDS country coordinator for Cambodia Geeta Sethi said.
"We teach them about peer pressure and making their own decisions, such as whether you should go to sex workers or not," she said, adding there were plans to extend the program into primary schools.
Cambodia has one of the highest HIV infection rates in Southeast Asia with 2.6 percent of its population suffering from HIV/AIDS. Studies have shown that up to 25 percent of Cambodian males aged 20 to 25 have visited a sex worker. But health experts have found that knowledge does not necessarily end risky behavior, with Malaysia offering an example of the complacency and other problems that occur among a more educated youth.
"A large proportion of Malaysians are aware that having multiple sex partners will increase their chances of getting HIV, that premarital sex puts them at risk of contracting the virus, but people still do have unprotected sex," HIV/AIDS adviser for UNAIDS Malaysia Angeline Ackermans said.
This is because most reported cases involve high-risk groups, such as sex workers and drug users, so the general population does not associate itself as being vulnerable to the disease, she said.
Similarly Singapore's youth are highly educated about the issue, with sex education part of the school syllabus for all students, but there is community concern that many youths seem not to care about the risks of contracting HIV.
A study conducted by Nanyang Technological University study last year found that only slightly more than a third of undergraduates who had premarital sex consistently used a condom, while one in 10 did not use protection at all.
Melissa Lim, a social worker with Student Care Services in Singapore, said she had encountered teens as young as 13 who, despite fear of getting pregnant, still had unprotected sex. "Among the teens, they think they are not likely to get [HIV], they won't be the unlucky one. The main fear among them is getting pregnant and being found out," she said.
Yasmine Yahya, AFP
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