Nepal’s roads are as unsafe as ever. The World Health Organization’s (WHO) 5th Global Road Safety Status Report, published in December 2023, paints a grim picture of Nepal’s roads. The WHO estimated 8,479 road traffic deaths in 2021; the Government of Nepal, however, reported 2,833 deaths in the same year, nearly three times lower than the WHO’s data. Further, figures show a 71-77 percent increase in Nepal’s absolute number of road deaths than in 2013. While the world witnessed a 5 percent decrease in the absolute number of deaths compared to a decade ago, with 108 countries reporting a decline between 2 percent and 50 percent, Nepal is drifting in the wrong direction, and the target of reducing road fatalities by 50 percent by 2030 seems far from reality.

Nepal supports the Global Plan for the Decade of Action for Road Safety 2021-2030, but it has failed to implement the recommendations of the Global Plan or a national strategy that sets a realistic trajectory target for the decade. An unbalanced and unsystematic focus on road construction safety is a significant failure, leading to persistently high rates of road traffic crashes, fatalities, injuries and substantial social and economic costs.

Economists have estimated that the economic losses of Nepal’s road crashes have tripled each decade—from $14 million in 1996 to $41 million in 2007 and $123 million in 2017. The 2021 national census recorded an increase in the absolute number of people with disabilities; however, data regarding the severity and type of disabilities caused by road crashes are still lacking.

Similarly, the second Decade of Action outlined the key areas for action and suggested action points aligning with the five road safety pillars (road safety management, safer vehicles, safer road users, post-crash response and safer driving environment) and speed control. It describes the government’s role and accountability towards safe systems, leading to the design of transport systems and the development of action plans. The lead agency, usually appointed by the government (absent in Nepal), coordinates and encourages individual or collective road safety endeavours of the private sector, civil society and academia. Equally crucial is capacitating and updating quality standards and law enforcement to evaluate the effectiveness of implemented interventions.

The urgent endorsement of the 8-year-pending Road Safety Bill’s draft is crucial for establishing a Road Safety Management apex body. This will lay the legal foundation for establishing an independent and fully-resourced National Road Safety Council. Once formed, the Council has to finalise the National Road Safety Action Plan (2021-2030). Nepal's failure to adopt the UN Road Safety Conventions and globally recognised vehicle safety standards has resulted in the widespread use of unsafe vehicles, contributing to the severity of road crashes and fatalities.

Traffic law enforcement in Nepal is inconsistent and inadequate. This includes lax enforcement of helmet-wearing laws for motorcycle passengers, a lack of legislation for passenger seatbelt use and child restraints and the widespread use of mobile phones while driving. Safe and high-quality helmets reduce the risk of death from head injuries by over six times, eventually mitigating the risk of brain injury by up to 74 percent. Public awareness campaigns and educational programmes promoting safe driving behaviours and road safety practices among road users are also severely lacking.

We must improve the existing road infrastructure to ensure safety for all types of road users. Nepal has 3.9 million motorised vehicles on its roads. The road network should also be suitable and safe for cyclists and pedestrians, as an unsafe road infrastructure puts them in danger. In 2021, pedestrians and cyclists accounted for 26.3 percent of the total road fatalities. Installing proper pedestrian crossings, traffic lights, and speed control measures around schools and residential areas should be prioritised.

Research evidence, technological innovations and good practice guidance documents are available to guide, support and educate decision-makers on road traffic injuries. Utilising them could save scarce financial resources on road safety; however, the significance of primary empirical research remains crucial. Despite a 5 percent decline in deaths globally, Nepal saw a 77 percent increase due to failed actions.

Nepal’s inability to fund road safety research and development limits evidence generation and hinders innovative solutions to the country’s distinct road safety challenges. Owing to the limited capability of crash data collection, the WHO has to model standardised estimates for Nepal. The police recorded approximately 20,000 injuries, while the Ministry of Health OPD records indicated almost 100,000 road traffic injuries. However, for the year 2021-22, police recorded, on average, 108 crashes daily (nationwide), of which 56 percent were recorded in Bagmati Province alone, and Madhesh and Koshi provinces made up 36 percent. It is difficult to believe that the remaining four provinces (Gandaki, Lumbini, Karnali and Sudurpaschim combined) accounted for only 8 percent of the total crashes. These statistical gaps hinder the ability to accurately assess the scale of a problem and monitor progress towards achieving road safety targets. The road crash data collection system created by the Nepal government with the support of donor agencies urgently needs to be rolled out.

Nepal’s emergency medical services, post-crash response and trauma care, are inadequate, causing delays in treating road crash victims and contributing to higher mortality rates and long-term disabilities among survivors. A sound emergency care system can save lives by strengthening the ambulance system and building the capacity of professionals and responders. A trauma hospital registry can provide data for evidence-based recommendations and help in continuous quality care improvements.