Key Findings. »» Road traffic accidents constitute 25% of all injury-related deaths in the Africa.

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1 ND CA EVELOPMEN T S ND PP FO AF RIC F EM ENT AF RI A LO D UN BANQ UE INE DE DEVE EN T EM PP A IC FR LO AIN DE DEVE Market Brief Statistics Department, June 2013, AfDB Chief Economist Complex AfDB Chief Economist Complex Mortality in Africa: The Share Table of Contents 1. Introduction: Mortality among population aged 15 and over 2 2. Injury-related deaths 2 3. Road traffic accidents: Who is most at risk 3»» Deaths due to road traffic accidents are highest among the most economically active population (15-59 years). 4. Road safety issues: Facing up to the challenge 4 5. Conclusion 5»» Men are three times more likely to be involved in road traffic accidents than females in the age group. Key Findings»» Nearly one in ten deaths of men (15-59 years) in North African countries can be attributed to road traffic accidents; 10% in Libya and Tunisia, 8% in Egypt and 7% in Sudan and Morocco. Mthuli Ncube Chief Economist & Vice President, ECON, Charles L. Lufumpa Director, Statistics Department (ESTA), ` Steve Kayizzi-Mugerwa Director, Development Research Department (EDRE), Victor Murinde Director, African Development Institute (EADI), This brief was prepared by the Statistics Department in the Chief Economist Vice Presidency of the African Development Bank. Its findings reflect the opinions of the authors and not necessarily those of the African Development Bank, its Board of Directors or the countries they represent. Designations employed in this report do not imply the expression of any opinion on the part of the African Development Bank Group concerning the legal status of any country or territory, or the delimitation of its frontiers. While every effort has been made to present reliable information, the African Development Bank accepts no responsibility whatsoever for any consequences of its use.»» Road traffic accidents constitute 25% of all injury-related deaths in the Africa.»» In Egypt, Tunisia, and Morocco, road traffic accidents account for more than half of injury-related deaths (Egypt 64%, Tunisia 58%, Morocco 51%).»» Nearly twice as many males aged die from injury-related causes (road traffic accidents, violence and others) than those that die from tuberculosis (20% vs. 10%), respiratory infections (20% vs. 6%), cancers (20% vs. 5%) while deaths due to HIV/ AIDS were only slightly higher than those for injury related deaths (22% vs. 20%).»» Strategies that can be adopted by governments to reduce the number of fatalities and injuries due to road traffic accidents include: improved road infrastructure; speed limits; compulsory seatbelts and child restraints; drink-driving laws, bans on the use of cellphones while driving; legal requirement for motorcyclists to wear helmets.»» Enforcement of road safety measures is generally weak across the continent. Alice Nabalamba, Assistant to the Director, Statistics Department (ESTA), Layout and production by Phoenix Design Aid A/S, Denmark A f r i c a n D e v e l o p m e n t B a n k

2 AfDB African Development Bank 1. Introduction: Mortality among population aged 15 and over The focus of this brief is on the population aged 15 years and over, as this comprises the major victims of road traffic accidents. In 2008, nearly 7 million deaths due to any cause were recorded in Africa among population aged 15 and above. This is equivalent to approximately 1,151 deaths per 100,000 population (Annex II, Table 1). One-third of deaths were due to infectious and parasitic diseases, including tuberculosis, HIV/AIDS, malaria, and respiratory infections. Non-communicable conditions accounted for 50% of all deaths, of which cardiovascular diseases accounted for 48%, with a slight gender differential (22% male vs. 26% female) (Global Burden of Disease, 2004 Update, WHO 2008; see Tables 1 & 2 in Annex II). Africa is a continent of such diversity that it is no surprise to find wide variations in mortality rates among countries. For example, deaths due to any cause ranged between 183 per 100,000 population in São Tomé & Príncipe to 1,642 per 100,000 population in Swaziland for those aged (see Annex I, Figure A.1) in In general, countries in the Southern African sub-region recorded the highest death rates, due to the high prevalence of HIV/ AIDS and related conditions. The death rate for males in this age group ranged from 109 per 100,000 in São Tomé & Príncipe to 915 per 100,000 in Malawi. Among women, deaths due to any cause ranged from a low of 63 per 100,000 in Tunisia to a high of 820 per 100,000 in Swaziland (Annex I; Figure A.3). For population aged 60 years and over, the differential in mortality rates dues to any cause among countries was also pronounced, ranging from 3,886 per 100,000 in Tunisia to 6,726 per 100,000 in Malawi (Annex I, Figure A.2). In the African region generally, mortality rates for men are slightly higher than for women, which is due entirely to injury-related deaths. Women have higher mortality rates than men for HIV/AIDS, which in 2008 caused a third of the deaths of females in the age group 15-59, compared to a death rate of 22% for men in the same age group (see Annex II, Table 2). Maternal conditions related to pregnancies and births were associated with 11.4% of deaths of women in the age group for the same year, which is significantly less than deaths caused by HIV/AIDS (31.7%) for women in the same age category (see Annex II, Table 2). 2. Injury-related deaths In 2008, injuries of any kind accounted for 9% of all deaths among those aged 15 years or over, but with major differences between young/old and males/females. Injury-related deaths were highest among the population aged years and particularly among men. Injuries accounted for 20% of deaths among men aged 15 59, compared to just 6% among females in the same age group (see Annex II, Table 1). Nearly twice as many males in this age group died from injury-related causes (20%) than from tuberculosis (10%), cardiovascular diseases (11%), cancers (6%), or respiratory infections (4%). Even deaths due to HIV/AIDS were close to those due to injury-related deaths (22%) among men. The number of deaths due to injury also far exceeded malaria-related deaths (at just 0.4%) for the male population in this age group. On the other hand, for females aged 15 59, injury-related deaths (at 6% of total deaths due to any cause) were far below deaths due to HIV/AIDS (32%), maternal conditions (11%) and cancers (8%) (see Annex II: Table 2). Data on the WHO African Region (which does not include Morocco, Tunisia, Libya, Egypt, Sudan, Djibouti, Eritrea or Somalia) shows that injury-related deaths are concentrated in the male age group, where they account for more than one-third of deaths (see Annex II, Table 4). 2

3 Market Brief. June 2013 AfDB 3. Road Traffic Accidents: Who Is Most at Risk? The most economically active people (aged 15 59) are at the greatest risk of dying as a result of road accidents. For this age group, road traffic accidents affected more than three times as many males as females. Overall, 5% of deaths among males aged are attributable to road traffic accidents, but this percentage rises to 6.5% for males in the age group in Sub- Saharan Africa.(Annex II, Table 4). Deaths due to road traffic accidents among males aged far exceed those due to malaria, diabetes mellitus, respiratory or digestive diseases. For females, however, almost all other causes of deaths carry more weight than road traffic accidents (the exceptions being malaria and violence). While road traffic accidents account for about one-quarter of injury-related deaths in the continent overall, in the North African countries of Egypt, Tunisia, and Morocco, they caused more than half of all injury-related deaths in 2008 (Egypt, 64%; Tunisia, 58%; Morocco, 51%). In Libya, Djibouti, Mauritius, Namibia and Niger, road traffic accidents also exacted a heavy toll, accounting for more than one-third of injury-related deaths (Libya, 43%; Djibouti, 42%; Mauritius, 37%; Namibia, 36% and Niger, 34%.) (Annex II: Tables 3 and 4). In 2008, road traffic accidents caused approximately 158,000 deaths and were the 13 th ranked cause of fatalities, accounting for 2.3% of all deaths on the continent (Figure 1). At present trends, with no effective mitigation, it is projected that globally by 2030, road traffic injuries will rank as the 5 th leading cause of death after cancer, cardiovascular disease, COPD (chronic obstructive pulmonary disease), and acute respiratory infections (WHO 2009). Road traffic accidents account for 10% of all deaths in Libya and Tunisia, 8% in Egypt, and 7% in Sudan and Morocco In Africa, almost one in ten deaths of young men (aged 15-29) are caused by road traffic accidents. among the population aged These five countries have the highest road traffic fatality rates in Africa, jointly accounting for nearly one-fifth of the continent s total death toll. While Nigeria and Ethiopia also contributed to a high proportion (23%) of road accident-related deaths to the continent s overall tally, road accidents represented less than 3% of deaths occurring in these countries. Thus Northern African countries (including Sudan) still stand out as having the highest death rates due to road traffic accidents. Among the elderly population, road traffic accidents account for 30% of all injury-related deaths, compared to falls, which account for only 9% of injury-related deaths. There is though a narrow sex differential for this age group: road fatalities account for 32% of all injury-related deaths among males and for 27% among females aged 60 years and over. The death toll due to road traffic accidents among elderly individuals in North African countries is even more alarming: 44% in Libya, 56% in Tunisia and Morocco, and 70% in Egypt. Assessing the Social and Economic Costs of Road Traffic Accidents The high death toll due to road traffic accidents needs to be tackled as a matter of urgency by national governments, not least because of the economic and social costs they impose. This is especially challenging to many African countries with relatively weak health care systems and where social protection for those surviving with life-changing injuries is limited. The high level of road traffic fatalities is of particular concern since this affects the younger segment of population (aged 15-29) the hardest, who constitute the most economically active population. However, estimating the economic costs related to road traffic accidents is Figure 1: Leading Causes of Death in Africa, Population Aged 15 years and over, 2008 Neuropsychiatric conditions Road traffic accidents Violence Maternal conditions Diabetes mellitus Diarrhoeal diseases Digestive diseases Repiratory diseases Tuberculosis Lower respiratory infections Cancers Cerebrovascular disease Ischaemic heart disease HIV/AIDS Source: Global Burden of Disease (GBD) 2004 Update, WHO (2008). 3

4 AfDB African Development Bank problematic. Projections are even more difficult to make in low-income countries in Sub-Saharan Africa, where records of economic activity and other vital statistics necessary to compute economic and social costs are not well documented. Similarly, large proportions of the population are employed in either the informal economy or in non-remunerative work and often their contribution to the economy is uncounted. What is clear is that economically disadvantaged families are hardest hit by the loss of an economically active family member, or by disabilities if the accident is not fatal. The burden of deaths due to road traffic accidents can be understood as comprising two main components: indirect costs and the value of mortality. Indirect costs represent the value of economic output lost because of premature death (WHO 2008). They are often measured in terms of lost potential earnings resulting from early mortality. The value of mortality is much more difficult to assess, although methods have been developed to value death in utility terms, such as potential years of life lost (PYLL). PYLL is the number of years of potential life not lived when a person dies prematurely. The indicator provides a way of weighting deaths occurring at younger ages, which are, a priori, preventable. It takes into account the number of deaths at each age at which deaths occur by giving greater weight to deaths at a younger age and lower weight to deaths at an older age. The number of deaths at each age is then multiplied by the global standard life expectancy at which death occurs. Thus, automobile accidents comprise a significantly higher proportion of years of life lost than total deaths, because they occur with greater frequency in young than in older people. 4. Road Safety Issues: Facing up to the Challenge According to the 2013 WHO Global Status Report on Road Safety, strategies already exist in many countries to reduce the number of fatalities and injuries due to road traffic accidents. Measures adopted include compulsory seatbelt use, drink-driving laws, speed limits, particularly in residential and commercial areas, and compulsory use of helmets for motorcyclists, among others. Several countries (e.g. Egypt, Kenya, South Africa, Uganda and Zimbabwe) have banned the use of hand-held devices such as cellphones whilst driving. But the enforcement of these strategies remains very weak in many countries. As a result, the number of deaths related to road traffic accidents has remained stubbornly high. It is estimated that globally 1.24 million people are killed in road traffic accidents each year and another 50 million are injured or disabled permanently (WHO 2009; WHO 2013). In Africa, an estimated 157,875 people aged 15 and over were killed in road traffic accidents in 2008 (the majority of them in the year age group). A number of factors contribute to the high number of road traffic accidents in Africa. These can be categorized into 3 main groups: road environment factors, vehicle factors, and human factors. Whereas human factors rank highest in contribution, all need to be addressed in promotion of road safety. Road environment factors may include poor road maintenance such as overgrown vegetation on road verges that impair visibility and road failures that constrict the road way; poor road layout such as road curvatures, unsuitable road layout for the traffic using it, and poor provision or lack of segregation of traffic types. Vehicle factors may include poor mechanical state, dangerously loaded vehicles which pose a danger to other road users, overloading of vehicles (axle-load non-conformity) which promote damage to the road and exacerbate problems of road maintenance. Human factors include speeding, non-compliance with seatbelt use, drink-driving, increased use of hand-held devices such as cellphones 38% of all road traffic deaths in Africa occur among pedestrians. while driving, and an increase in automobile ownership in many countries. In Africa alone, automobile ownership increased from below 50 to about 60 cars per 1,000 persons between 2002 and In countries such as Tunisia, Swaziland, South Africa, Botswana, Mauritius, and Seychelles, an estimated 1-2 of every 10 persons now owns an automobile (AfDB Data Portal, 2013). It is therefore no coincidence that in middle-income countries of Tunisia, South Africa and Mauritius, the proportion of injury-related deaths attributable to road traffic accidents exceeds the African average (Annex II: Tables 5 and 6).. The high number of road traffic accidents involving pedestrians, or persons riding 4

5 Market Brief. June 2013 AfDB motor cycles or bicycles, is indicative of deficiencies in both the infrastructure, as well as in road safety enforcement in Africa. With expanding road infrastructure networks in Africa, it is imperative that greater attention be paid to road safety measures to reduce the high number of accidents. As the WHO Global Status Report on Road Safety 2013 (p. 6) makes clear: 38% of all African road traffic deaths occur among pedestrians. However, most countries do not have policies in place to protect these road users. Moreover in many countries, there is an increased use of motorbikes for public transport, and often these are in poor mechanical state and are usually overloaded. Public transport needs to set high safety standards. Public awareness campaigns on the need to use seat-belts and child restraints to avoid death and severe injuries would assist in changing attitudes toward car safety. Legislation should make it compulsory for both drivers and passengers to wear seat-belts. Taxis too, should also be fitted with seat-belts for passengers. The public also needs to be educated (e.g. through posters, TV advertisements and other advocacy programs) on the dangers of speeding, driving while under the influence of drink or drugs, backed by regulatory fines commensurate with traffic offences for those found to be in breach of the law. To this end, more equipment (e.g. breathalyzers, speed detectors) should be introduced and traffic officers trained in their use. Finally, owners of cars over a certain age (e.g. 3 years) should be required to hold an annual road-worthiness certificate for their vehicles. Such measures could significantly reduce road deaths and improve road safety although they would require financing, particularly in the set-up phases. 5. Conclusion Mortality rates due to any cause is high in Africa compared to other global regions. Infectious and parasitic diseases such as malaria, diarrheal diseases, HIV/AIDS and tuberculosis constitute a large proportion of these deaths, particularly because of their high prevalence in young children and young adults. Mortality rates caused by these diseases (as shown in the tables and figures) remain high, even when those aged below 15 years of age are excluded. Cardiovascular diseases on the other hand are more prevalent in the older population. Increasingly, however, the question of how to reduce the level of road traffic accidents is presenting a challenge for African economies and societies, especially in view of the high growth rate of the population, increasing urbanization and high automobile congestion in larger cities. Available data show that deaths due to road traffic accidents are highest within the and more specifically in the year age group. This age category comprises people who are just entering post-primary schooling, post-secondary training, and completing post-secondary education. This population group also comprises a significant proportion of the economically active population in Africa, and those just starting their careers. However, the availability, quality, and reliability of data limit a comprehensive assessment of road traffic accidents and their social and human costs. Data on deaths, injuries, disabilities, (including whether the victim was an occupant in an automobile or a pedestrian/cyclist), and the number of licensed and unlicensed drivers involved in road traffic accidents are not consistently collected or compiled into harmonized databanks at present for all countries. Similarly, data on accidents caused by road environment failures or other infrastructure problems are not well captured. This impacts governments capacity to develop improved road safety policies and other preventative measures and to monitor their effectiveness over time. More importantly, information on the true economic cost related to road traffic accidents will need to be compiled at regular intervals in as many African countries as possible. The need for reliable and updated data on road traffic mortalities is dependent on robust national statistical systems and a skilled staff to compile and maintain the data needed by both governments and international organizations, and other data users. In this respect, development partners like the AfDB, WHO, and others should continue to lend their assistance through funding and technical assistance, including capacity-building to strengthen disease, death, injury and disability registries, road infrastructure and other transport statistics, and national statistical systems in general. 5

6 AfDB African Development Bank References WHO Global Status Report on Road Safety: Supporting a Decade of Action. WHO, Geneva. WHO African Region Status Report on Road Safety in Countries of the WHO African Region, WHO Regional Office for Africa, Brazzaville, Republic of Congo. WHO Global Burden of Disease, 2004 Update. WHO, Geneva. Annex I: Figures Figure A.1: Mortality due to any cause per 100,000 population aged 15-59, by country, Figure A.3: Mortality caused by road traffic accidents per 100,000 population, males and females, years, by country, 2008 disease, and HIV/AIDS per 100,000 population aged years, 2008 Figure A.2: Mortality due to any cause per 100,000 population aged 60 and over, by country, 2008 Figure A.4: Comparative mortality rates for road traffic accidents, cardiovascular Annex II: Tables Table 1: Africa: Cause of death per 100,000 population aged 15 years and over, 2008 Table 2: Africa: Cause of death for population aged 15 years and over, 2008 (as % of total deaths) Table 3: WHO African Region: Cause of death in population years and over, 2008 Table 4: WHO African Region: Cause of death in population years and over, 2008 (% of total deaths) Table 5: Africa: Deaths due to injuries and road traffic accidents per 100,000 population aged 15-59, 2008 Table 6: Africa: Deaths per 100,000 population aged 60 years and over due to injuries and road traffic accidents, 2008 Notes for Figures A1, A2, A3, A4: (*): Reasonably complete death registration data available with underlying cause of death coded using ICD-9 or ICD-10 without excessive use of inappropriate or non-specific codes. (+) Incomplete death registration data, and/or other forms of nationally representative information on causes of death (e.g. verbal autopsy, sample registration data) available. Cause of death models may be used to adjust for biases due to incomplete population coverage, other adjustments made using country-specific information for specific causes. For all other countries, information on all causes of death were not available. Cause of death modeling was used to estimate broad distribution of causes of death for Communicable Diseases, Noncommunicable Diseases and Injuries, by age and sex for the country level of all-cause mortality and per capita income. Cause of death patterns within the three major cause groups were based on death registration data from other countries in the region. Further country-level information and data on specific causes listed was also used. Separate specific multi-cause models were used for the major causes of child death. 6

7 Market Brief. June 2013 AfDB Figure A.1: Mortality due to any cause per 100,000 population aged 15-59, by country, 2008 São Tomé and Príncipe Tunisia Morocco Algeria Libya Egypt (+) Cape Verde Mauritius (*) Eritrea Seychelles (*) Senegal Niger Madagascar Comoros Mali Rwanda Gambia Mauritania Sudan Djibouti Gabon Benin Togo Ghana Kenya Burkina Faso Congo Liberia Angola Nigeria Dem. Rep. Congo Equatorial Guinea Tanzania Sierra Leone Somalia Guinea Chad Burundi Ethiopia Cameroon Botswana Guinea-Bissau Uganda Namibia Central African Republic Zambia Mozambique Côte d Ivoire South Africa Zimbabwe Lesotho Malawi Swaziland Source: Global Burden of Disease (GBD) 2004 Update, WHO (2008). 7

8 AfDB African Development Bank Figure A.2: Mortality due to any cause per 100,000 population aged 60 and over by country, 2008 Tunisia Morocco Mauritius (*) Libya Seychelles (*) Algeria Eritrea Senegal Egypt (+) Gambia Niger Cape Verde Botswana South Africa Djibouti Mauritania Sierra Leone Mali Sao Tome & Principe Burkina Faso Togo Africa Madagascar Kenya Benin Sudan Ghana Tanzania Comoros Liberia Namibia Zimbabwe Nigeria Rwanda Gabon Angola Guinea Lesotho Swaziland Chad Dem. Rep. Congo Mozambique Ethiopia Zambia Congo Guinea-Bissau Cameroon Burundi Somalia Côte d'ivoire Uganda CAR Equatorial Guinea Malawi Source: Global Burden of Disease (GBD) 2004 Update, WHO

9 Market Brief. June 2013 AfDB Figure A.3: Mortality caused by road traffic accidents per 100,000 population, males and females, years, by country, 2008 Somalia Niger Sao Tome and Principe Seychelles (*) Algeria Senegal Madagascar Mali Morocco Togo Zimbabwe Gambia Eritrea Mauritius (*) Tunisia Liberia Comoros Nigeria Cape Verde Rwanda Gabon South Africa Botswana Mauritania Egypt (+) Kenya Dem. Rep. Congo Benin Libya Africa Burundi Chad Sierra Leone Ghana Tanzania Burkina Faso Cameroon Guinea-Bissau Côte d'ivoire Equatorial Guinea Guinea Angola Lesotho Uganda Central African Rep Djibouti Ethiopia Zambia Congo Sudan Mozambique Swaziland Malawi Namibia Female Male Both sexes Deaths due to Road Traffic Accidents per 100,000 Population Source: Global Burden of Disease (GBD) 2004 Update, WHO

10 AfDB African Development Bank Figure A.4: Comparative mortality rates for road traffic accidents, cardiovascular disease, and HIV/AIDS per 100,000 population aged years, by country, 2008 Somalia Niger Sao Tome & Principe Seychelles * Algeria Senegal Madagascar Mali Morocco Togo Zimbabwe Gambia Eritrea Mauritius * Tunisia Liberia Comoros Nigeria Cape Verde Rwanda Gabon South Africa Botswana Mauritania Egypt + Kenya Dem. Rep. Congo Benin Libya Burundi Chad Sierra Leone Ghana Tanzania Burkina Faso Cameroon Guinea-Bissau Côte d'ivoire Equatorial Guinea Guinea Angola Lesotho Uganda CAR Djibouti Ethiopia Zambia Congo Sudan Mozambique Swaziland Malawi Namibia Road Traffic Accidents Cardiovascular diseases HIV/AIDS Deaths by Cause per 100,000 Population Source: Global Burden of Disease (GBD) 2004 Update, WHO

11 Market Brief. June 2013 AfDB Table 1: Africa: Cause of death per 100,000 population aged 15 years and over, 2008 Both Sexes Male Female Both Sexes Male Female Both Sexes Male Female Cause of death All Ages 15+ All Ages 15+ All Ages All Causes 1, , , , , , Communicable, maternal, perinatal and nutritional conditions Infectious and parasitic diseases Tuberculosis HIV/AIDS Diarrheal diseases Malaria Respiratory infections Maternal conditions Non-communicable diseases Cancers Diabetes mellitus Cardiovascular diseases Ischemic heart disease Cerebrovascular disease Respiratory diseases Digestive diseases Injuries Road traffic accidents Violence Source: Global Burden of Disease (GBD) 2004 Update, WHO

12 AfDB African Development Bank Table 2: Africa: Cause of death for population aged 15 years and over, 2008 (as % of total deaths) Both Sexes Male Female Both Sexes Male Female Both Sexes Male Female Cause of death All Ages 15+ All Ages 15+ All Ages Percentage of all causes All causes Communicable, maternal, perinatal and nutritional conditions Infectious and parasitic diseases Tuberculosis HIV/AIDS Diarrheal diseases Malaria Respiratory infections Maternal conditions Non-communicable diseases Cancers Diabetes mellitus Cardiovascular diseases Ischaemic heart disease Cerebrovascular disease Respiratory diseases Digestive diseases Injuries Road traffic accidents Road traffic accidents as % of injury related deaths Violence Source: Global Burden of Disease (GBD) 2004 Update, WHO

13 Market Brief. June 2013 AfDB Table 3: WHO African Region*: Cause of death in population 15 years and over, 2008 BOTH SEXES MALE FEMALE Total MALE FEMALE All Causes Communicable, maternal, perinatal and nutritional conditions Infectious and parasitic diseases Tuberculosis HIV/AIDS Diarrhoeal diseases Malaria Respiratory infections Nutritional deficiencies Non-communicable diseases Cancers Diabetes mellitus Neuropsychiatric conditions Cardiovascular diseases Respiratory diseases Digestive diseases Genitourinary diseases Injuries Road traffic accidents Violence Source: Global Burden of Disease, 2004 Update, WHO (2008) *Notes: The WHO African Region does not include Morocco, Tunisia, Libya, Egypt, Sudan, Djibouti, Eritrea or Somalia 13

14 AfDB African Development Bank Table 4: WHO African Region*: Cause of death in population 15 years and over, 2008 (% of total deaths) BOTH SEXES MALE FEMALE Total MALE FEMALE All Causes Communicable, maternal, perinatal and nutritional conditions Infectious and parasitic diseases Tuberculosis HIV/AIDS Diarrhoeal diseases Malaria Respiratory infections Nutritional deficiencies Non-communicable diseases Cancers Diabetes mellitus Neuropsychiatric conditions Cardiovascular diseases Respiratory diseases Digestive diseases Genitourinary diseases Injuries Road traffic accidents Road traffic accidents as % of injury related deaths Violence Source: Global Burden of Disease, 2004 Update WHO (2008). *Note: The WHO African Region does not include Morocco, Tunisia, Libya, Egypt, Sudan, Djibouti, Eritrea or Somalia. 14

15 Market Brief. June 2013 AfDB Table 5: Africa: Deaths due to injuries and road traffic accidents per 100,000 population aged 15-59, 2008 Injury-related Deaths Motor Road Accidents Road Traffic Accidents as Percentage of all Injuries Total Male Female Total Male Female Total Male Female Africa Namibia Malawi Swaziland Mozambique Sudan Congo Zambia Ethiopia Djibouti Central African Rep Uganda Lesotho Angola Guinea Equatorial Guinea Côte d Ivoire Guinea-Bissau Cameroon Burkina Faso Tanzania Ghana Sierra Leone Chad Burundi Libya Benin Dem. Rep. Congo Kenya Egypt Mauritania Botswana South Africa

16 AfDB African Development Bank Injury-related Deaths Motor Road Accidents Road Traffic Accidents as Percentage of all Injuries Total Male Female Total Male Female Total Male Female Gabon Rwanda Cape Verde Nigeria Comoros Liberia Tunisia Mauritius * Eritrea Gambia Zimbabwe Togo Morocco Mali Madagascar Algeria Senegal Seychelles * Sao Tome & Principe Niger Somalia Source: Global Burden of Disease (GBD) 2004 Update, (WHO 2008). 16

17 Market Brief. June 2013 AfDB Table 6: Africa: Deaths per 100,000 population aged 60 years and over caused by injuries and road traffic accidents, Injury-related Deaths Motor Road Accidents Road Traffic Accidents as Percentage of all Injuries Total Male Female Total Male Female Total Male Female Africa Egypt Tunisia Morocco Djibouti Libya Sierra Leone Niger Liberia Gambia Angola Senegal Burkina Faso Madagascar Mauritania Benin Togo Mali Cameroon Guinea-Bissau Ghana South Africa Comoros Algeria Equatorial Guinea Gabon Cape Verde Congo Sao Tome & Principe Mauritius * Chad Nigeria Ethiopia

18 AfDB African Development Bank Rwanda Lesotho Zimbabwe Sudan Central African Rep Guinea Tanzania Burundi Eritrea Malawi Kenya Botswana Namibia Mozambique Zambia Swaziland Dem. Rep. Congo Uganda Côte d Ivoire Somalia Seychelles * Source: Global Burden of Disease (GBD) 2004 Update (WHO 2008.) 18

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