This anonymous essay was submitted to Open Philanthropy's Cause Exploration Prizes contest and posted to the Forum with the authors' permission.

If you're seeing this in summer 2022, we'll be posting many submissions in a short period. If you want to stop seeing them so often, apply a filter for the appropriate tag!


In 2019, about 55 million people died worldwide. Of these, a remarkable 1.2 million are caused by traffic fatalities of various descriptions, or 2.3% of the total. This is more than homicide, conflict, fire, drownings, drugs, and alcohol combined, and about as much as malaria and HIV together. These deaths are further concentrated in the poorest countries. In low, lower middle, upper middle, and high income countries those proportions are 4.0%, 2.4%, 2.4%, and 0.9%. To focus on a specific LIC, in Uganda there were 12,000 road deaths in 2016, 5.7% of all cause mortality, there were a further 180,000 serious injuries, and the cost of all road deaths and injuries was estimated as 10% of yearly GDP (Road Safety Facility). 

Furthermore, road injuries don’t just kill and maim, but they also disproportionately orphan and widow. Unlike other important sources of mortality, deaths on the road are heavily concentrated in the productive ages, where each death is likely to leave dependents in desperate condition. Unlike e.g. malnutrition, income and social status are weakly protective, so that traffic regularly kills doctors and other highly educated workers which are always hard to train and retain in developing countries. 

Road injuries are also extremely hard to avoid at the individual level. Children must walk to school on narrow roads with high speed traffic, workers must board minivans of unknown maintenance status to get to work, and anybody can of course be hit any time by a recklessly speeding driver. 

Aside from the carnage executed daily on Ugandan roads, all of these serious injuries will require expensive care in the Accident and Emergency wards. In 2018, road injuries caused 36% of all emergency room admissions, and 67% of traumas at Mulago National Referral Hospital in Kampala, and this burden on the healthcare system necessarily detracts from the standard of care that can be offered to other hospital users. While statistics are hard to come by, policing traffic doubtlessly also drains police resources, both for routine traffic control and dealing with accidents (first aid, redirecting traffic, documenting it). These resources could otherwise be used for improving public safety.

Furthermore, high road safety fatalities complicate both foreign investment and aid: foreign staff need to be provided with chauffeured vehicles, which need to be sufficiently massive to protect against impacts from compact cars. There is also the risk of company vehicles running over pedestrians, adding to the ongoing tragedy, and likely causing animosity in the general population. The risk of death and dismemberment for oneself or a loved one, and the hours stuck in traffic must also be part of the reason why educated citizens decide to leave their country, even when other factors would make them want to stay. 

Why Roads Are Dangerous 

Because of their mass, speed, availability, and due to their proximity to much more vulnerable road users, motorized vehicles are extremely effective killing machines. So effective in fact that they have been used unmodified as weapons time and again by terrorists, often with tragic success. 

Due to this inherent potential lethality of motorized transport, even absent criminal intent, minimizing road fatalities requires extensive resources, care, planning, and effort. Generally this is far beyond the reach of governments in LIC, many of which have only recently passed laws banning drunk driving and speeding, let alone have the manpower and equipment to actually enforce them. 

This problem is exacerbated when, as in most of the world, speeding cars, motorbikes and minivans rush along roads that are used by opposing traffic, pedestrians, cyclists, and various sorts of sellers without any sort of physical barrier, or even lane markings. Under these conditions, the smallest distraction on the part of the driver, or thoughtless move by a pedestrian can cause a horrific accident. 

Just as in developed countries, speeding, alcohol, and reckless behavior are the major sources of accidents in LIC. This can sometimes lead to write off the cost of these fatalities as bad behavior by individuals, but we should remember that very often these accidents result in the deaths of bystanders, and in any case one can ride a bus drunk and not die. 

An additional reason for the high fatality rate in developing countries is that the cars are often imported older vehicles that have reached the end of their useful lives in richer countries. This means that they are often unsafe even if driven impeccably, due to faulty steering or brakes. 

More generally, motor vehicles are exceptionally lumpy investments, which require frequent preventative maintenance, but can also break down at any time, taking the vehicle out of service for a variable length of time and requiring a greater or smaller cost to repair. In countries with weak financial institutions and small firm size, it therefore becomes difficult for private individuals and owner/operators of motorbike and van taxis to maintain a reasonably consistent level of serviceability across the vehicle fleet, even if consumers would be willing and able to pay the average cost of such a maintenance regimen. 

Roads are also the battleground of an evolutionary arms race in vehicle mass. In car dependent societies, people eventually realize that a heavier vehicle is safer in a collision regardless of who’s fault it was, which creates an incentive to purchase the heaviest and safest vehicle possible. This is a perfectly reasonable reaction to the incentives provided, but it creates a large negative externality on other users: while these larger vehicles are generally safer for the occupants, they have large negative externality on other road users, due the generally poorer visibility, worse braking performance, and shape that hits the torso instead of the lower leg. The effect is a continuous race by all road users to purchase the heaviest vehicle they can afford, which in the US has contributed to a 24% average increase in new vehicle mass. This of course exacerbates road safety issues further for vulnerable users (which now includes owners of lighter vehicles). For example 4,302 pedestrians were killed in traffic collisions in 2010, and by 2019 that number had grown to 6,205. (Crashstats

The Crucial Role of Mobility 

Why do people the world over brave these appalling odds? Because urban mobility is crucial to securing a prosperous and meaningful life. Cities exist to give access to specialization, trade, and scale. All of these factors require mobility, and the general pattern is for a denser urban core where most of the actual work happens close together, and sparser, peripheral residential areas which are generally more pleasant and affordable to live in. 

Mobility allows city dwellers to work, study, and live close to the optimal density for each activity. This spatial arrangement means that every morning a significant fraction of the population of a city will have to move to the downtown area, and then back to their homes in the afternoon. Mobility also allows workers to interact with a large number of other business establishments for intermediate goods and services they require, or potential customers for their goods. Finally, mobility also allows consumers to access goods at the best price from across the urban area, ensuring that the market is truly integrated and competitive and doesn’t devolve into a series of local fiefdoms with monopoly power. 

This is what makes cities such powerful economic engines, but conversely, this is also why citizens must continue to subject themselves to the dangers of dangerous city streets. If they didn’t take these risks, they would have limited access to both the labor and consumer markets. Without mobility, an urban neighborhood is just a village with worse air quality. 

For all these reasons, transportation ranks along sanitation and safety as one of the key determinants for a successful city. A city that cannot handle the daily commute efficiently is like an engine with a clogged air intake. It might sputter around, but it will never deliver its full potential. Workers that are stuck in traffic, or must walk two hours for lack of transit options, aren’t producing anything of value to them or society. And the very unpredictability of traffic makes it impossible for anything to reliably start on time, even if the greatest care is exercised. 

Transportation in most large cities of Africa is extremely slow. Dr Kobusinye, a trauma surgeon, injury epidemiologist at the Makerere School of Public Health in Kampala told me that to go to her office she has to leave home at 6.30 AM, in which case she can drive to her office in 20 minutes. But if she left even a little later, she would risk being stuck in traffic for two and half hours. The poor and professional class alike end up spending most of a day to perform an errand that could have taken less than an hour. 

Deborah Nakkungu, a Kampalan master student I interviewed on the issue told me that absolutely everybody she knows has a boda boda accident story, and that she herself has been in three, the worst of which while being taken to her highschool, and further that conversations within her social circle constantly revolve around the accident they were almost in, or the accident their friend was in, or the accidents that they saw on the way to meeting their friend. Even the guest pastor at her church, which had flown in from the US, said during the sermon that he loved coming to Uganda but was always extremely scared of the roads. 

More generally, besides being slow, traffic is inherently unpredictable, and even with best efforts, a country can be no more punctual than its transportation system. The inability for meetings to start on time, or goods to be transported in a predictable time frame means that aside from the time actually wasted in traffic, time will also be wasted arriving early to important meetings when traffic is unexpectedly light. 

Clearly, the current mobility system in Kampala, which relies largely on Boda Bodas and paratransit vans (called “taxis”), is imposing an enormous cost on the citizens of Kampala, which is paid daily in blood, but also in time and missed opportunities. 

Not only is the transportation in most metropolises in LIC a disaster under both effectiveness and safety grounds, but the situations could very easily get worse rather than better. If African countries were to follow the personal vehicle model that the West went through over the twentieth century, as they develop economically their citizens will naturally want to purchase their own personal vehicles, which will further add to the congestion and traffic fatalities. 

Further, if the city is to avoid complete and constant gridlock, wide swathes of it will need to be destroyed to construct freeways, just as was necessary in cities in the US, and to a lesser extent in Europe. This will generally only be possible with massive foreign financing, which besides increasing the possibility of endogenous defaults, will further expose the countries in question to the shifting tides of financial markets. 

The fundamental issue is that while single occupant vehicles are fantastic for people that live in rural areas, or have to visit different addresses each day, they are an exceptionally inefficient way of moving people on predictable commutes in urban areas. Aside from cost and engineering aspects, simple geometry means that as it stands Kampala CBD is simply impossible to serve with personal vehicles. For example, let’s assume that 1 million out of the 2.5 million commuters wished to commute into Kampala by car. One lane of traffic can carry a maximum of 2000 cars per hour, so to move one million cars in one hour we would need 500 incoming lanes. All of these cars would then have to be parked somewhere using at least 16sqm for the parking spaces themselves, without any access roads. After the workday was over we would need a further 500 lanes to get them out. 

Therefore a car commute for one million people would require 1,000 radial lanes, occupying a full 4km of lane width (plus allowance for sidewalks, interchanges, and ring roads) to get them in and out, and a full 16 sqkm of bumper to bumper and mirror to mirror parking space. The problem is that Kampala’s central division, where the heaviest concentration of jobs is located, has only 16sqkm of surface area to begin with, and 20 km of perimeter, so that the bare minimum of space necessary to move that many cars would consume around 20% of the perimeter and ALL of the surface area. Effectively, the only way to serve Kampala CBD would be to effectively destroy it, and build a much sparser CBD with fewer jobs on top of its ruins. 

Kampala today manages this because around half of commuters walk to work, and most of the rest take a paratransit fifteen person van (locally called taxis) at work. Each of these transportation modes is around five to ten times as efficient as cars in their use of travel lanes, and further they do not require a large vehicle to be parked for the entire day in the central district. It is this space efficiency which has allowed Kampala to grow as much as it has, the model is now bursting at the seams. 

Any further movement towards personal vehicle commuting would mean that each minivan taken out of service would be replaced by around ten new cars, and there is simply no way that road infrastructure investment could possibly accommodate this demand. Therefore, if Kampala and its inhabitants are to prosper, its transportation investments need to be concentrated in car alternatives that both in principle and in practice have demonstrated the ability to move the number of people required into the places where they work and study. 

While the specific circumstances of each city are unique, the situation of Kampala is largely generalizable to the major urban centers of the region. Walking, minivans, and motorcycle taxis are how Africans get around in most of the large metropolises of the continent, and indeed most metropolises in Low Income Countries are served by some mix of these, and are experiencing broadly similar trends in congestion, road fatalities, and air pollution. 

Transportation policy is inherently political 

According to Dr. Kobusingye, the solutions to these issues are trivial in a technical sense, while the major roadblocks are entirely sociopolitical. Anybody who has looked at the problem understands that having organized city bus lines with larger vehicles on dedicated lanes would move more people for the same amount of road space and for a similar cost. But the current system provides a livelihood for hundreds of thousands of people, and they have a strong ability to influence policy electorally or through protests of various degrees of intensity. 

Given the requirement to tradeoff various social priorities, a coherent integrated transportation policy can only be the result of a political process. But the experience of cities the world over has shown some broad trends, and we can expect that a reasonably effective solution for Kampala might borrow some elements of the following. 

Bus Rapid Transit. From its modern origins in Curitiba in 1982, the brainchild of the visionary architect (and three-time mayor of the city) Jaime Lerner. His realization was that mass transit could be achieved for far less than tunneling or even surface rail by simply taking over streets from cars, and converting them for use by large buses with dedicated lanes. This approach, facilitated by Curitiba’s rational grid layout and eventually complemented by bike paths and pedestrian areas to create an integrated transportation network at a fraction of the cost of traditional system. 

This idea was picked up by a number of cities in Latina America, such as Bogota and Mexico city, and more recently also in African cities such as Johannesburg and Dar-es-Salaam. Most of these systems are heavily used and are indeed overcrowded, which shows that they were effective at meeting transportation need. Though there have been persistent issues with overcrowding as people take advantage of the new mobility options, so in terms of reputation some of these systems have been victim of their own success. 

Another effective transportation pattern is the creation of a network of protected bike lanes connecting residential areas to employment centers. Bike lanes are exceptionally space efficient compared to cars, both in transit and when stored, and even the best bike infrastructure has lower construction costs than even roads, let alone rails.

 Further, bikes provide citizens the ability to move around a city at about 15km/h, at a small fraction of the cost of a car, or even public transportation, and are an inherently safe option when the surface is smooth and cars are physically excluded. Cycling’s reputation as an unsafe travel mode is largely due to the need to interact with the multi-ton vehicles they are forced to share the road with. 

Walking is a crucial component of any urban transportation plan, as it is the cheapest option, and is generally considered pleasant up to fifteen minutes or so. Further, pedestrians are around 10 times more efficient than cars in their use of space, and five times more than a typical mixed traffic lane. The key here is two fold: to ensure that pedestrians can move around their immediate area without risk of cars, and to ensure that as many trip generating activities (government offices, schools, commercial areas) are sufficiently dispersed that most of the population can reach them within a 15 minutes walk. This preempts many trips (by both employees and users) that would otherwise clog the limited routes into the downtown area, and can also help revitalize failing peripheral neighborhoods. (Source)

All of these solutions are widely known to those with an even passing interest in transport matters, and this is true both internationally and within Uganda, which has many local NGOs advocating for precisely such an approach. 

These are cost effective, technically unchallenging interventions that could transform within years the lives of the inhabitants of Kampala, and of many cities like it. But as in many other cities, the current alignment of local politics and public opinion prevent their implementation. 

As in so many aid interventions, the objective is not to design some sort of fantasy transport system from abroad that will never be implemented, but rather to empower locals by helping those that wish to educate their countrymen on these better options, and to nurture the resulting organizations so that they can become effective advocates for the commuting population of their cities, which can then demand the policies which it then deserves, an are within their means. 

Possible Interventions

The possible interventions can be tentatively grouped in four broad categories 

  1. Increasing the number of initiatives
  2. Improve the chances of success of the initiatives
  3. Decrease the learning iteration time
  4. Favor spread of successful innovations to other locations

Increasing the number of initiatives 

This can be achieved by direct interventions such as funding local transit activists to increase the scale of their current activities, but also via more indirect interventions such as scholarships in urban studies for nationals of the target country, commissioning surveys on commuter behavior, paying for improved record keeping of road injuries, translating educational material in languages other than English, and funding both existing conferences and new ones where practitioners can network and share successful and less successful interventions and communication strategies. 

A case in point in the difficulties of finding data to support transport initiatives is the writing of this essay, the text of which was largely complete in a couple of evening, but for which I had to sometimes spend hours tracking down specific a specific statistic, which often turned out not to exist. The creation of a transportation data clearing house, which aggregated and harmonized open data, explained which were based on actual data, and which were interpolated based on local and regional trends, and pointing users towards data sets that are not open access, but nonetheless exist and could potentially be obtained for research needs by asking the relevant organization for access. 

As another example, Dr. Kobusinye mentioned that Kampala lacks any sort of data regarding where people commute to and from, especially for the half of them that walk to do so. Funding a series of surveys to establish a baseline knowledge of the major commuting flows throughout the Kampala region would make it easier for transport advocates to e.g. identify the corridors where bike infrastructure could make the biggest difference, and to push the case for doing so more forcefully. 

Another point of note is that while development economists I contacted were all aware of the inefficiency and risks of transportation in developing countries through working in them or through personal travel, the topic is extremely marginal in the academic literature. The urban economics literature has of course produced multiple studies of BRTs and the like, but I am not aware of a single Development Economics Syllabus that deals with transportation as a separate issue, though many will cover a paper or two when they cover infrastructure (often Donaldson’s on the Railroads of the Raj, which for all its brilliance is not likely to spark in the the minds of the students). So the first time most grad students that choose development economics discover how inefficient and dangerous transport is in most capital cities in the developing world is when they first visit the country they have won a grant to do research in. By that time their early stage research agenda has been in some way determined, and traffic gets filed away as a problem to overcome in the pursuit of research, rather than its own field of study, and transport and road safety issue in LICs remains a neglected field. 

To remedy this situation, a good intervention could be to commission a set of teaching materials at the graduate level, which professors teaching Development Economics could freely adapt for their own classes. These would cover the papers in the development literature, as well as in adjoining fields, but also provide a broad overview of transportation issues in LICs, as well as reviewing available funding sources, data sources, and organizations that could be partnered with. 

Improving the chances of success 

All good faith effort towards safe, reliable, and affordable transportation for the citizens of LIC metropolises should be praised. But in the end the interventions actually have to work if people’s lives are to change, and this means that both the advocacy needs to actually translate in new transportation policy and infrastructure, and those changes have to both improve the lives of citizens, and be sustainable politically and financially in the long run. 

To increase the chances of success, a possible intervention could be facilitating cooperation between officials in cities that are planning or building transportation projects, and officials from cities that already completed similar projects under similar conditions. For example Turin constructed a very successful one line metro system adopting the technology solutions that had worked well in Lille and Rennes, and contracting the latter city to consult in creating their own in house teams. 

Decreasing the learning iteration time 

The work of the transport engineer is never finished, both because the actual circumstances of the city change, making the previous infrastructure suboptimal, and because occasionally even the best laid transportation plans inevitably overlook some important set of potential users, or end up overcrowded in certain sections because demand is greater than predicted. 

Unfortunately what often happens is that these problems are only noticed after a decade or so in service, when the next phases of the project have already been designed, if not actually constructed. For example, it is common for all transportation projects regardless of mode to be underutilized initially, but have ridership continuously grow for the first decade or so as people change routine, home, or jobs to take advantage of it. Unfortunately this means that by the time that the first lines to built become overcrowded, additional lines have already been built or even constructed without the revised capacity requirements having been taken into consideration. 

In practice this means that the learning loop only completes after multiple generations of investment have already been made. This problem is hard to avoid, but one safeguard would be to provide extra funding to continuously collect real time data on how and why commuters use the transportation system, to ensure that emerging trends are spotted as soon as possible. 

This data can also aid researchers in developing better models to forecast future demand or other important quantities, or inform the decision on which corridors to build next. For example if many passengers are visiting the CBD simply to change over to another line going to their destination, a ring line connecting peripheral areas can actually decongest the center more than adding yet another radial line.