Delivering road safety in India: Leadership priorities and initiatives to 2030

India has the world’s highest reported number of annual road crash fatalities. According to the World Health Organization, road crash fatalities in India account for approximately 11 percent of the estimated 1.35 million global toll each year. Vulnerable road users, primarily pedestrians, cyclists, and two-wheelers, account for almost 54 percent of all fatalities and serious injuries. Road safety management at the national and subnational levels in India lack a comprehensive and inclusive approach. Governance challenges impede the mobilization of a systemic, targeted, and sustained road safety program. A stronger emphasis needs to be placed on institutional ownership of the problem, accountability for safety, safer infrastructure, a regulatory framework that demands greater vehicle safety for all road users, targeted enforcement of unsafe road user behaviors, and improved post-crash health services. The urgency of the road safety situation is being recognized at all levels of government—central, state, union territory, and district. However, agencies responsible for road safety in India are inadequately empowered and resourced to deal with the escalating danger on their roads. More effective, efficient, and scaled-up initiatives are needed.