Egypt’s emergency call system begins with a member of the public making a 123 call. The call taker collects basic data, including a description of the crash, location and the caller's personal information. A notice is then created in the ambulance database (CAD). A dispatcher – a technician who sends a radio or telephone signal to the nearest ambulance – reviews the data, contacts the caller if the address is unclear and monitors the ambulance's arrival. The notice reaches the ambulance via radio or a call to the ambulance operations room. Additional data are also provided upon arrival at the scene of the crash using the same method, a step that can take time.

There is a need for technology that helps:

route emergency calls with minimal human intervention and with wider coverage than traditional wireless networks;

reduce the time it takes for reports to be routed from the operations room to ambulances;

the paramedic transfer data from the crash scene to the operations room receiving the reports;

the paramedic provide emergency services during the crash (audio, video, data);

the operations room receive the reports to track the location of the ambulance and intervene, if necessary, to direct the driver; and

the ambulance crew see the location of the report on maps and measure the distance and time to reach the crash site.

To meet these needs, the Egyptian Ambulance Authority and the Unified National Network created the CAD mobile application.

When a citizen calls an ambulance, the report is transferred to a tablet in the ambulance nearest to the crash site.

The ambulance crew reviews the data and moves to the location of the report.

Communication between the ambulance and the ambulance operations room is via the tablet, saving citizens' time.

Any comments are exchanged with the operations room are via the tablet, allowing both sides to see data related to the patient.

The CAD mobile application has been rolled out in Port Said Governorate and 6th of October District (part of Giza Governorate), and there are plans to extend the system nationally. While the intervention is technical and professional, involving no direct community interaction, it directly impacts the quality of services provided when an ambulance is requested, contributing to enhanced response speed and field performance efficiency.

Challenges included training staff and creating a work environment that embraces the use of technology to raise performance efficiency and improve the quality of services provided.

The roll out will be evaluated over a 6 month period to extract lessons learned and identify the best implementation mechanisms ahead of expansion to other governorates.

The Islamic Republic of Iran had carried out road safety improvement projects for many years without the effectiveness of the interventions being systematically evaluated. Decisions tended to be based on engineering judgment rather than empirical data.

To accurately measure the effectiveness of engineering interventions to improve road safety at high-risk locations requires before-and-after studies at the intervention sites. The findings of the studies are then used to produce quantitative effectiveness coefficients – crash modification factors (CMFs).

To provide evidence-based indicators to guide future safety investments, Iran launched a CMF development programme. Led by the Road Maintenance and Transportation Organization, in collaboration with road safety councils, universities and research centers, insurance companies and the Ministry of Health and Medical Education, the programme involved:

establishing a national framework for developing CMFs through before/after crash studies;

the selection of sites for intervention in highways, freeways and intersections

data collection on crashes, exposure and road conditions before and after interventions;

statistical analysis to determine CMFs for each intervention type; and

the integration of CMFs into national road safety guidelines to prioritize countermeasures.

Among the challenges the programme faced were the vast geographic coverage, diversity of road types, large variations in traffic and geometric conditions, incomplete crash data and inconsistent reporting. These were overcome by using a representative sample of sites across regions, stratified analysis and the development of a centralized crash data management system in coordination with traffic police.

Indicators were developed based on the results of the studies and then revised following evaluation of the before and after effects of each intervention. The revision cycle is an ongoing process, allowing for the continuous improvement of indicators to determine the best interventions.

To improve the accuracy of CMF, future evaluations will incorporate advanced statistical models, including Empirical Bayesian analysis and hierarchical models, with more detailed exposure and crash data systematically integrated into the evaluation process.

As part of the Public Security Directorate's, represented by the Traffic Department, drive to strengthen laws related to traffic safety in line with World Health Organization (WHO) best practices, efforts began in 2024 to amend Jordan’s 2001 regulations for driving under the influence of alcohol.

The WHO National Data Coordinator of Road Safety attended several workshops and remote meetings with WHO and regional experts which included discussions on WHO best practices and blood alcohol concentration (BAC) while driving.

WHO recommends a maximum BAC limit of 0.05g/dL for the general public when driving, and an upper limit of 0.02g/dL for novice drivers. Under the 2021 regulations, the limit for driving vehicles under the influence of alcohol was set at 0.08g/dL. (Paragraph (a) Item (1) of Article (46) of the Traffic Law No. (47) of 2001 and its amendments).

Data was obtained on the number of drink driving violations from the Criminal Information Department and for the first time the figures were included in the 2024 annual report on traffic accidents in Jordan (Table 1 and Table 2). The proportion of deaths from crashes involving drivers who had consumed alcoholic beverages accounted for 2.4% of the total number of fatalities.

Table 1. Number of crashes involving human and material injuries and their results for drivers under the influence of alcohol and psychotropic substances while driving during the year 2024

Table 2. Number of human injuries and fatalities for crashes involving drivers under the influence of alcohol and psychotropic substances while driving during 2024 disaggregated by severity

 A detailed study – Traffic accidents and their consequences for drivers under the influence of alcohol and substances during 2024 –  was conducted for the first time by the Traffic Department to gain a deeper understanding of the extent of the problem and furnish the data and analyses needed to make evidence-based decisions and direct awareness, regulatory and legislative efforts. The study shed light on the legal, technical and social aspects of the phenomenon, paving the way for the development of realistic and implementable solutions to reduce the problem.

Based on the global BAC best practices recommended by WHO and a thorough understanding of the extent of the problem in Jordan, work began to amend legal BAC limits. Consultations and institutional meetings were held with security, legislative and technical bodies, including the Prime Minister’s Office, the Ministry of Interior, the Public Security Directorate, the Traffic Department, the Public Security Judiciary Directorate, the Jordanian Traffic Institute, the Driver and Vehicle Licensing Department and the Ministry of Health.

These efforts resulted in the issuing of amended instructions for 2025 for driving under the influence of alcohol (Box 1).

The changes reflect the Public Security Directorate/Traffic Department's commitment to enhancing road safety and achieving compliance with international standards and offer a model for collaborative institutional work based on sound evidence and scientific studies.

Yarmouk, the first city in Kuwait to receive WHO Healthy City accreditation, provides a model of how community-based health promotion can drive safer and more sustainable urban environments.

Under its Strategic Plan 2017–2025, the Yarmouk Healthy City Committee identified “enhancing safe housing and work environments” as a strategic objective, with a particular focus on road safety. The initiative emerged after community assessments revealed frequent minor crashes in residential zones, unsafe crossings near schools, limited awareness of safe-driving behaviours and low compliance with seatbelt and child-restraint use.

In response, in 2018 Yarmouk launched a coordinated road-safety programme led by the Healthy City Committee in collaboration with the Ministry of Health, the Ministry of Interior’s Traffic Department and Kuwait Municipality.

The programme aimed to translate national priorities into local action through practical participatory measures. Streets were redesigned with speed-reducing features, improved lighting and standardized school-zone signage. The Municipality incorporated traffic-safety audits into its planning processes and community volunteers helped identify hazardous areas and propose improvements.

Public engagement became a cornerstone of the initiative. The Committee organized regular community forums and workshops on safe driving and emerging technologies, involving parents, teachers, students and local drivers. School campaigns during Gulf Cooperation Council Road Safety Week introduced children to safe crossing techniques and the importance of seat-belt use. Young volunteers conducted street observations of driver behaviour and their findings were used to inform awareness raising materials that were then displayed across the city. Health centre staff were trained to collect data on road incident injuries, providing data for evidence-based planning and the continuous monitoring of progress.

All schools in Yarmouk achieved compliance with Safe School Zone standards, significantly improving the safety of children during peak commuting hours, and more than 2000 residents participated in awareness events.

The Yarmouk model has been taken up by other Kuwaiti Healthy Cities, including Mishref and Sulaibikhat. Road safety is not just a transport issue – it is a community-health issue. Through the Healthy City approach, Yarmouk has turned its streets into safer, healthier spaces for all residents.

Yarmouk’s experience demonstrates that sustainable improvements in road safety depend as much on community ownership, intersectoral collaboration and reliable data as they do on infrastructure development. The partnership between the health, police and municipal sectors ensured that interventions were comprehensive and coordinated, while active youth involvement helped shift social norms around driving behaviour. Integrating traffic-injury reporting into health information systems further strengthened accountability and guided targeted prevention.

The Yarmouk Healthy City Committee now plans to expand its initiatives by introducing smart-mobility technologies such as radar-based speed monitoring and digital awareness boards. The Safe Streets for All model is now being rolled out across Kuwait’s growing network of Healthy Cities. The next phase will focus on developing national healthy mobility guidelines aligned with the Decade of Action for Road Safety 2021–2030.

In 2006, 16-year-old Georges Nassim Khoriaty was killed in a car crash. Following the death of the young pedestrian, Georges’ family determined to turn their grief into action. They established the Georges Nassim Khoriaty (GNK) Foundation, planting the seeds of a vision that would go on to transform road safety education in Lebanon.

The Khoriaty family’s vision in establishing the GNK Traffic Academy was to reduce the number of traffic crashes, deaths and disabling injuries on Lebanon’s roads by promoting safe driving behaviours and fostering a responsible attitude towards the safety of both drivers and pedestrians. The Academy’s aim is to educate children and adolescents aged 3 to 18 about in-car and pedestrian safety through an accredited interactive e-learning and simulator-based curriculum, and instill the ethics and rules of safe driving.  The GNK Traffic Academy, built next to the site where Georges lost his life in Kfarhazir, North Lebanon, was inaugurated in 2016. The Academy is more than a school. It is a living tribute to Georges, a place where children and young adolescents learn not only to follow traffic rules, but to respect the lives of their fellow citizens.

The Academy’s approach is unique. It combines classroom learning with hands-on experience. Students use simulators, but also electric cars to navigate a mini city complete with roads, traffic lights and roundabouts. Here, road safety is not a set of rules on paper; it is experienced, practiced and internalized.

The Academy’s ISO-certified curriculum is delivered in 3 languages and 5 educational steps. From toddler to teen, each student undergoes a structured journey. They start with theoretical lessons on traffic signs and road traffic crash prevention, progress through interactive simulations, then put their knowledge into practice in the Academy’s traffic garden. The final steps include a knowledge assessment and evaluation module. Students leave not only with a certificate, but with real experience of driving ethics, safety, awareness and responsibility.

By October 2025, more than 13 000 students from public and private schools across Lebanon had graduated from the Academy, including hundreds of children with disabilities. Every year, the Academy reaches around 5000 new students, empowering a new generation to drive change on Lebanon’s roads.

The success of GNK Traffic Academy is counted in lives saved, families spared from tragedy, and a culture of safety slowly but surely taking root. Through the Academy, Georges’ legacy continues to inspire. It teaches children that every seatbelt fastened, every pedestrian respected and every careful manoeuvre can make a difference. The GNK Traffic Academy shows how local initiatives can transform road safety across a country, one student, one lesson and one life at a time.

In 2009, his late Majesty Sultan Qaboos Bin Said gave a speech on road safety underlining how the burden and consequences of road traffic crashes impact individuals, families, communities and the Government and are the responsibility of all parties involved. Between 2003 and 2011, the population of Oman increased by almost 40%. There was an increase in major crashes of 6% (8209), an increase in injuries of 1.6% (11 618) and an almost 9% (1139) increase in fatalities. The number of registered vehicles grew to 881 360 and the number of licensed drivers to 989 279. In recent years, these numbers have increased significantly.

Analyses of road crashes in Oman revealed speeding to be the cause of the majority of fatal crashes. In response, and in alignment with the Decade of Action for Road Safety 2011-2020, in 2005 the Sultanate introduced an automated speed enforcement programme. Starting with 125 fixed and 40 mobile cameras, the Royal Oman Police gradually increased the number of cameras up to mid-2013 when newer technologies were introduced, including red-light cameras, laser-guns and vehicle-mounted automated speed enforcement systems. The use of this approach and technologies has continued into the current Decade of Action for Road Safety 2021-2030 to date.

The number of police patrols and automated speed cameras were increased so that all roads were covered. To combat community resistance to the changes, the National Committee for Road Safety (NCRS) launched campaigns to raise awareness about the importance of the speeding countermeasures. The campaigns used TV, radio and social media networks to highlight how the increased presence of police personnel and traffic policing activities were needed to enhance road safety.

A subsequent evaluation conducted by the Directorate General of Traffic revealed how this approach, and road users' perceptions that the enforcement is present everywhere, was helping change the behaviour and attitudes of reckless drivers. 

There was a significant decrease in number of crashes, injuries and fatalities between 2012 until 2018. The number of fatalities fell by 44% (637) despite an increase in the total number of registered vehicles to 1 502 259 and of licensed drivers to 1 601 832.

The general trend of road crashes in 2024 shows that the decrease is continuing.

Pakistan is committed to World Health Assembly Resolution 72.16 – Emergency care systems for universal health coverage: ensuring timely care for the acutely ill and injured – which aims to ensure timely and effective emergency and trauma care is available to all. It is equally committed to UN General Assembly Resolution 74/299 on improving global road safety and the Decade of Action for Road Safety 2021–2030 which aims to reduce severe road injuries by at least 50%.

In Pakistan, emergency health care systems are often overwhelmed, with trauma centres like the Shaheed Mohtarma Benazir Bhutto Institute of Trauma (SMBBIT) in Karachi bearing the brunt of critical case management. In such contexts, implementation of the WHO Clinical Registry, with its built-in analytical capabilities, plays a crucial role in identifying potentially preventable deaths, other poor outcomes and near misses that signal gaps in care or system weaknesses.

By systematically collecting and analysing data, the Registry enables health care providers to improve the quality of emergency services and, ultimately, save lives.  

The WHO Clinical Registry platform for systematically collecting, aggregating and analysing case-based clinical care encounters was developed to respond to country needs and support systematic quality improvements in emergency care.

The advantages of the WHO Trauma Registry include:

a multi-lingual and multi-platform that can easily be translated across 28 languages;

it allows offline data entry in low connectivity settings that can be synced periodically when stable Wi-Fi is available;

the Registry utilizes agreed WHO datasets – a minimum set of recommended data elements for effective monitoring and quality improvement of care – developed through extensive consultations with global stakeholders; and

it hosts a range of dashboards and standard reports for users to view injury epidemiology trends and monitor key indicators over time, for a single facility or across facilities.

SMBBIT began implementing the WHO Clinical Registry in 2025. The facility team was virtually trained and a data collection strategy initiated. The plan is to expand this successful experience nationally so hospitals across the country can use the Registry’s data-driven approach to enhance the quality of emergency services.

The Registry has the potential to save countless lives and significantly improve Pakistan’s emergency care landscape. The Social Research and Development Organization, a Karachi-based NGO, is facilitating WHO's efforts to implement the Clinical Registry in Karachi, Pakistan’s most populous city, and helping promote its wider adoption.  

Like many countries that have undergone rapid development, Qatar faced a rising toll of road traffic injuries. With more vehicles on the roads and a growing population, road safety became an urgent concern.

Rather than respond with isolated measures, Qatar chose a comprehensive path grounded in coordination, technology and education. The National Traffic Safety Committee (NTSC), founded to unite governmental, law enforcement, transportation, municipal, health and civil society sectors behind the common goal that no life should be lost needlessly on the roads, lies at the centre of Qatar’s approach, exemplified by the National Road Safety Strategy 2013–2022, extended to cover 2025–2030, with the goal of halving traffic fatalities by the end of the decade.

The Strategy’s strength lies in integration. Qatar recognizes that safer roads depend not on one actor but on collective efforts. Roads are now designed with safety audits. Data systems track every crash in real time and awareness campaigns such as Safe Journey and Drive Safely Qatar nurture a culture of responsibility. The creation of the Qatar Road Safety Association gave citizens and private partners an active voice in shaping safer transport.

The NTSC framework is used for coordination by over 20 national entities. National databases inform evidence-based decision-making and intelligent traffic management systems aid in collision prevention. Stronger collaborations, fewer deadly accidents and increased public awareness that road safety is the responsibility of everyone are among the outcomes.

A traffic research database was established to facilitate knowledge exchange between government sectors concerned with road safety. Traffic crashes were studied and analysed, a methodology for classifying serious injuries according to their severity was developed to propose appropriate engineering solutions, and specialized engineering databases were set up to store information related to road assets and link relevant data.  There is a sustained system for traffic control including speed cameras, red-light cameras at intersections and weighing devices for trucks to monitor traffic violations.

The Ministry of Transport issued 2 unified engineering guides for road design and traffic control and a comprehensive strategy to review and update speed limits across the road network was developed. An annual speed survey and monitoring project was implemented. Speed surveys were conducted across all road categories and the results correlated with traffic crashes.

The Ministry of Transport also launched the comprehensive Land Transport Plan 2050 which aims to develop a safe, sustainable and smart transport system. A comprehensive pedestrian crossing plan for the State of Qatar was completed, and a bicycle plan is being prepared.

Efforts were made to improve driver training and testing through specialized courses, new trainer standards and follow-up on trainers' work. Two schools were accredited to grant a professional competency certificate to drivers of vehicles transporting hazardous materials, with an emphasis on youth training permits.

Awareness campaigns were conducted on key risk factors, including safety guidelines around schools, hospitals, mosques and other public places, alongside campaigns on installing pedestrian barriers and guardrails on roads and bridges and compliance with speed bump regulations. Arabic, English and Hindi are used across different media to disseminate awareness messages to the widest possible audience.

Qatar’s story does not end with prevention. Recognizing that every second counts after a crash, Qatar has upgraded its post-crash emergency response system. The National Command Centre (NCC) brings emergency services together under one roof, enabling seamless coordination and rapid response, and anyone in Qatar can dial 999 to reach ambulance, police and civil defence services. Using advanced technologies such as GPS-based dispatching, real-time mapping and secure communication, the NCC ensures that emergency teams reach victims swiftly and efficiently.

The Hamad International Training Centre works to strengthen workforce capacities. There is ongoing professional development training for paramedics within the ambulance service workforce, helping to ensure that care starts as soon as assistance arrives. Thousands of paramedics and ambulance service personnel have undergone certified training in trauma management and basic life support, and public training programmes are available.

There are obstacles still to overcome, especially in extending coverage to industrial and offshore areas, but Qatar's plan is clear. The response should become quicker and more intelligent, with investments in digital links between ambulances and hospitals, satellite communication and predictive analytics.

For WHO and the global road safety community, Qatar’s integrated efforts offer an example of how leadership, data and determination can turn vision into a new reality, one safe journey at a time.

The General Secretariat of the Ministerial Committee for Traffic Safety (MCTS) is spearheading the strengthening of road safety management in Saudi Arabia. It plays coordinating, follow-up, and periodic evaluation roles, working with regional traffic safety committees and forming specialized committees – overseen by the Ministerial Committee for Traffic Safety– to follow up on interventions. MCTS has developed a common approach to road safety, including a formal evaluation method that includes indicators and targets, and effective mechanisms to monitor activities at a decentralized level. Success in strengthening the quality of reporting of road traffic mortality was reflected in a reduction in the gap between reported and World Health Organization (WHO) estimated road traffic deaths. The Global status report on road safety 2023 recorded 6035 reported fatalities in 2021 versus WHO estimates of 6651. Saudi Arabia has also improved its civil registration and vital statistics grouping to group 2A.

The General Secretariat of the Ministerial Committee for Traffic Safety (MCTS) have been closely coordinating and supporting the recommendations of the Global Plan of the Decade of Action for Road Safety 2021-2030 (safety of road infrastructure, vehicles, multi-modal transport, safety of road users and post-crash response). The integrated work of the entities within the MCTS system has resulted in the following achievements:

Safety road infrastructure:

The Kingdom has created an account with the International Road Assessment Programme (iRAP) to enhance safety and improve the quality of its roads. Implementation of the Saudi Road Code, which adopts international best practices, is overseen by the Road Code Steering Committee.

Initiatives to improve infrastructure safety include the Eastern Province Municipality’s Emergency Parking Initiative, the unified Traffic Model for Urban Abha which is adopting innovative solutions to enhance the safety of roads and intersections, the Ministry of Municipalities and Housing’s unified digital system for the management and maintenance of urban roads, a new smartphone application that connects communities and government authorities to improve road services and a new road guide for pilgrims

Safety of vehicles:

Infrastructure upgrades are adopting innovative techniques. A roller compacted concrete layer has been developed, initially for use on truck lanes, demolition waste is being used in asphalt mixtures and the General Authority of Roads has become the first authority in the Middle East to systematically measure ground coatings. The Saudi Standards, Metrology and Quality Organization (SASO), in cooperation with several government and private entities, is implementing an ambitious plan to develop the periodic technical inspection system for vehicles. Short-front license plates for sports vehicles with specific manufacturer specifications have been introduced to accommodate all types of motorized vehicles.

Multi-Modal Transport:

Bicycle path development projects are ongoing, as is the Riyadh Metro project. A recent survey of public satisfaction with the Metro showed that 60% would use the Metro and other public transportation to commute to work or school, 71% believed the Metro would change their commuting habits and 81% believed it would reduce traffic congestion. The Saudi Road Code includes a chapter on infrastructure standards required for autonomous vehicles. The Saudi Authority for Accredited Valuers (TAQEEM) has launched an electronic estimation service to assess vehicle damage resulting from minor accidents. The Ministry of Municipalities and Housing has launched a paid parking permit service to regulate and encourage investment in the sector and establish parking spaces according to the requirements of the Saudi Road Code and the General Transport Authority has launched the Kingdom's first hydrogen truck on a trial basis as a step towards building a hydrogen mobility ecosystem.

Safety of road users:

Road safety awareness campaigns implemented by entities concerned with road safety included the Safe Holiday campaign and the Crossing Safely initiative launched by the Holy Capital Municipality. They also encompassed the Aslam wa Salam initiative, which aims to enhance safety standards for delivery motorcyclists, and the Life is a Skill manual issued by the Family Affairs Council to promote the role of parents and educators in developing children’s life and road safety skills.

Post-crash response:

The Kingdom has achieved a notable improvement in emergency response to traffic accidents, with air ambulance flights increasing by 33.65%, reflecting its commitment to enhancing survival rates and reducing complications resulting from accidents. Also, enhancing post-crash response during the Hajj season has involved the adoption of modern technologies, including the use of drones, and activating specialized emergency medical pathways for severe injuries to increase survival rates and reduce complications and mortality.

Road traffic legislation and enforcement have also been strengthened. Royal Decree No. (M/86), for instance, dated 9/14/1443 AH, amended the Traffic Law to allow the bank accounts of traffic violators to be seized.

Monitoring and evaluation:

Kingdom is actively sharing its experiences in strengthening data and research. Saudi Arabia’s multisectoral drive to strengthen research capacity around road safety has involved King Abdulaziz University (KAU), which has completed an innovative research project using artificial intelligence to monitor emergency lane violations on highways in real time. The Saudi Road Research and Accelerated Pavement Testing Centre has integrated the latest technologies in its work, including the Heavy Traffic Load Simulator. In a national first, the Riyadh region deployed a robot equipped with a 360⁰ camera to inspect and evaluate safety on bridges, and a patent has been granted, titled the Camel Eyes project for the use of artificial intelligence technologies to improve road safety.

Looking ahead, the Kingdom is working to develop the safety of its electric vehicle infrastructure, unify standards for vehicle safety, and is exploring ways to contribute to the planned Gulf Cooperation Council legislative and policing framework. There will also be a greater focus on improving the reporting of non-fatal injuries, including strengthening the role of injury surveillance and trauma registries.

In Sudan, fatalities from road traffic crashes are often a result of help arriving late, or without the tools needed to save lives. Ambulance service coverage is patchy, and many roads have been destroyed in the ongoing conflict. In most cases the traffic police respond first, often with no equipment and no medical training.

Sudan’s National Ambulance Project (NAP) has begun to change this. Building on pre-war initiatives, the project is  initiated under Federal Ministry of health- directorate  of Emergency care agencies reimagining the prehospital care system based on the premise that those who arrive first at crash scenes must be equipped to save lives.

Recognizing that the traffic police are usually first on the scene, NAP have  a formal agreement with the Ministry of Interior to integrate them into the emergency response system. It includes:

His excellency minister of health initiative of training 5000 traffic police officers in first aid and trauma response, turning them into effective first responders;

equipping officers with automated external defibrillators (AEDs) to manage cardiac emergencies at crash sites;

joint planning for ambulance distribution, ensuring that new vehicles are stationed in blind road areas – high risk sites that are hard to reach.

Thanks to NAP, the average response time has dropped from 90+ minutes to just 15–25 in the areas covered. Instead of waiting and hoping, patients are now stabilized on-site, triaged according to the severity of their injuries and transported in fully-equipped ambulances staffed by trained responders. For the first time, trauma care in Sudan begins at the roadside rather than the hospital.

The transformation is an ongoing process. The end goal, though, is clear. The system needs to expand until every Sudanese citizen, from Khartoum to the most remote rural village, has the same chance of survival. Each new ambulance deployed, each dispatcher trained, each ambulance centre activated, is a step towards a future where road crashes no longer end with preventable deaths.

The numbers are already stacking up.

1950 citizens were directly supported in 2024

So far in 2025, 3714 emergency calls have been answered and 2065 critical cases safely transferred

6% of call are beginning served ( and only 3.1% delays or rejections.

The fleet of 230 ambulances includes 148 new vehicles from global partners (Japan, the Arab Fund, the Arab-African Bank, Qatar Charity)

224 ambulance staff trained in advanced trauma response

9 ambulance centres activated across Sudan, with specialized equipment in 3 states

But the project is about people rather than statistics. Patients like the high school student in Khartoum who went into labour during her final exam. The ambulance team rushed her to hospital, ensuring both mother and child were safe. Or the victims of a bus crash in White Nile who were stabilized and directed to hospitals that had been pre-alerted.

Each story reflects how a once reactive, fragmented system is now coordinated, preventive and actively saving. Lives

In addition to ambulances, the NAP addresses :

1. Governance
   A central ambulance authority with standard operating procedures aligned to WHO trauma and emergency medical services (EMS) guidelines.
2. Coverage
   Establishing centres along highways and urban areas, with a phased plan covering all 18 states.
3. Human Resources
   Training national service recruits, paramedics and nurses in WHO-certified prehospital care.
4. Digital systems
   GPS-enabled tracking, electronic patient records and 24/7 call and dispatch centres.
5. Community Engagement
   Training traffic police officers as first responders, supplying them with AEDs and integrating them into the national EMS network.
6. Financing Despite all the achievement of NAP in maintaining the pre-hospital emergency services finance remains one of the major challenges affecting expansion and sustainability. It depends on short term support and ad-hoc contribuions from humanitarian donors. The service is paid with height costs compared to Sudanese income because there is no fixed funding stream to operate the program, despite our attempts to build non-traditional partners and PUBLIC – PRIVATE Partnerships in order to minimize the cost.

Looking forward

A significant challenge for the project is the current low level of community awareness regarding the proper procedures for requesting and accessing the emergency medical service. The project's publicity and outreach efforts remain limited because several key program components are still in the underdeveloped stage. This lack of readiness and subsequent weak public profile is primarily attributable to constraints in human resources and insufficient financial support to fully implement all aspects of the program.

Sudan is proving that even in fragile contexts, structured and scalable EMS systems can save thousands of lives. The next phase will expand coverage to all 18 states, integrate air ambulances for remote regions and strengthen digital data systems for real-time monitoring and research.

The NAP shows what is possible when vision, partnerships and practical innovation meet. It is not just about faster ambulances and reducing response times, it is about giving every Sudanese citizen a fair chance of survival after a crash.

It is not clear what these figures refer to. 96.6% call coverage? Coverage of what? Clarify. The references need to be clear and explicit.

Daily emergency room reports reveal that a large percentage of deaths or complications resulting from road crashes are linked to delayed response times and a lack of awareness of the correct procedures to apply in the event of an crash on the part of drivers and citizens.

The problems are most severe in rural areas and on highways, which often lack emergency infrastructure and nearby service points. Occasional lack of coordination between agencies (police, transportation and health) was shown to contribute to increased pressure on ambulance personnel, exposing a clear need for effective and direct intervention by the Emergency and Ambulance Directorate and an action plan based on a realistic assessment of the situation that could facilitate a more effective use of available resources.

To respond to the problems, fixed and mobile road ambulance stations have been established, operating 24 hours a day. The stations are distributed across governorates, along highways and vital intersections, staffed with trained personnel and fully equipped ambulances which coordinate directly with central operation rooms.

Each ambulance station has a digital and printed medical services map, including the nearest hospitals and health centres, with a clear description of the services provided. This allows for the rapid referral of cases based on the type and severity of the injury. The maps were prepared in cooperation with health directorates and medical authorities.

A series of focused training sessions was conducted for ambulance personnel working on the roads, with a focus on:

rapidly assessing injuries;

rapid decision-making for referral;

providing lifesaving first aid; and

coordinating with the traffic police to increase preparedness to deal with emergencies at any time of day or night.

A joint working protocol was adopted with the traffic police to facilitate ambulance access to crash scenes, and with the Ministry of Disaster Management to ensure the removal of obstacles and the provision of a safe place for emergency intervention. Hotlines were activated between emergency operations rooms and traffic police rooms across governorates.

The Ambulance and Emergency Directorate, in cooperation with the relevant authorities (transportation, traffic, municipalities­) has deployed awareness and guidance signs at intersections and main entrances. The signs contain concise and effective visual messages, including:

Your reckless driving could end a person's life"

🟨 "Seatbelt is life... not a habit"

🟩 "Leaving the ambulance lane open... you could be next"

🔶 "Golden minutes start from you... report immediately"

The messages aim to change bad driving behaviours and build a sense of individual and collective responsibility among drivers and citizens.

The Emergency and Ambulance Directorate is also working to create a national database that documents traffic crashes and analyses locations and causes, with the aim of providing practical recommendations, including ways to modify traffic signals, improve lighting and redesign hazardous areas. Data is periodically assessed with the relevant authorities (traffic, municipalities, health, etc.) in participatory evaluation sessions, informing practical decisions to improve safety. The results are also used to monitor the performance of ambulance teams and identify areas that need enhanced response or the establishment of new emergency points.

To strengthen legal deterrents, the Emergency and Ambulance Directorate provides periodic recommendations on ways to tighten penalties for behaviours that threaten safety, including obstructing ambulances, reckless driving and random interventions at crash sites. Recommendations cover license revocation, severe fines and requiring violators to participate in awareness and rehabilitation programmes.

Standardized instructions have been adopted to outline correct behaviour at crash sites, including not transporting an injured person in the absence of a specialized team, making room for ambulance crews and avoiding filming or crowding. Community teams have been trained in each governorate to implement the protocols, with team members ready to respond to crashes, organize crowds and secure the intervention site until ambulances arrive. These efforts are supported by ongoing awareness campaigns on the roads and in the media.

A standardized evaluation model is implemented after each crash, including analyses of response times, agency coordination and driver behaviour, and any shortcomings. The data forms the basis of follow up reports that are used to help develop plans and improve field interventions.

A bi-monthly evaluation mechanism has been launched for each emergency point that:

monitors response time;

identifies the causes of any delays or obstacles;

documents cases and driver complaints; and

issues follow-up reports and immediate recommendations to improve performance.

In a short period, the plan has achieved tangible results. Average response times have been reduced by more than 40% in some areas. More than 70% of main roads are now covered directly by ambulance stations or connected to a nearby centre. Cooperation between citizens and ambulance teams has increased, and, perhaps most important, more critical cases have been saved during the "golden minutes" following the implementation of direct guidance.

Building on these successes, the Ambulance and Emergency Directorate is extending the experience to other roads and rural areas; developing a smart application for direct emergency guidance for drivers; expanding awareness campaigns in cooperation with schools and educational institutions, and working to establish permanent first aid stations in cooperation with local and international organizations.

The Syrian experience shows how good planning, coordination and field training can make a real difference in saving lives.

Impact of the changes: a case study

Following a traffic crash on a rural road between the governorates of Hama and Homs in which a car carrying 5 people overturned, a report was sent to the nearest ambulance station, just 7 minutes away. An ambulance was immediately dispatched. The ambulance team rapidly assessed the injuries and 2 critical cases, including a child, were transferred to Hannah National Hospital in less than 20 minutes. The remaining injured were treated at the scene.

There was close coordination with the traffic police who cleared the road. This rapid intervention saved 2 lives, according to the doctors' report.

The child had suffered multiple bruises. She had a dilated right pupil and loss of consciousness (Glasgow Coma Scale 7), signs indicating life-threatening increased intracranial pressure. She was kept in a stable condition, her vital signs and level of consciousness monitored frequently, and her symptoms updated and documented throughout the hospital referral.

After she was delivered to the hospital an emergency CT scan revealed a widespread epidural haemorrhage and she was prepared for urgent surgery. Before entering the operating room, her left pupil dilated – another dangerous indicator of brain herniation. During surgery the haematoma was completely removed and the haemorrhage controlled. The patient was then transferred to intensive care

Five days later she was discharged with a completely normal neurological examination and without any significant disability.

Tunisia has developed a Master’s programme to accelerate the shift towards professionalizing and institutionalizing road safety management. The lack of specialized academic programmes in road safety engineering had been identified as hindering the creation of a qualified workforce and the Master’s degree was designed to fill this gap, support the Decade of Action for Road Safety 2021–2030 and align with Tunisia’s national road safety strategy. The Institut Supérieur du Transport et de la Logistique de Sousse (ISTLS) degree offers interdisciplinary coursework on traffic systems, crash data analysis, human behaviour, road design, intelligent transportation systems and public policy. It includes fieldwork, partnerships with public institutions such as the National Road Safety Observatory (ONSR) and the Ministry of Transport and applied research on road safety challenges.

Graduates are equipped to work on road safety audits, infrastructure planning, enforcement strategy and post-crash management. The programme is led by ISTLS, in collaboration with the Ministry of Higher Education and Scientific Research, the Ministry of Transport, ONSR, the municipalities of Sousse, Monastir and Mahdia, the National Guard and Traffic Police,  civil society organizations and non-governmental organizations and international road safety partners, including WHO support programmes.

Challenges included resistance to creating a niche academic programme due to perceived limited demand and the lack of teaching materials tailored to the Tunisian context. Efforts to overcome the challenges involved engagement with stakeholders, including ONSR and local municipalities, to demonstrate existing gaps, collaborative curriculum development involving local experts and incorporating international benchmarks, and the integration of private sector actors – insurance companies and engineering firms – through the development of internships, project opportunities and e-learning modules to widen national and regional access.

The programme actively involves local communities through student-led audits and awareness campaigns in Sousse. Community feedback was collected through surveys during field visits and roundtable discussions, with the feedback guiding continuous curriculum improvements.

Evidence of impact includes:

increased number of professionals graduating with road safety expertise;

enhanced capacity of municipalities to integrate safe system approaches;

research conducted by students that has directly supported local crash hotspot analyses and intervention prioritization; and

the employment of graduates in public agencies and consultancies focused on traffic safety projects.

Next steps include the introduction of a formal alumni tracking system to monitor long-term professional impact and regular course effectiveness assessments using employer feedback and national road safety indicators.

Since 2019 and the COVID-19 pandemic, the number of delivery motorcycles in the Emirate of Abu Dhabi has drastically increased. With the growth of the sector, a new challenge to road safety emerged. Delivery motorcycle-related traffic crashes increased by 140% in just 2 years (2019–2021).

The increased demand for delivery services resulted in a rise in the number of companies and motorcycles operating in the sector, exposing shortfalls in the regulatory framework, particularly concerning training, working hours and operational standards. Inexperienced drivers with limited knowledge of traffic laws and regulations were often employed, and there was no mandatory professional training on road safety and safe driving practices. Problems were compounded by the continuous recruitment of new drivers, and by a lack of cooperation on the part of operating companies in complying with general and personal safety requirements, including working hours, required by the Integrated Transport Centre and Abu Dhabi police.

In response, interventions led by Integrated Transport Centre and Abu Dhabi police, in collaboration of Ministry of Human Resources and Emiratisation, the Abu Dhabi Department of Economic Development and private operators included awareness workshops for delivery motorcycle riders.

Companies were mandated to provide compulsory training for riders on road safety procedures and driving practices. The Community Contributions Authority Ma’an supported and funded dedicated rest stops for riders. Surveys and opinion polls were conducted: delivery riders were asked to identify the challenges they faced and a public survey was carried out to assess public perceptions of riders' behaviour before and after they received the compulsory training. Subsequently, a decline in fatal and serious injuries was reported

Next steps include the continuation of training, education and enforcement efforts, using innovative technologies, as Abu Dhabi pushes towards vision zero 2040.