Morbidity and mortality due to road traffic injuries (RTI) is one of the few public health problems where society and decision makers still accept death and disability on such a large scale as inevitable. Discussion only revolves around the number of deaths and injuries we are willing to accept. The partial departure from this mode of thinking is ‘Vision Zero’ for road safety that was adopted by the Swedish parliament in 1997. The long-term objective is that no one shall be killed or seriously injured in traffic and that the design, function and use of the transport system shall be adapted to the standards this requires. In this article we try to understand the concept of RTI as a public health problem and why that understanding has led to the introduction of Vison Zero and then sporadic attempts to establish road safety as a fundamental human right. We provide some details surrounding these events, the reasons for their limited success, and suggest ways in how we might move forward in establishing a place for rights and obligations to ensure road safety in reality.

Some of the ways forward include:

(a) Every policy, law or safety standard (concerning roads, vehicles or traffic management) established by the state to be accompanied by a justification for the same by including systematic reviews of the scientific evidence used for the decision and the expected safety benefits in numerical estimates.
(b) Manufacturers of vehicles and other road-based technologies to explicitly state the quality and limits of the safety features embedded in their technologies.
(c) International agencies dealing with road safety (state and non-state) to examine all sources of systematic reviews of road safety interventions and use them to justify the policies they pursue. They should also make it explicit that they will fund road safety activity by non-government organisations only if they promote interventions justified by scientific evidence.