In the last three decades, the incidence of traffic crash fatalities and injuries has been reduced significantly in the high-income countries but not in the low and middle-income countries. The traffic patterns in the former are not only different but also less complex than those in the latter. Traffic in low-income countries comprises a much higher share of vulnerable road users and so vehicles, roads and the environment have to be designed for their safety. Solutions for such problems are not readily available and very innovative work needs to be done around the world to arrive at new policies and designs. In addition to crashworthiness of vehicles, transportation planning, exposure control, intelligent separation of non-motorised traffic on major roads, and traffic calming are likely to play a much more important role.