Worldwide, some 300 000 children die each year in road traffic crashes, a further 300 000 children drown, and some 100 000 die in fires.1 Many millions of children are seriously injured and hundreds of thousands sustain permanent disabilities. The public health response to this human tragedy is pitiable and raises important questions for child health professionals. Why, for example, is the death of a child following abuse taken as clear evidence of the failure of our collective efforts to protect children, whereas a child pedestrian death represents only the failure of an individual child to stop, look, and listen when crossing the road? And why did medical research “declare war” on cancer and ignore injury, when as many children die from injury as from all forms of cancer combined?

Most of the road deaths, particularly those in the developing world, involve children as pedestrians.2 In Britain, the pedestrian injury epidemic peaked in the 1930s with an average of nine deaths each day.3 Since then death rates have …