Khat, driver impairment and road traffic injuries: a view from Ethiopia.

Globally, road crashes are the ninth single biggest cause of death, killing 1.2 million people annually. The World Health Organization estimates that this could rise to 2.4 million by 2020, with 85% of this increase being in lowand middle-income countries. Road traffic crashes cost developing countries a staggering 1–2% of their gross domestic product.1 However, relative to the burden of disease, road safety research receives little funding – especially in lowand middle-income countries. While driver impairment is recognized as a significant global cause of road crashes, research into impairment has focused on issues of concern to high-income countries. Issues of primary concern to low-income countries have been neglected. One of these is the stimulant effect of the leaf khat (Catha edulis, also spelled qat or kat), commonly chewed by drivers in Ethiopia and other countries in eastern Africa and the Arabian peninsula. While there is sufficient evidence that khat may be a major contributor to road traffic crashes in this part of the world, its effects are still poorly understood. More research is urgently needed to inform policy in the countries where it is chewed.