With his head bowed and in a voice that was breaking with emotion, the husband of Mana Matsunaga and the father of their daughter, 3-year-old Riko, reignited the debate in Japan about old people getting behind the wheel of vehicles on the nation's roads.

Matsunaga (he has requested that his first name not be reported) was addressing a press conference on April 24, just days after his family had been run down and killed by a car driven by 87-year-old Kozo Iizuka in the Tokyo district of Ikebukuro. Security footage has shown Iizuka's car driving through red traffic signals and across pedestrian crossings before striking Mana Matsunaga's bicycle and two trucks and finally coming to a halt.

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Nine other people, including Iizuka, were injured and police have already stated that they believe human error was to blame for the tragedy. "I had believed I would watch my daughter grow up and become an adult, and that I would spend the rest of my days with my wife until the end of our natural life," Matsunaga said. "I am in despair. Our future was lost in the blink of an eye."

With a portrait of his wife and daughter on the table in front of him, he called on the elderly and people with older relatives to intervene if they believe that they are too infirm to still drive.

'Don't get behind the wheel'

"I want people who are not confident in their ability to drive to refrain from getting behind the wheel," Matsunaga said. "And if there is someone in your family whose driving worries you, please take the time to discuss that at home."

The accident caused shock in Japan, but the incidents have continued. On May 4, a 74-year-old woman was arrested in Fukuoka prefecture in southern Japan after she ran down two elementary school children, which left them requiring treatment in hospital.

The total number of traffic deaths in Japan hit a record low for a second consecutive year in 2018, according to the National Police Agency, with 3,532 road deaths during the year, down 162 from the previous year. The number of fatal accidents caused by people aged 75 or older, however, increased during the year, up by 42 cases to 460. Police statistics indicate that the biggest single cause given for an accident occurring was the elderly driver becoming "confused" with the vehicle's pedals.

"This latest incident has really pushed the debate in society and I hope that it will also make the politicians in the Japanese parliament think hard about how we can stop more accidents like this happening," said Makoto Watanabe, an associate professor of media and communications at Hokkaido Bunkyo University.

"It was shocking and I think that more and more drivers — including me — feel that Japan's roads are becoming increasingly risky because of the rising numbers of elderly drivers. "And that means that there is a growing sense among ordinary people that something needs to be done at last," he said. "The problem is that in politics, in the police and in the courts, change only ever comes slowly to Japan."

There are an estimated 17 million Japanese aged 65 or older with a driving license

Growing number of elderly

The nation's road authorities recognized some years ago that Japan's demographic problems — a falling birth rate and a rising number of people living longer lives, thanks to modern medicine — would have an impact on the transport sector. Revisions to the road traffic law went into effect in 2016, requiring anyone over the age of 75 to obtain a certificate of competence to drive when they renew their driving license every three years.

The tests are designed to identify drivers whose memory or judgement are impaired.

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There are an estimated 17 million Japanese aged 65 or older with a driving license and the new laws have been accompanied by a police campaign aimed at older drivers urging them to voluntarily give up their license if they feel unsure behind the wheel. "We reached the conclusion a few years ago that it was the best thing if my father stopped driving," said Makoto Hosomura, whose father, Kinzo, is now 98.

"But it was a difficult conversation to have," he said. "My father has always been very independent, he enjoyed going to his allotment to care for his vegetables and there is very little in the way of public transport in this part of Saitama prefecture," said Hosomura. "But in the end, we all agreed that it was the safest step to take."

Rising public anger

Watanabe says public anger over the issue has reached a point that the authorities need to take action, whether that be at the national or local level. "I think that everyone appreciates that taking driving licenses away from people living in rural areas is going to cause some inconvenience, so there is a need for a sensible approach," he said. "Cities, for example, have good networks of public transportation and congested streets, so it would make sense to encourage people in urban areas to stop driving."

Private companies have also recognized the scale of the problem and are stepping in with suggestions. Motorway operator Nippon Expressway Co. has recently introduced a scheme whereby it holds a "graduation ceremony" for any elderly driver who goes on one last journey before handing over their car keys.