Lema has long since recovered from his injuries. A paramedic, he is also an energetic advocate for better bike rider safety, whose personal experiences illustrate where Australia is losing the fight against road trauma, and how we might win it. Road safety: are we doing it wrong? A national 10-year road safety strategy, published in 2011, aims to reduce Australia's road toll by 30 per cent by 2020. Australia is one of several nations that has a long-term goal of reducing the road toll to zero, perhaps an impossibly ambitious target but one that nevertheless drives authorities such as Victoria's TAC to seek to continually push down the number of deaths and serious injuries on the road. But a recent review of the 10-year strategy revealed a host of areas where Australia is failing to reduce the carnage, especially for "vulnerable road users" such as motorcyclists, cyclists and pedestrians.

The overall picture is encouraging: in the 10 years to 2013, Australia's road toll reduced 25 per cent, from 1583 fatalities to 1193. But as this graph demonstrates, efforts to reduce the road toll are failing among most categories of vulnerable road users. This graph was published last month as part of a major review of Australia's 10-year road safety strategy by AustRoads, the national body that sets road standards in Australia. The review says we will have to take a much more radical approach to road safety if the "vision zero" ambition is a sincere one.

The focus on "blaming the driver" – in which hoons, drunks and "irresponsible" drivers are viewed as the main cause of crashes – must shift, the review states. "We are concerned that this distinction perpetuates the 'blame the driver' attitude still common in the media and the community," it states. Instead, more effort must be made to build a "safe system" that accepts that people make mistakes, and design roads that reduce crash risks as much as possible. 70,000 killed or injured every year Professor Ian Johnston was director of road safety at VicRoads for five years in the 1980s and remains one of the leading voices in Australia calling for a change in direction in road safety strategy.

He believes Australian society is too complacent about the fact that more than 1000 people die on the roads each year, while tens of thousands are admitted to hospitals. "The target is to reduce serious injury and death by 30 per cent by 2020," Professor Johnston says. "That means more than 70,000 Australians will be killed or seriously injured on the roads every year. Have we ever asked the community if they're happy with that?" The February review of Australia's road safety strategy also notes very little headway is being made in reducing serious injury, sometimes referred to as the "hidden road toll". Between 2001 and 2011 the rate of serious injuries rose about 10 per cent, then fell off to 2001 levels, "while road death rates fell almost by one third", the report says.

"Analysis of the hospital data showed the rise in serious injuries was largely due to substantial increases in the numbers of injured motorcyclists and cyclists." A graph shows the number of serious injuries requiring hospitalisation, from 2008 to 2012 (excluding Queensland), jumped around between 60,000 and 66,000 over that time. Johnston, an adjunct professor at Monash University Accident Research Centre (MUARC) and co-author of the 2013 book Eliminating Serious Injury and Death from Road Transport, says Australia has been slow to build safer roads, "but we get away with it by blaming the driver". "One of the root causes of the problem is we're forever telling the public we're winning, lowering the road toll, and in a sense that's true but are we happy with little incremental gains?" he says.

Safer roads, in a roundabout way The review of Australia's 10-year road safety strategy points to some examples of changes to street design that have improved safety. Among them is a pair of roundabouts in South Melbourne, next to the bayside suburb's popular market. The local council decided to change the streetscape to prioritise foot traffic. Raised pedestrian crosswalks were built at the roundabout entrances.

The modest design change led to significant changes in behaviour, an observational study found. Motorist speeds on approaching the roundabouts reduced, and pedestrians became far more likely to cross the street at the zebra crossings. The changes have slowed the flow of traffic in the area, arguably making it less attractive to drive to the market, but there is evidence pedestrian safety has been improved. Researchers, also from MUARC, have called for a larger study to substantiate their findings. Safer by design Marcel Lema remains an avid cyclist, despite having been hurt so badly while riding several years ago. Often among the hordes of weekend bunch riders found on Beach Road in Melbourne's south, Lema was among those who successfully lobbied for car parking bans on the street on weekend mornings, a change brought in in 2011.

As The Age reported in December, Beach Road has become a safer place for cyclists, with injury rates decreasing against the city-wide trend for them to have risen significantly in recent years. The improvements on Beach Road have been attributed to a mix of better rider behaviour and changes to the street that have made it safer for riders. Calls are growing to similarly ban on-street parking on a stretch of Sydney Road, where cyclist Alberto Paulon was killed last month when a woman opened her car door in his path and he was knocked beneath a moving truck. Professor Johnston says incidents like the death of Mr Paulon are less a case of bad driver behaviour than unsafe road design that makes road trauma more likely. "We've designed a system where dooring is going to happen," he says.