Anthropologists have showed only marginal interest in road safety, despite the loss of some 1.3 million people killed in road crashes every year, the bulk of which occurs in ‘developing’ countries. 2011 marks the beginning of a UN Decade of Action for Road Safety. Its scope is ambitious: to save five million lives and fifty million injuries by the end of the ‘decade’ in 2020. In this article, the author examines the way public health professionals and educators have appropriated the language of epidemiology to argue that road death and injury can be viewed as an ‘epidemic on wheels’ or a ‘disease of development’, to mention two often cited epithets among participants in the global road safety lobby. One major consideration of interest to anthropologists and policy makers is to what extent this effectively essentializes road death in Africa and depoliticises its injury politics. Bearing in mind the historical context of medical interventions in Africa, the article examines the global road safety lobby and its affinity with public health as a form of transnational governance, arguing alternatively that if the UN Decade of Action on Road Safety is to have any significant impact, it must recognize more clearly the political stakes being raised in claims to reduce deaths and injuries caused by automobility.