Economic growth in Vietnam in the 1990s dramatically increased the number of motorcyclists, which rose by 2008 to 95 percent of the country’s 32 million registered vehicles. But until 2007, few riders used helmets, leading to tens of thousands of motorcycle deaths each year. Following a multilateral initiative to make helmets mandatory, enacted into Vietnamese law in December 2007, adult helmet use jumped overnight from around 30 percent to over 95 percent, with an estimated impact of reducing injuries by 69 percent and fatalities by 42 percent.
This case study is part of a series that accompanies The Bridgespan Group article "Audacious Philanthropy: Lessons from 15 World-Changing Initiatives" (Harvard Business Review, Sept/Oct 2017). See below for 15 stories of social movements that defied the odds and learn how philanthropy played a role in achieving their life-changing results.
- The Anti-Apartheid Movement
- Aravind Eye Hospital
- Car Seats
- CPR Training
- The Fair Food Program
- Hospice and Palliative Care
- Marriage Equality
- Motorcycle Helmets in Vietnam
- The National School Lunch Program
- 911 Emergency Services
- Oral Rehydration
- Polio Eradication
- Public Libraries
- Sesame Street
- Tobacco Control
This breakthrough was achieved by concerted cross-sector and multilateral efforts. In 1999, on the heels of growing concern by Vietnamese authorities, United Nations Children's Fund (UNICEF) and the first post-war US ambassador to Vietnam, Pete Peterson, galvanized international support, making “Safe Vietnam” a signature initiative. The effort drew in a number of other embassies, as well as the World Health Organization (WHO), alongside the country’s prime minister, the director of Vietnam’s National Traffic Safety Committee (NTSC), local nonprofits like the Asia Injury Prevention Foundation (AIPF), and global funder The Atlantic Philanthropies.Atlantic’s representatives and the US Embassy convened the major players and helped to coordinate the coalition’s strategy. Despite two earlier failed government attempts to selectively mandate helmet use (one in Ho Chi Minh City and one on select national roadways), the initiative’s work chalked up success after success, drawing on global road safety campaign precedents.
First, the coalition partners advanced a shared understanding of the seriousness of the problem, including a landmark household survey in 2001 led by the Hanoi School of Public Health and funded through UNICEF with the support of Atlantic. The survey polled 46,000 people and showed the prevalence of death and injuries to be so severe that the government initially pushed back against its results. But the government came around, and the coalition pivoted to developing solutions. By 2002, AIPF, which had used Atlantic grants to explore ways to prevent motorcycle injury, had a design for a lighter, much more comfortable helmet specifically designed for tropical climates like Vietnam, and with another major Atlantic grant, opened a manufacturing facility in-country to produce them (and directed all profits from the factory to road safety and public awareness campaigns). Finally, the coalition reached out to the international community after the United Nations adopted a global road safety resolution in 2005 and drew more funders to the cause, including the Bloomberg Family Foundation, WHO, and the World Bank.
With a credible cause, product at the ready, and promotion underway, NTSC director Bui Huynh Long’s proposal for a well-designed mandatory helmet law gained traction rapidly. The Vietnamese government introduced the new helmet law in early 2007, followed by a large-scale (philanthropy and multilateral donor-funded) public education campaign, and a robust enforcement regime. The law came into effect in December 2007, and the adult rate of helmet usage jumped far more than proponents had imagined possible, with ongoing efforts to convince adults to helmet their children.
Philanthropy’s Stake in Large-Scale Change
Our research shows that breakthrough social initiatives share a set of five practical approaches to large-scale change. Philanthropy supported two of them in the case of proliferating adult motorcycle helmet use in Vietnam with evidence this would lower injury and deaths:
- Build a shared understanding of the problem: Early shoestring research and a subsequent nationwide household injury survey led by the Hanoi School of Public Health (funded by Atlantic grants to UNICEF) demonstrated the seriousness of the problem. Although the government “initially balked” at the findings, they would later use the results of these studies in developing the mandatory helmet law.
- Drive demand, don’t assume it: AIPF’s work to design a tropical motorcycle helmet that would appeal to Vietnamese riders and manufacture these helmets in-country (funded by Atlantic) created an entirely new class of helmet. An industry has sprung up to copy this design—meeting demand for AIPF’s Protec helmet. Also, the extensive public awareness and education work, backed by the Bloomberg Family Foundation and multilateral funders, relied on powerful messaging about the deadly risks of not wearing a helmet. A television ad campaign by Ogilvy & Mather, commissioned by AIPF (a nonprofit supported by Atlantic) in the lead up to the law’s implementation, used especially compelling imagery.
Researched and written by Consultant Andrew Flamang of The Bridgespan Group, based on a Bridgespan interview with Le Nhan Phuong, former Vietnam country director for The Atlantic Philanthropies, as well as selected secondary sources
Center for Global Development. “Millions Saved: Vietnam’s Comprehensive Helmet Law.”
Craft, Greig. “Letter to Worldwide Partners- Vietnam Helmet Wearing Milestone / A Christmas Gift.” December 21, 2007.
Levine, Joshua Jake. “Head Injury in Vietnam: A Developing Country Struggles to Cope with Head Injury in Traffic.” The Vietnam Business Journal, August 1997.
McDonnell, Mary B., Van Bich Thi Tran, and Nina McCoy. “Helmet Day: Lessons Learned on Vietnam’s Road to Healthy Behavior.” Social Science Research Council, May 2010.
Parker, Susan. “Telling the Story of The Atlantic Philanthropies in Viet Nam.” The Atlantic Philanthropies, December 2013.
Pervin, Aaron, Jonathon Passmore, Mirjam Sidik, Tyler McKinley, Nguyen Thi Hong Tuc, and Nguyen Phuong Nam. “Viet Nam’s Mandatory Motorcycle Helmet Law and Its Impact on Children.” Bulletin of the World Health Organization 87 (2009): 369–373.
Road Safety in Ten Countries Project. “Road Safety in Ten Countries: Viet Nam.” World Health Organization.
Sullivan, Paul. “Giving Like Michael Bloomberg: ‘Find One Small Thing.’” The New York Times, May 20, 2016.
WHO Global Health Observatory Data Repository. “Road traffic deaths, Data by country.”
WHO Violence and Injury Prevention and Disability (VIP). “Motorcycle helmet wearing becomes law in Viet Nam.”