New Zealand's road toll is heading the wrong way fast - increasing sharply while in most of the western world it is declining.

From 2016 to last year, the road toll increased by 16 per cent, to 379 deaths. So far this year it stands at 154 deaths, well ahead of the 146 at the same time last year.

In Norway and tiny Luxembourg, the number of road deaths decreased by 22 per cent from 2016 to last year. On a percentage basis, that made them the life-saving leaders among 32 countries in the Organisation for Economic Cooperation and Development (OECD), according to a new report.

Other countries with big reductions were Finland, 18 per cent, and Slovenia, 20 per cent.

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In the United States, a much larger country, where 37,150 people died on the roads in 2017, there had been a 0.8 per cent reduction from 2016, according to the 2018 road safety report of the International Transport Forum at the OECD.

The annual report was released to coincide with the global summit of transport ministers in the German city of Leipzig this week.

The forum says when the increases and decreases are considered together, "preliminary 2017 figures suggest a slight decrease in the number of road deaths".

"Fewer traffic fatalities than in 2016 were recorded in 20 of 29 countries of the International Road Traffic Data and Analysis Group for which 2017 fatality data are available.

"Only five countries registered increases of 2 per cent or more in the number of road deaths compared to 2016."

The trend since 2000 for most of those countries has been downwards, but the speed of this slowed from 2010 and in 2015 and 2016 the number of road deaths plateaued or even increased in some.

In New Zealand from 2010 the road toll trended sharply downwards but then picked up again just as quickly, and last year's tally rose slightly above 2010's.

Ministry of Transport mobility and safety principal adviser James Campbell said it was considering whether to adopt a "vision zero" approach, which would aim to eradicate fatalities and serious injuries from the transport system.

He said the main causes of fatal and serious-injury crashes were drivers speeding, drinking alcohol, failing to give way or stop, and not paying attention. Failure to use a seatbelt was playing an increasing role.

"Improved economic conditions can contribute to adverse road-safety outcomes [by] encouraging additional travel, particularly by young, vulnerable drivers."

In the international report, New Zealand features in a section on rural roads.

"Inappropriate and relatively high speeds, the lack of physical separation, as well as poor roadsides increase the occurrence and severity of road crashes [in rural areas].

"In 2016, road fatalities on rural roads represented between almost 40 per cent, in Portugal, and 76 per cent, in New Zealand, of all road deaths."

Campbell said about 40 per cent of New Zealand's state highways had a two-star safety rating - which meant the roads had undivided opposing lanes, were poorly aligned, featured hazards such as narrow or unsealed shoulders or had unforgiving roadside objects such as trees, deep ditches, and concrete poles.

The Automobile Association says the key actions needed to reduce New Zealand's road toll are:

• Targeting of those who don't use a seatbelt, who are very few of total vehicle users but up to one-third of those who died in crashes.

• Ensuring at least 5000 of the highest-risk drink-drivers caught each year have breathalyser-like alcohol interlocks installed on their vehicles so they can't be started if the driver has been drinking.

• Giving the police the ability to test the saliva of drivers for drugs.

• Mass investment in safety measures for the highest-risk roads, such as rumble strips, barrier separation and better intersections.

On speed, the international report advocates limits that would mark a big change if adopted in New Zealand.

"Where motorised vehicles and vulnerable road users share the same space, such as in residential areas, 30km/h is the recommended maximum."

The AA said it had surveyed members 20 times in the past five years, finding consistently that 80 per cent opposed blanket reductions to 40km/h in urban areas.

"In some places 30km/h will be an appropriate limit, and we have a growing number of those around the country, but we support an approach that targets the highest-risk roads and looks at engineering roads up to be safer as well as potentially lowering limits where that's appropriate."

The national manager of road policing, Superintendent Steve Greally, said the police were committed to reducing the number of fatal and serious-injury crashes and needed everyone's help.

"We would love to see everybody paying full attention to driving sensibly and to the conditions every time they get into or onto a motor vehicle."