Economic Costs Road crashes cost roughly between 1 and 3 percent of a country's Gross National Product (GNP) and act as a drag on economic development. Individual country estimates vary from lows of 0.3 percent in Vietnam and 0.5 percent in Bangladesh to highs of over 4 percent in New Zealand and USA. Typically the figure is about 1.0 percent of GNP in developing countries, 1.2 percent in transition countries and 2.0 percent in industrialised countries. The total global economic cost of these crashes is estimated to be about $500 billion per year world-wide and about $60 billion per year in developing and transition countries-more than the entire annual flow of Official Development Assistance to these latter countries. The 700,000 people killed each year in developing and transitional countries, together with the estimated 12 to 23 million injured, also consist mainly of the economically active members of society between the ages of 25 and 40. These casualties impose large costs on the economy as a whole and represent a significant drain on the scarce (trained) work force in these countries. Click here to see a table of estimated costs of road crashes for different countries. Social Impacts The vast majority of road deaths occur to the young and those in the prime of life. EU road fatalities die on average 40 years too early. Road crashes are also a leading cause of head injuries and acquired disability. Care for the disabled will largely fall on families and friends. Household income often decreases from the loss of a victim's or carer's earnings. The sudden and unnatural death or disability of a loved one leaves families traumatised and suffering. There is also the fear of road crashes. Walking and cycling, the healthiest and most non-threatening of transport modes, are discouraged by perceived road danger. Burden on the Health Sector "We don't rest or eat because of your road accidents" (Ugandan doctor, 1996) The only health problem not to benefit from the Human Genome Project is that of injury. With a health expenditure of US$5-8 per capita recommended by WHO, there is little spare health care resources in developing countries. In most countries, the health sector focuses mainly on communicable diseases and malnutrition, and road crashes represent an unwelcome drain on the resources available for treating these conditions. Road crashes often have a knock on effect with scheduled surgeries being postponed for the "hot" emergency road casualties requiring immediate treatment. Road casualties also tend to stay longer than average in hospital. A 1997 UK road safety expenditure review found that half of all government expenditure was for the Health Service and treatment of road casualties. Click here to see a table summarising UK road safety spending. The amount hospitals can claim from insurance companies for treatment of road crash casualties was subsequently raised from UK£3,000 to £10,000 per casualty. Burden on the Police The Police are responsible for investigating road crashes and for the clean up at the scene, often including the removal of the dead. In many countries, road crashes are investigated by the general police, which means less resources for the investigation of violent crime. Estimates of police resource costs spent on road crashes are difficult to collect. In the UK, a 1997 review of road safety expenditure concluded that over £270 million was spent on enforcement, over three times the amount spent on road safety engineering schemes.