The economic effects of Malaria and Poverty in sub-Saharan Africa

Unlike sudden epidemics, such as swine flu or bird flu, which receive extensive coverage for their novelty and surprise, malaria has been around a long time and remains a widespread and deadly pandemic.

No other infectious disease, particularly in sub-Saharan Africa, inflicts a more devastating economic toll, keeping whole populations trapped in poverty. As Jeffrey Sachs, the preeminent economist and author of The End of Poverty (Penguin Press, 2005), once wrote, “Malaria and poverty are intimately connected.”

Malaria is a mosquito-borne disease, and thus specific to a tropical climate. (It was only eradicated in the US in 1951; in fact, the CDC was established in Atlanta in 1946 with the primary purpose of eradicating malaria).

According to the World Health Organization (WHO), there were 247 million cases of malaria in 2006, causing nearly one million deaths, mostly among African children.

Nearly half of the world’s population is at risk of malaria, particularly those living in lower-income countries. Baruch Blumberg, the American physician and Nobel laureate in virology, once stated that half of all human deaths from the beginning of time can be attributed to malaria.

Beyond the human toll, the economic toll is significant: In high-rate areas, malaria decreases GDP by as much as 1.3% in countries with high levels of transmission. Over the long-term, these annual losses have separated countries with and without malaria, particularly in Africa.

The health costs of malaria are considerable for individuals and governments in already-poor situations. According to the WHO, in some countries the disease accounts for up to 40% of public health expenditures, 30% to 50% of inpatient hospital admissions, and 60% of outpatient health clinic visits.

People and communities already in poverty who can’t afford treatment are sent deeper into poverty.

Malaria and other tropical diseases, such as hookworm and Schistosomiasis (blood flukes), “occur in the setting of poverty and they promote poverty,” says Dr. Peter Hotez, professor and tropical-disease expert at George Washington University, in an interview with Minyanville. They are all preventable and curable; for malaria, the cost of insecticide-treated bed nets is $10.

In a Time editorial in 2007, Sachs wrote, “Not only does malaria sap worker productivity and scare away business investment, but it also, paradoxically, increases the rate of population growth. Instead of having two or three children, couples in a malarial region often choose to have six or seven — unsure how many will survive.”

The unintended consequences are important: With so many children, poor families can’t invest much in each child’s education. And women are also constrained because child rearing consumes so much of their adult lives.

Where malaria has been eradicated, there have been clear economic success stories: in Greece, Italy, and Spain after World War II, and even the American South after the war.

According to a research paper Sachs published in 1998, in the South there were 135,000 cases of malaria with 4,000 deaths in 1935. Large-scale drainage projects in the 1930s, followed by insecticide spraying after the war, brought malaria under control by the end of the 1940s. In the next decade, the South caught up economically with the rest of the country.

Finally, health experts are starting to predict that, as global warming intensifies, malaria will begin showing up in areas unaccustomed to it.

Source: The Minyanville

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3 Comments

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3 responses to “The economic effects of Malaria and Poverty in sub-Saharan Africa

  1. Doctor Michel ODIKA

    Can malaria be controlled? Inherent in this question is implicit recognition that the disease increasingly requires innovative approaches that comply with the challenges of today and prepare for those of tomorrow.

    ADVOCACY FOR A RESPONSE-TO-DEMAND APPROACH
    Personally, I think that the malaria response stands at a cross-roads. Especially noteworthy is the fact that an effective response to malaria critically depends on sustained growth in targeted investments until the disease is controlled in terms of mortality ratios. At the same time, advocacy to improve governance and leadership remains essential (1,2). Also essential is making far better use of available resources, be they human resources, information, financing or infrastructure. That means streamlining the flow of financial resources to the frontlines of the disease and putting it to optimal use.

    SPENDING MONEY WHERE IT MOST HELPS
    Today there is substantial body of evidence on the comparative advantages, in terms of efficiency and effectiveness, of strategies centred on environmental safety. For example, those low- and middle-income countries that spend the least on environmental safety are also those countries that experience the full impact of malaria. In many regards, available evidence reveals that environmental safety is at least equal to, and often more efficient and effective than, care infrastructures in addressing malaria on a global scale. Historically, this stems from the fact that no country has ever controlled – and still less eradicated – malaria as a result of purely medical approaches. Yet, in many, if not most sub-Saharan African countries (starting with Congo-Brazzaville, my native country), resource allocation still clusters around struggling curative services, neglecting the potential of disease protection and health promotion. At the same time, African governments lack the expertise to mitigate the adverse effects on health from other sectors. Consequently, in a context where money is often tight and needs are always high, the money currently spent on providing malaria-exposed populations with the full range of bnasic services is far short of expectations. More importantly, it does not come close to meeting the requirements not only because of the constant shortfall in the funding flows available (particularly in the worst-hit countries). Briefly and simply, it is also because there is often a mismatch between where money is most needed (hygiene and sanitation) and where money is predominantly spent (antimalarials, counterfeit drugs included).

    Based on the above-mentioned facts, I’m convinced:
    – that time has come for exploding the long-standing myth that care infrastructures must be at the forefront of tackling malaria;
    – that African health authorities have to make malaria a priority in their budget allocations;
    – that African governments gain to develop country-wide systems for continually gathering, analyzing and reporting data on malaria-related spendin, in all sectors, not just the health sector (broad vision for the response to malaria);
    – that most of the money spent on mitigating the impact of malaria should go towards improving hygiene and sanitation – e.g. waste disposal;
    – that “Malaria Observatories”, innovative structures that have yet to be established, can be helpful in promoting the multisectoral and collaborative response of a disease of critical concern.

    Doctor Michel ODIKA (Congo-Brazzaville, Central Africa)

    1. Michel ODIKA, Advocacy for a Malaria Observatory (http://www.booksie.com/health_and_fitness/article/michel_odika/advocacy-for-a-malaria-observatory-in-congobrazzaville/nohead/pdf/ver/8)
    2. Michel ODIKA, Malaria Observatory (http://www.slideboom.com/presentations/183737/Malaria-Observatory)

  2. Hello guys, I am Erica and I am want to post this text at my own website, with link to your blog, for my visitors.

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