Plasmodium parasites, transmitted by mosquitoes, are the infectious agents behind malaria. These parasites are among the oldest known diseases and continue to affect hundreds of millions of people worldwide, particularly in sub-Saharan Africa. Malaria shapes economies at the micro and macro levels, impacting health but also broad socio-economic development. Studying the economic consequences of the disease shows how prevention can be a cornerstone for sustainable development, and helps us to understand why we must continue investing in it.
The Economic Burden of Malaria
Malaria exposes people, their families, and their countries to massive economic loss – loss sustained via different mechanisms.
1. Healthcare Costs
The most obvious costs are the direct expenses of testing and treatment, and the medications needed to combat the parasite. Diagnostic tests, antimalarial drugs, and healthcare expenses all carry price tags that can be substantial, especially in endemic regions where families may already be poor.
Sample: In countries such as Nigeria and India where malaria is widespread, the cost of medical treatment can devastate household budgets and precipitate economic hardship.
2. Lost Productivity
One way that malaria reduces economic productivity is by its effect on individuals’ ability to work. Children sick with malaria might miss out on school and, if they do, their ability to concentrate and learn might be reduced, affecting their future earnings as adults. Adults sick with malaria might have less work capacity or miss work entirely, again reducing overall earnings.
Example: Malaria-related absenteeism from both agriculture and industry has been calculated to result in a significant loss of productivity. In Tanzania, malaria-related absenteeism from agriculture is estimated to result in yield loss equivalent to 0.6 percent of the crop product.
3. Economic Impact on Businesses
Beyond individuals, malaria has an impact on businesses and economies. Firms with a presence in malaria-endemic areas can incur increased healthcare expenses for their staff, reduced productivity due to sickness, and greater expenditure on preemptive control methods. All these factors can discourage investment and limit economic growth.
For example: Mining companies in Africa operate in endemic malaria areas where malaria accounts for additional staff health costs and loss in productivity.
The Ripple Effect of Malaria on Development
The indirect damage caused by malaria to economic development and broader social objectives is often greater than the direct cost of the disease alone:
1. Impediments to Economic Growth
The economic injury caused by malaria can even affect the rate of economic growth. This might stem from the fact that prevalence rates of malaria can correlate with lower rates of GDP growth. The inability to work, the cost of healthcare, and other factors feed a destructive cycle of impoverishment and economic decline.
Example: The World Health Organization conservatively estimates that Africa suffers economic losses of more than $12 billion a year due to malaria, in the form of lost productivity and health expenditures, which our work finds makes it more difficult to achieve the SDGs. This reflects the fact that malaria can be a drag on development and economic productivity in other areas.
2. Impact on Education and Human Capital
Malaria reduces learning by making children sick and need to miss school. Children with poor health can also suffer from lower levels of cognitive development. Lower academic achievements reduce chances for well-paid employment, and thus good economic prospects.
For example: Children who are frequently absent from school because of malaria will fall behind in their classes, reducing their lifetime earnings and perpetuating cycles of poverty.
3. Hindered Investment and Development
High levels of malaria burden discourage foreign and domestic investment in affected areas. Since investors see the high prevalence of malaria as a risk factor, they will invest less in affected areas, and businesses will take longer to develop and grow. Malaria also hinders infrastructure development. Resources that could boost productive capacity often get diverted to address the significant health impacts of the disease.
Example: Building roads in a malaria-endemic area will be more costly and less efficient, causing further delays for a much-needed infrastructure project, and thus constraining economic development.
The Case for Malaria Prevention
In summary, there is a strong economic rationale to invest in the prevention and control of malaria, and evidence to support that prevention is a cost-effective investment with significant economic benefits. There are numerous economic benefits of prevention which mount up – reduction in the burden of malaria results in substantial economic savings and improved development outcomes. Key prevention approaches include:
1. Insecticide-treated nets (ITNs)
ITNs are a useful tool in reducing malaria incidence because they reduce access by mosquitoes to the people who are most vulnerable to infection. Thus, ITNs can decrease malaria incidence leading to reductions in health-care costs and improvements in labour productivity. ITNs protect children from malaria, helping them stay in school and preventing educational underperformance.
For example: Improvements in human health can be shown to be cost-effective. For example, the mass distribution of insecticide-treated bed nets (ITNs) across the nation of Ethiopia has reduced cases of malaria by 40 per cent and related healthcare expenditures by 21 per cent, illustrating the economic return on investment in prevention.
2. Indoor Residual Spraying (IRS)
Insecticide residual spraying (IRS) is a malaria control intervention that entails spraying the interior walls of housing structures with an insecticide. Internationally, IRS programs have proven effective at considerably reducing malaria transmission and preventing malaria outbreaks. IRS can also reduce overall malaria-related healthcare costs and lost productivity.
For example, in Southern Africa, tax-financed IRS programs have helped to drive down malaria cases and allowed for economic growth.
3. Prompt Diagnosis and Treatment
With early diagnosis and proper treatment, severe illness due to malaria can be prevented. Proper treatment can also reduce the financial costs of the disease through reduced healthcare expenditure, lower losses of productivity, and overall lower inflation.
Example: Programmes involving the use of rapid diagnostic tests (RDTs) and access to antimalarial drugs have been shown to reduce malaria-related expenditure and improve economic outcomes in these areas.
4. Vaccination
Novel and bednet-based malaria vaccines bring us closer every day to the exciting new frontier of prevention. Vaccines can vastly reduce incidents of malaria, thereby lowering the cost of health care and bolstering productivity.
Example: The RTS,S malaria vaccine that has now been introduced in pilot programmes shows the potential of vaccines to contribute to savings and improved development outcomes.
The Role of Policy and Investment
Effective policies and investments are critical to scaling up malaria prevention and achieving sustainable development:
1. Government Commitment
Governments can prioritize malaria prevention by setting policies and providing funding. Binding countries to malaria control programs and embedding them in national health plans can help drive policies and resource allocation.
For example, the Global Fund to Fight AIDS, Tuberculosis and Malaria provides countries with financing and technical assistance to help them expand national malaria programme coverage. To make these commitments effective, countries must provide financial and political support.
2. International Support and Collaboration
Acting alone, our countries would struggle to sustain a national campaign contributing the needed resources and engaging the necessary human resources and negotiation. One of the key characteristics of networks such as this is their international membership; international organizations, donors, and partnerships play an important role in supporting malaria prevention. They help to provide funding, share best practices, and strengthen global and local efforts to tackle malaria.
For example: The Roll Back Malaria Partnership, and the World Health Organization, provides global leadership, support and coordination to help countries prevent malaria and achieve the sustainable development goals.
3. Investment in Research and Innovation
Investing in research and development will create new prevention tools and strategiesThere are various ways how research can continue to improve prevention. New vaccines, insecticides, and diagnostic tools could come to market, allowing researchers to ensure that people receive the prevention tools that will be the most effective against the parasite.
Example: Research on new malaria vaccines and treatments could substantially decrease the economic costs of malaria and development inputs.
Investment in prevention through insecticide-treated nets, indoor residual spraying, early diagnosis and treatment, and vaccination can reduce the cost of malaria in terms of healthcare expenditures and loss of productivity, education, and development. These actions will also help countries reach the Sustainable Development Goals.
Scaling up of these malaria prevention measures will depend critically on the strength of political commitment at the national and international levels, as well as adequate investment in research in the years to come. In the long run, enthusiasm for malaria prevention will be highest where it has the potential to lay the foundation for longterm economic stability and global development.
