The economic burden of malaria

Malaria and poverty are intimately connected. Controlling for factors such as tropical location, colonial history, and geographical isolation, countri es with intensive malaria had income levels in 1995 of only 33% that of cou ntries without malaria, whether or not the countries were in Africa. The hi gh levels of malaria in poor countries are not mainly a consequence of pove rty. Malaria is geographically specific. The ecological conditions that sup port the more efficient malaria mosquito vectors primarily determine the di stribution and intensity of the disease. Intensive efforts to eliminate mal aria in the most severely affected tropical countries have been largely ine ffective. Countries that have eliminated malaria in the past half century h ave all been either subtropical or islands. These countries' economic growt h in the 5 years after eliminating malaria has usually been substantially h igher than growth in the neighboring countries. Cross-country regressions f or the 1965-1990 period confirm the relationship between malaria and econom ic growth. Taking into account initial poverty, economic policy, tropical l ocation, and life expectancy, among other factors, countries with intensive malaria grew 1.3% less per person per year, and a 10% reduction in malaria was associated with 0.3% higher growth. Controlling for many other tropica l diseases does not change the correlation of malaria with economic growth, and these diseases are not themselves significantly negatively correlated with economic growth. A second independent measure of malaria has a slightl y higher correlation with economic growth in the 1980-1996 period. We specu late about the mechanisms that could cause malaria to have such a large imp act on the economy, such as foreign investment and economic networks within the country.