1998 Articles

The Economic Burden of Malaria

Gallup, John Luke; Sachs, Jeffrey D.

Malaria and poverty are intimately connected. Controlling for factors such as tropical location, colonial history, and geographical isolation, countries with severe malaria had income levels in 1995 only 33% of countries without malaria, whether or not the countries were in Africa. The high levels of malaria in poor countries are not mainly a consequence of poverty. Malaria is very geographically specific. The ecological conditions that support the more efficient malaria mosquito vectors primarily determine the distribution and intensity of the disease. Intensive eradication efforts in the most severely affected countries have been largely ineffective. Countries that have eradicated malaria in the past half century have all been subtropical or islands. These countries' economic growth in the five years following eradication has almost always been substantially higher than growth in their region. Cross-country regressions for the 1965-90 period confirm the relationship between malaria and economic growth. Taking into account initial poverty, economic policy, tropical location, and life expectancy among other factors, countries with severe malaria grew 1.3% lower per year, and a 10% reduction in malaria was associated with 0.3% higher growth per year. The paper concludes with speculation about the mechanisms that could cause malaria to have such a large impact on the economy, including the possibility that the effects attributed to malaria are really the result other unmeasured tropical diseases.