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The Economic Impact of Malaria

Malaria is not only deadly, it is also costly, robbing individuals, businesses, and governments of a lot of money. Malaria remains a major public health issue, particularly in sub-Saharan Africa. It is a disease caused by Plasmodium parasites transmitted to humans through the bite of an infected female Anopheles mosquito.

More than half of the world’s population is at risk of malaria and it kills more than 600,000 people every year. It is a major cause of death in under-five children in sub-Saharan Africa, killing a child every two minutes.

There are over 350 – 500 million cases of malaria in a year, and Africa bears a huge share (60%) of it. In Nigeria, malaria is responsible for about 30% of deaths of children under the age of five, 25% of deaths of children under one year, and 11% of deaths of pregnant women.

But Malaria does not only rob of us our loved ones, it steals from us. It is not only a public health problem, but also a deterrent of a people’s socioeconomic development.

Malaria costs Africa more than $12 billion every year, being the costs of healthcare treatment, absenteeism, decreased productivity as a result of the illness, and reduced foreign investments and tourists. Malaria can result in more than a 5-6% drop in a nation’s gross domestic product. In some countries, more than 15% of sick-days off work are attributed to malaria treatment. In endemic areas, it can result in a huge decrease in a child’s learning and mental development.

In 2013, Nigeria spent $2.4 billion on malaria alone. This covered operational costs of treatment facilities and salaries for staff.
In Ghana, a 2014 survey showed that businesses in the country lost about $6.58 million to malaria, 90% of this cost was spent on treating malaria. Indirect cost was caused by 1,300 workdays lost due to employee malaria cases and absenteeism annually.
This economic burden affects governments and individual – particularly low-income earning – households alike: malaria affects women and children most and this drains financial resources in these homes. Families lose more than 25% of their income to fighting the disease.

In Nigeria, malaria accounts for more than 40% of all healthcare costs incurred by families, depleting more than 7% of a family’s monthly income. In a 2013 survey in Enugu state in Southeastern Nigeria, it was revealed that half of the households had at least one episode of malaria, spending an average of 12.57US$ (N4,500) for outpatient treatment and 23.20US$ (N8,500) per child. Most of these payments are out-of-pocket spendings since close to 50% of people in Nigeria live below the poverty line.

These direct costs include the cost of treatment, medical consultation, laboratory investigations, and costs of transportation to and from the healthcare center as well as private laboratories. Indirect costs, such as productivity at work while away from work or school, are often higher than these medical costs. From the survey, the cost incurred by loss of income due to time spent on malaria treatment is 12.88US$ (N4,700) per episode.

It even costs the healthcare providers more to treat malaria, with an average recurrent cost of 30.42 US$ (N11,000) and a capital or non-recurrent cost of 133.07 US$ (N48,000) to treat one case of malaria for outpatients. For those that were admitted into the hospital ward for treatment, recurrent and non-recurrent costs were 48.02US$ (N17,500) and 1857.15US$ (N677,000) respectively.

Combining the costs incurred by individuals and healthcare providers, 176.04US$ (N64,000) and 1928.37US$( N700,000) to treat one case of malaria for outpatient treatment and hospital admission respectively.

One sure way of reducing this burden is strengthening prevention of the disease. Do you use insecticide-treated nets? Do you take intermittent malaria prevention when pregnant? Do you use indoor malaria sprays?

Goverments in sub-Sharan Africa also need to strengthen some of these interventions if they must mitigate this economic burden. Free drugs for malaria prevention are not always provided free, and where they are, they often run out of stocks quickly. In addition, the national health insurance scheme that provides preventive and treatment services to employees of the federal government only covers less than 5% of the Nigerian population, a majority of whom work in the informal sector.

Until these interventions work fully and more efficiently, this burden may continue to be a looming phenomenon that stunts our health and economic growth in sub-Saharan Africa.

 

Sources: Onwujekwe O, Uguru N, Etiaba E, Chikezie I, Uzochukwu B, Adjagba A (2013). The Economic Burden of Malaria on Households and the Health System in Enugu State Southeast Nigeria. PLOS ONE 8(11). e78362

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