The economic cost of malaria in Africa
Shepard, D.S.; Ettling, M.B.; Brinkmann, U.; Sauerborn, R.
Tropical Medicine and Parasitology Official Organ of Deutsche Tropenmedizinische Gesellschaft and of Deutsche Gesellschaft für Technische Zusammenarbeit 42(3): 199-203
1991
ISSN/ISBN: 0177-2392 PMID: 1801147 Document Number: 375549
Although malaria is the major health problem in Africa, there is little research on its economic impact. This study adapts a framework for assessing the economic costs of illness to available data on malaria. Direct costs of illness are the costs of treatment and control activities, and indirect costs are the value of lost time due to morbidity and premature mortality. Direct costs were estimated by applying the average estimated health systems costs per case to the number of cases. Indirect costs were assessed by multiplying adult output per day times the estimated production time lost through both adult and childhood cases. As data are not available to assess the economic impact of malaria in Africa as a whole, 4 case studies were performed on countries or regions for which needed data could be found. The 4 sites (Rwanda, Solenzo medical district of Burkina Faso, Mayo-Kebbi district, Chad, and Brazzaville, Congo) were chosen to illustrate the diversity in kinds of data which can be used (aggregate national health statistics versus household surveys) and in locations (urban versus rural). Costs were calculated for the recent past and were projected to 1995 based on recent epidemiological trends. Estimates for all sub-Saharan Africa were derived from the averages of these sites. In 1987, a case of malaria cost $9.84 (in 1987 US dollars) - $1.83 in direct costs and $8.01 in indirect costs. As the average value of goods and services produced per day in Africa was $0.82, this cost is equivalent to 12 days of output. By 1995, the average cost of a malaria case is projected to rise to $16.40 (still in 1987 US dollars) due to increasing case severity and chloroquine resistance. At the same time, per capita output is predicted to fall to $0.77, so the burden of one case will rise to 21 days of output. In per capita terms, the burden of malaria is forecast to rise from $1.34 to $4.02. For Africa as a whole, the annual economic burden of malaria was $0.8 billion as of 1987 and will rise to $1.7 billion in 1995; it represented a 0.6% share of GDP previously, and a 1.0% share for 1995.