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Malaria: The Disease of Poverty Costs a Fortune


And its heavy economic toll expected to worsen with climate change.

Unlike sudden epidemics, such as swine flu or bird flu, which receive extensive coverage for their novelty and surprise, malaria has been around a long time and remains a widespread and deadly pandemic.

No other infectious disease, particularly in sub-Saharan Africa, inflicts a more devastating economic toll, keeping whole populations trapped in poverty. As Jeffrey Sachs, the preeminent economist and author of The End of Poverty (Penguin Press, 2005), once wrote, "Malaria and poverty are intimately connected."

Viral Threats
Malaria is a mosquito-borne disease, and thus specific to a tropical climate. (It was only eradicated in the US in 1951; in fact, the CDC was established in Atlanta in 1946 with the primary purpose of eradicating malaria).

According to the World Health Organization (WHO), there were 247 million cases of malaria in 2006, causing nearly one million deaths, mostly among African children.

Nearly half of the world's population is at risk of malaria, particularly those living in lower-income countries. Baruch Blumberg, the American physician and Nobel laureate in virology, once stated that half of all human deaths from the beginning of time can be attributed to malaria.

Beyond the human toll, the economic toll is significant: In high-rate areas, malaria decreases GDP by as much as 1.3% in countries with high levels of transmission. Over the long-term, these annual losses have separated countries with and without malaria, particularly in Africa.

The health costs of malaria are considerable for individuals and governments in already-poor situations. According to the WHO, in some countries the disease accounts for up to 40% of public health expenditures, 30% to 50% of inpatient hospital admissions, and 60% of outpatient health clinic visits.

People and communities already in poverty who can't afford treatment are sent deeper into poverty.

Malaria and other tropical diseases, such as hookworm and Schistosomiasis (blood flukes), "occur in the setting of poverty and they promote poverty," says Dr. Peter Hotez, professor and tropical-disease expert at George Washington University, in an interview with Minyanville. They are all preventable and curable; for malaria, the cost of insecticide-treated bed nets is $10.

In a Time editorial in 2007, Sachs wrote, "Not only does malaria sap worker productivity and scare away business investment, but it also, paradoxically, increases the rate of population growth. Instead of having two or three children, couples in a malarial region often choose to have six or seven -- unsure how many will survive."

The unintended consequences are important: With so many children, poor families can't invest much in each child's education. And women are also constrained because child rearing consumes so much of their adult lives.

Where malaria has been eradicated, there have been clear economic success stories: in Greece, Italy, and Spain after World War II, and even the American South after the war.

According to a research paper Sachs published in 1998, in the South there were 135,000 cases of malaria with 4,000 deaths in 1935. Large-scale drainage projects in the 1930s, followed by insecticide spraying after the war, brought malaria under control by the end of the 1940s. In the next decade, the South caught up economically with the rest of the country.

Finally, health experts are starting to predict that, as global warming intensifies, malaria will begin showing up in areas unaccustomed to it.

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