Why we need to step up the fight against malaria

Malaria is a parasitic infection passed between people through the bite of a female anopheles mosquito. One hundred years ago, most of the world was at risk of catching malaria, with the disease spreading as far north as the Canadian-US border and Northern England during most summers (the last known Irish outbreak was in Cork in the 1860s, but it has not been common here since the Bronze age).

Today, malaria has been eradicated from all areas with a temperate climate and much of the subtropics. However, in the warmest parts of the planet, there are an estimated 212 million cases every year and they result in about 400,000 deaths. The vast majority of these are African children aged under five, in part because most adults in malarious areas have developed immunity to the infection.

Malaria not only causes untold pain and heartache to millions of people across the world, but it also makes it difficult for those countries to generate substantial economic growth, thereby helping to trap people in perpetual poverty. Malaria nets, treatments costs and travelling to local treatment centres is not cheap if you're one of the 1.3 billion people in the world living on less than $1.25 a day. A variety of studies have shown that people in rural Africa spend upwards of 6 per cent of their total income on either treating or preventing malaria. In one such study, Jane Chumba concluded that while many households may be able to afford one incidence of malaria, their finances have often not fully recovered before the disease strikes again, meaning that they are slowly pushed towards greater hardship. These expenses take away what little discretionary expenditure households have to invest in nutritional food, books and school fees for their children, and preventing other illnesses that will make them sick and keep them poor.

Critical time

As well as the simple financial costs of treating malaria, parents take an average of 3-5 days off work every time their children become sick. This further reduces income, particularly as malaria is most common at the end of the rainy season, which coincides with the harvest, the most critical time for work in most rural communities. Children who are ill miss a similar amount of time from school, with malaria accounting for up to 50 per cent of all medical-related absentees in some parts of Africa. This is not only disruptive to the individual child’s education, but the high absentee rate can hold the whole class back. After malaria, children often suffer low levels of iron, making them tired and reducing learning capability, and children who have dealt with severe malaria infections can suffer brain damage that will stunt their development for years afterwards.

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Most regions that eliminated malaria have seen large boosts in their economic output 15-20 years after eradication

Finally, bereavement and the pain of losing a child or sibling has unsurprisingly been shown to take a huge toll on the rest of the family, both emotionally and financially, with parents and children missing significant amounts of work and school, as well as being less attentive when present.

Boosts

It is for these reasons that most regions that have eliminated malaria have also seen large boosts in their economic output 15-20 years after eradication, once the first generation of children who have grown up without malaria enter the labour force, this advantage then continues for quite some time, as wealthier adults and governments are able to invest more in the next generation. John Gallup and Noble Prize-winning economist Jeffrey Sachs estimate that having malaria reduces a country's economic growth by 1.3 per cent a year per person. To put that in context, if Ireland's growth rate from 1960 to 2017 had been this much lower per year, we would be almost exactly half as wealthy as we are today.

None of us chose to be born in malarious or non-malarious, hot or cold, rich or poor countries

This disadvantage is only made worse by the fact that many other diseases also spread much more easily in hot climates than they do in the cold. It is thus not a coincidence that most of the world’s richest countries lie far north or south of the equator, while almost all of the poorest ones are in the tropics.

None of us chose to be born in malarious or non-malarious, hot or cold, rich or poor countries. But what is clear is that disease helps trap people in a vicious cycle in which they do not have the means to stay healthy, and so do not have the health required to build a strong economy.

This is why I believe our Government should work swiftly to meet its 2015 target of giving 0.7 per cent of gross national income, to help pull the world’s poorest people out of this vicious cycle.

Anthony McDonnell is a senior health economist at the University of Oxford