Malaria is most entrenched in the poorest countries in the ... events... · countries at risk...

• Malariaisadevastatingdiseasewithsome40percentoftheworld’spopulationin107countriesatrisktodayi.Itkillsachildevery30seconds,andsome3millionpeopleayear-thelargemajorityinthepoorestcountriesofsub-SaharanAfrica.

• Malariaisoftenreferredtoastheepidemicofthepoorii.Whilstthediseaseisinlargepartdeterminedmainlybyclimateandecology,andnotpovertyperse,theimpactofmalariatakesitstollonthepoorest–thoseleastabletoaffordpreventativemeasuresandmedicaltreatment.

• Theimpactofmalariaisnotonlyfeltintermsofthehumansufferinganddeathitcauses,butalsobythesignificanteconomic

costandburden–tobothfamilies/householdsandnationaleconomies.Malariaslowseconomicgrowthanddevelopmentandperpetuatestheviciouscycleofpoverty.

• ItisnocoincidencethattheonlypartsofAfricathathavesignificantlyreducedmalariaarethenorthernandsoutherntips,hometotherichestcountriesonthecontinent.IntheWesternHemisphere,thecountrywiththeworstmalaria,Haiti,alsohappenstobethepoorestcountryinthatregioniii.

Malaria is most entrenched in the poorest countries in the developing world

“Malaria and poverty are intimately connected. As both a root cause and a consequence of poverty, malaria is most intractable for the poo-rest countries and communities in the world that face a vicious cycle of poverty and ill health”.

The Earth Institute, University of Colombia

Credit:DanielCima/AmericanRedCross

Economic Cost of Malaria on Countries • Malariacanbeaneconomicdisaster.Countrieswithhighmalariatransmissionhavehistoricallyhadlowereconomicgrowththanincountrieswithoutmalariaiv.Thosecountriesthathavebeenabletoreducemalariahaveshownsubstantialgrowthandimprovedprosperityafterwardsv.

• EveryyearmalariaisestimatedtocostAfrica$US12billioninlostGrossDomesticProduct(GDP).ItisestimatedthediseasehasslowedeconomicgrowthinAfricaby1.3percentperyearasaresultoflostlifeandlowerproductivity–whateconomistscalla“growthpenalty”vi.Whenrepeatedyearafteryearitisaseriousconstrainttoeconomicdevelopment.

• Thedirectcostsofmalariaincludehighpublicexpendituretoattempttomaintainhealthfacilitiesandinfrastructure,manageeffectivemalariacontrolcampaignsandprovidepubliceducation.

• Forcountrieswithahighmalariaburden,thediseasemayaccountforasmuchas40percentofpublichealthexpenditure,withmalariaaccountingforupto50percentofoutpatientvisitsvii.InTanzania,forexample,malariaaccountsfor30percentofthenationaldiseaseburdenviii.

• FiguresinTanzaniaalsoshowthatmalariaaccountsfor43percentofunder-fiveoutpatientattendance,35percentofunder-fivehospitaladmissionsand37percentofunder-fivehospitaldeathsix.

• Theindirectcostsofmalariaarealsowidelyfeltasworkerproductivitylowerswithincreasedsickleave,absenteeismandprematuremortalityoftheworkforce.Formanythetransmissionperiodofmalariacoincideswiththeplantingseasonwhichfurtherlowersagriculturalproductivityx.

• Forendemiccountries,themerepresenceofmalariacanalsodeterinvestment,savingsandturnawayapotentiallyincome-generatingtourismtrade.

Economic burden for households • Thehumansufferingandlossoflifecausedbymalariaisoftenmatchedbytheeconomicburdenplacedonfamilieswhobearthedirectcostsfromtheirownpockets.Personalexpenditureincludesspendingoninsecticide-treatednets,doctors’fees,anti-malariadrugs,transporttohealthfacilities,supporttothepatientandfuneralcosts.Thiscanputanunbearablestrainonhouseholdresources–inGhanamalariacarecancostupto34percentofapoorhousehold’sincomexi.

• Therearealsoindirectcostsforfamiliesandhouseholds.Thepermanentneurologicalandphysicaldamagescausedbysevereepisodesofthediseasehamperchildren’sschoolingandtheirgeneralwell-being.Thiscandirectlyaffecttheireducationandabilitytoearninlaterlife.Absenteeismfromworkalsoimpactsonhouseholdincome.

Malaria & the MDGs• In2000theinternationalcommunityusheredinthenewmillenniumbyadoptingtheUNMillenniumDeclarationthatwastranslatedintoaroadmapsettingouteightMillenniumDevelopmentGoals(MDGs)tobereachedby2015.

• AttheMDGmid-waymarkin2007theconsensuswasthat,whilsttherearesomegroundsforoptimism,progressisunevenandextremepovertyandpoorhealthremainarealityformillions.As2015drawsnearer,theinternationalcommunitymustaccelerateandscaleupeffortstogetontrack.

Credit:ThorkellThorkelsson/IcelandicRedCross

• Itiswidelyacknowledgedthatcontrollingmalariaisanintegralpartofacomprehensivedevelopmentframeworkwithakeyroleinpovertyreductionxii.ItthereforehasamajoreffectontheabilitytoachievetheMDGs,andmustbeaddressedifwearetoimproveuponprogresstowardsmeetingthesegoals.

• ThereisasynergyacrossthegoalsandtargetssetoutintheMDGSwiththeresultthatprogressinonetargetislikelytobearesultandcauseofprogressinothers.Andmalariaisnoexception.IthasapositiveimpactonachievingtheotherMDGs,especiallythoserelatingtohealth,educationandpovertylevelsxiii.

How tackling malaria will contribute to achieving the MDGs; • Eradicatingextremepovertyand

hunger (MDG 1)

Theeconomicburdenofmalariaforbothfamiliesandgovernmentstakeasignificanttoll,reducingopportunitiesforeconomicgrowthandimpactingonhouseholdincome.WithmalariacostingAfricaanestimatedUS$12billionperyearinlostGDPandconsumingupto25percentofhouseholdincomesand40percentofgovernmenthealthspending,reducingandcontrollingmalariawilldirectlyhelpcountriesandcommunitiesliftthemselvesoutofextremeandchronicpoverty.

• Achieveuniversalprimaryeducation (MDGs 2)

Tacklingmalariawillhaveapositiveeffectonreachinguniversalprimaryeducationtargetsasthediseaseisaleadingcauseofillnessandabsenteeisminbothchildrenandteachers.

Episodesofmalariaalsocausestuntinginchildren’sphysicalandmentaldevelopmentwhichinturncontributetoimpairedcognitivedevelopment,lowercompletionofprimaryschoolstudiesandlowerreturnstoeducation.

Inaddition,thetraditionalroleofgirlsinhouseholdsascarersalsoimpactsontheirenrolmentandcompletionrateswhenmalariaepisodesamongfamiliesandhouseholdsremainshighxiv.

• Reducechildmortality(Goal4)

ThefourthMDGaimstoreducebytwothirdsthemortalityrateamongchildrenunderfive.WithmalariatheleadingcauseofchildmortalityinAfrica,accountingfor20percentofallchildhooddeaths(oneineveryfive)xv,scalingupmalariacontrolprogrammeswillhavesignificantbenefits.

Theproperuseofa$10bednethas,forexample,beenshowntoreduceunder-fivemortalitybyupto25percentxvi.

• Improvematernalhealth(Goal5)

MalariainterventionshaveaclearanddirectroletoplayinmeetingMDG5whichaimstoreducematernalmortalityratebythreequartersby2015.Pregnantwomen(particularlyduringfirstandsecondpregnancies)andtheirunbornchildrenareparticularlyvulnerabletomalaria;thediseaseisfourtimesmorelikelytostrikepregnantwomenthanotheradults,andhaslife-threateningimplicationsforbothmotherandchildxvii.

ResearchalsoshowshowHIVandmalariacombinetoadverselyaffectpregnantwomenandtheirinfants.HIVfurtherworsenspregnancy-associatedmalarialeavingmothersandtheirchildrenparticularlyvulnerablexviii.

• CombatHIV/AIDS,malariaandother diseases (MDG 6)

Malariaisanimportanttargetinthisgoalthataimstohaltandreversetheprevalenceofmalaria,alongwithHIV/AIDSandotherdiseases.

Tacklingmalariawillnotonlyreducemorbidityandmortalityfromthediseaseitself,butalsohasanimpact

Credit:HeinePedersen/DanishRedCross

i WorldMalariaReport,WHO/RBM/UNICEF,2005ii EconomicCommissionforAfrica,EnhancingHealth

Systems:Malaria’sNegativeImpactinAfrica,October2005

iii TheEconomicBurdenofMalaria,JeffreySachs&JohnLukeGallup,CenterforInternationalDevelopment,Harvard,February2001

iv TheEconomicBurdenofMalaria,JeffreySachs&JohnLukeGallup,CenterforInternationalDevelopment,Harvard,February2001

v TheEconomicBurdenofMalaria,JeffreySachs&JohnLukeGallup,CenterforInternationalDevelopment,Harvard,February2001

vi RBMPartnershipSecretariat,TheAbjuaDeclarationandthePlanofActioninTheAfricaSummitonRollBackMalaria,2000,WHO

vii RollBackMalariaInfoSheetviii MinistryofHealthandSocialWelfare,Tanzania,cited

inEastAfricanBusinessWeek,15May2007

ix MinistryofHealthandSocialWelfare,Tanzania,citedinEastAfricanBusinessWeek,15May2007

x EconomicCommissionforAfrica,EnhancingHealthSystems:Malaria’sNegativeImpactinAfrica,October2005

xi WHOandUNICEF,AfricaMalariaReport2003,Genevaxii EconomicCommissionforAfrica,EnhancingHealth

Systems:Malaria’sNegativeImpactinAfrica,October2005

xiii EconomicCommissionforAfrica,EnhancingHealthSystems:Malaria’sNegativeImpactinAfrica,October2005

xiv EconomicCommissionforAfrica,EnhancingHealthSystems:Malaria’sNegativeImpactinAfrica,October2005

xv RollBackMalariatoAchievetheMDGsxvi UNICEF,25AprilRelease2007xvii RollBackMalariaxviii PublicLibraryofScience,UniversityofToronto,June

2007)

• RedCrossEUOffice,Belgium

• German Foundation for World Population(DSW),

HeadOffice,GermanyandBrusselsoffice,Belgium

• European Parliamentary Forum,Belgium

• GermanRedCross,Germany

• Friends of the Global Fund Europe,France

• Equilibres et Populations,France

• SpanishRedCross,Spain

• SpanishFederationofFamilyPlanning,

Spain

• Malaria Consortium,UnitedKingdom

• Global Health Advocates,

UnitedKingdom

• BartleyRobbsConsultants,

UnitedKingdom

Forfurtherinformationcontact:StecyYghemonos–ProjectCoordinatorRedCrossEUOffice

65rueBelliard,Box7–B-1040Brussels•Tel:+3222350688E-mail:stecy.yghemonos@redcross-eu.net•Website:www.europeanallianceagainstmalaria.org

ProducedbytheEuropeanAllianceAgainstMalaria,September2007

Members of the European Alliance Against Malaria:

PrintedonCyclusrecycledpaper

on,forexample,HIV/AIDS.Theconnectionbetweenthetwodiseaseshasbeendocumented-HIVcanincreasetheriskofmalariaanddeathduetomalaria,whilstmalariacontributestoanincreaseinviralloadamongHIV-positiveadultsthathasthepotentialtoacceleratetheprogressionfromHIVtoAIDS.Clearlythereareimplicationsattheprogrammaticlevellookingatmoreintegratedservicesforpreventionandtreatmentofbothdiseases.

• Globalpartnershipsfordevelopment and access to affordable essential drugs (Goal 8)

Arangeofpublic-privatepartnershipsareworkingonimprovingaccesstoanti-malarialdrugsanddevelopingnewtoolstotacklethedisease.Theseeffortscanserveasabasisforimprovingaccesstootheressentialmedicines.