April 25, 2000
Study Says Combating Malaria Would Cost Little
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By DONALD G. McNEIL Jr.
ARIS, April 24 -- Malaria hurts African economies more than has been recognized but could be better controlled for relatively little money, says a study to be released on Tuesday.
The study, by the Harvard University Center for International Development and the London School of Hygiene and Tropical Medicine, will be presented in Nigeria at the first conference at which African heads of state will meet to discuss malaria, which kills more than a million people a year, mostly children.
Analyzing the effects of malaria on 27 African economies from 1965 to 1990, the study found that the disease cut 1 percentage point a year from the annual growth rates of those economies. If malaria had been eliminated in 1965, Africa's annual gross domestic product would be $400 billion now, rather than $300 billion, the study estimated.
The economic models, according to the director of the Harvard center, Jeffrey Sachs, took into account more than the costs of treatment and losses associated with death. They also estimated the losses from tourists and foreign investors avoiding malaria-prone countries, the damage done by large numbers of sick children missing school and the increase in population and impoverishment that ensues when parents decide to have extra children because they know some will die.
In most affected countries, the disease crosses class lines. "It doesn't matter if you are rich or poor, your chances of catching it are high," said Nils Delaire, president of the Global Health Council, a participant in the conference.
The conference in Abuja, Nigeria, is sponsored by the World Health Organization and draws together other United Nations agencies, the World Bank, Western donors and the heads of 20 African countries in an effort to unite their attack in a Roll Back Malaria campaign to halve deaths in 10 years. The chief weapon that they endorse is simple, bed nets treated with insecticide.
After that, the proponents favor additional spraying to kill larvae and educating rural people in using simple blood tests and cheap drugs to keep patients alive until they can reach doctors.
Nets alone could cut the disease by half, but only 2 percent of African children sleep under them. Each $8 spent on prevention adds about a year of healthy life to an African, said Ann Mills, an analyst from the London School who worked on the study.
"World spending on malaria control and research for Africa is maybe 10 cents per case per year," Mr. Sachs said. "It's quite dreadful. World Bank lending for malaria is de minimus. The big pharmaceutical companies see it as a disease of the very poor. So they never view it as much of an investment priority."
Many malaria-prone countries, he added, have per capita incomes of less than $300 a year and health budgets too small for "these very reasonable interventions."
He suggested that Western nations could significantly cut the disease by spending $1 billion a year on malaria. The United States share of that, he said, would work out to 75 cents an American.
"In a world where we're enjoying riches beyond what was imagined 20 years ago, we can do afford to do more than we do," Mr. Sachs said. He might even, he said, also suggest $1 billion for AIDS and $1 billion for tuberculosis, for a total of $2.25 an American.
