Direct and indirect significance of malaria

African Economy

One of the most serious tropical diseases seen around the world is malaria. Malaria has a very significant negative impact on the economic on many of the poorest nations of the world. This article does a survey on the direct and indirect significance of malaria on South Africa and studies the issues regarding the use of Dichloro diphenyl trichloroethane – DDT as an insecticide in the efforts to control the malaria vector. Malaria is recorded as early as the late nineteenth and early twentieth centuries in the records of the Europeans and these records show that malaria had played a significant role in inhibiting the economic development of Africa and also had a role in causing severe economic costs. The areas that are still seen to display the malaria disease today are just one fifth of what was existing at the start of the twentieth century. The use of DDT in the control of the malaria vector is regarded as the cause of this historical success in controlling malaria. However in the recent years there has been an alarming rise in the number of malaria cases being reported from South Africa and this significant rise is seen throughout Southern Africa. (the Economic Costs of Malaria in South Africa: Malaria Control and the DDT Issue)

There have been several factors that have been attributed as the cause for this alarming rise in the number of malaria cases reported. These factors include the higher rainfall in the recent years, increased migration and the reduced use of DDT in controlling the malaria vector. This heavy rise in malaria cases in the recent years is likely to cost the local and national economies a heavy price. The direct costs on the economy of South Africa would include the costs of care and control of malaria while the indirect costs would include the losses in productivity and the loss of future earnings as a result of death due to malaria. The conservative estimates on this economic loss are estimated to be about twenty million dollars for the period 1997 to 1998. In a selected group of countries malaria is likely to cause an economic loss of one thousand million dollars which amounts to nearly four percent of the Gross Domestic Product -GDP for the year 1998. In South Africa malaria is more commonly seen in the rural areas, where agricultural and labor intensive industries rule the roost. The incidence in these rural areas thus has a severe negative impact on the economy and just as in the past has an effect in hampering the economic development of the region.

There are a number of reasons why DDT has been phased out from use in the control of the malarial vector in South Africa. The lobbying of a number of environment conscious organizations is one of the reasons despite the success the insecticide displayed in saving of lives and preventing the disease and its spread in the developing countries. DDT may not be an ideal insecticide, but it does display several advantages over the insecticides available as an alternative and also has a track record that is proven. Despite the fact that a number of countries in Southern Africa still continue to use DDT in an effort to control the malaria vector the UNEP Governing Council has gone ahead and pressed for the banning of DDT and eleven other persistent organic pollutants – POPS. This potential banning threat as seen in the case of DDT displays a trend in which environmental pressure from mostly the developed countries thrusting standards upon the developing economies, where these standards are not accepted nor are they considered appropriate. There are possible alternatives to DDT, but all these alternatives are more expensive and are more complicated in their use than DDT. Thus the banning of DDT would not only cause the removal of the most potent weapon in the control of the malaria vector but also result in the death of many people and bring on very significant economic loss which has been estimate to be about four hundred and eight million dollars on poor countries that can ill afford such losses. (the Economic Costs of Malaria in South Africa: Malaria Control and the DDT Issue)

The WHO report on the effect of Malaria on the African economy in 2000 indicated that the GDP of Africa could have been significantly higher up to one hundred billion dollars if the elimination of malaria had been successful in the earlier years. This report goes on to add that beside increasing the economic productivity it would have had a positive impact in increasing the income of the families in Africa. The evidence was strong in that malaria hindered economic development in Africa and malaria was the major cause in the poor economic performance of the sub-Saharan African countries where there has been a persistent decline in per person GDP since 1990. Statistical estimates show that had malaria been eliminated thirty five years ago then the sub-Saharan Africa’s GDP would have been higher by thirty two percent and this would tantamount to five times the developmental aid that was made available to the whole of Africa in 1999. The economic growth of Africa is retarded by about 1.3% every year on account of malaria. This slow down in the economy owing to malaria is over and above the short-term costs of the disease. The short-term benefits by controlling malaria itself work out to be between three to twelve billion dollars every year. (Economic Costs of malaria are many times higher than previously estimated)

Malaria is thus has a negative impact on the living standards of the future generations, which many consider unnecessary and a handicap on the economic development of the continent that can be prevented. Malaria free countries are seen to average three times more GDP per person than countries ravaged by malaria. It is possible to have healthy year of life using one to eight dollars on the effective treatment of malaria and this makes malaria treatment as cost-effective a public health investment as is the case with measles vaccines. Malaria is seen as negatively impacting on the health and development of the children of Africa and acts as a drain of life on the African economies. The report goes on to recommend that one billion dollars be spent every year on the prevention and control of malaria and this expenditure be mostly centered on Africa. This amount is much greater than what is currently being spent on these measures. The argument in favor of this expenditure is that it is economically justifiable in that the short-term benefits by the effective control of malaria would bring about an increase of about three billion dollars to twelve billion dollars in the productive capacity of Africa.

Malaria is the cause of about one million deaths every year in Africa and of this nearly seventy percent are children. Studies have shown that the better availability and use of treated mosquito bed nets could prevent fifty percent of the malaria disease seen in children. This is surprising as today only two percent of the children are protected by the use of treated bed nets. Besides the availability and use of treated bed nets other factors that could reduce the spread of malaria include rapid diagnosis and quick treatment with the relevant therapies preferably at home, preventing malaria at the time of pregnancy, and detecting and responding to malaria epidemics quickly. Thus reducing the malaria disease by half is a realistic and achievable target as the tools and the economic justification are present. The factors that need to come into play are leaders fro both the private and public sectors to come forward to undertake the responsibility. (Economic Costs of malaria are many times higher than previously estimated)

The economic performance of the African countries in 2002 was not as expected with a drop seen from an average of 4.3% in 2001 to 3.2% in 2001. Taking into consideration all the fifty three countries in Africa only five countries met the Millennium Development goals of seven percent growth. Among the others forty three registered a growth rate of less than seven percent and five even showed a negative growth rate. The reasons for the poor economic performance in Africa can be put down to drought and HIV / AIDS in various parts of southern and eastern Africa and armed conflicts in Central African Republic, Ivory Coast, Madagascar and Zimbabwe. Yet well managed countries with solid reform agendas and a record of good governance and stability did show good performance with Mozambique standing out with twelve percent growth among then fastest in Africa. Countries like Ethiopia, Uganda and Rwanda with well managed reforms also performed reasonably well and shoeing a growth rate of six percent. The worrying trend for Africa includes the drop in the bilateral flow of official development assistance- ODA to African economies seen in the last decade with the exception of education. (Overview – Accelerating the Pace of Development)

The next worry is the flight of capital from many of the African economies and the fact that the total amount of flight of capital equals the sub-Saharan Africa’s GDP, which over the past twenty seven years works out to about one hundred and eighty seven billion dollars. It is believed for every dollar that flows into Africa in the form of foreign loans eighty cents flows out as capital flight. One of the significant constraints to the growth in Africa is the low savings and investment. Trade and current account deficits are another source of worry. Though overall fiscal discipline showed improvement, fiscal profligacy remains an issue. Some of the African currencies experienced massive price increases due to conflicts and political instability giving cause for concern. The adverse climatic conditions seen in 2002 had a severe negative impact on agriculture. The four key challenges that the African countries face include escaping poverty by going beyond averages; attaining fiscal sustainability and thereby exiting from dependence on aid, enthusing the African bureaucracies and thereby enhancing the capacity to deliver, and moving to mutual accountability and thereby taking the most effective path to development effectiveness. (Overview – Accelerating the Pace of Development)

Taking the year 2003 into consideration the forecast for the economy of Africa is mixed. Growth is expected to increase to about 4.2%. There are increased chances of a global slow down due to increasing oil prices, financial turbulence and the deteriorating business sentiments in the developed world. This is likely to have a significant impact on the economic growth of Africa. In addition the deteriorating political and economic conditions in countries like Zimbabwe and Ivory Coast only add to the problems for the economic growth of Africa. Recurrent floods or drought especially in the Horn of Africa could have a negative aspect on the agricultural output from Africa. (Recent Economic Trends in Africa and Prospects for 2003)

The poorest continent in the world is Africa. In the midst of all the bad news there is seen a glimmer of hope for a change for the better in Africa. A growing number of sub-Saharan African countries are putting out signs of economic growth and this has come through the better economic policies and structural reforms that these countries have undertaken. These countries have been successful in their attempts to reduce domestic and external debt by enhancing the economic efficiency. There has been a greater emphasis on public spending on areas like health care, education and the other necessary social services. There has also been a move towards democracy in this area and thereby encouraging cooperation between the state and civil society. Still domestic and external shocks cause the economic and social situation in the sub-Saharan Africa to remain fragile and vulnerable. The region has a lot to do to catch up in the ground lost over the last twenty years. Poverty is still all around despite the upswings in economic growth rates. (Promoting Growth in Sub-Saharan Africa: Learning What Works)

Investment is still low key and this reduces the possibility to diversify economic structures for boosting growth. In addition a number of these countries are just emerging from the shadow of civil wars that have been a setback for any developmental efforts. On the other hand fresh conflicts have developed in other parts of the continent. These conflicts coupled with poor weather conditions and the reduction in the terms of trade has set back the economic momentum in the region for the past two years. Therefore the countries in this region have to overcome major challenges in their attempts to raise growth and reduce poverty and join the mainstream world economy. The economic growth rates need to be raised even further if poverty is to be alleviated and enable these countries to reach the levels of the developing nations. The real requirement is for these countries to maintain sustained and substantial increase in the real per capita GDP growth rates and also improve the social conditions. (Promoting Growth in Sub-Saharan Africa: Learning What Works)

The enormity of the human toll and suffering due to HIV & AIDS is seen most in the sub-Saharan Africa, where it has become the leading cause of death. The epidemic has caused over 15 million deaths in Africa since its onset. In the sub-Saharan region in 2004 nearly 2.3 million adults and children have succumbed to AIDS. There are many countries in the region that have been unable to bring the epidemic under control and nearly two thirds of the HIV positive people in the world are seen in this region as a result, even though they hold only ten percent of the world’s population. The possibility that a number of countries in the region will be locked in a vicious cycle looms high as the number of people falling ill and subsequently succumbing to AIDS has a severe impact on several parts of the African society that include demographic, household, the health and education sectors, workplaces and economic aspect. In most of the countries in which the HIV / AIDS epidemic is present there is immense pressure on the health sector. With the maturing of the epidemic the demand for care for those existing with HIV / AIDS is even more and this leads to elevated levels of death among the health workers. In this region the yearly direct costs due to AIDS is estimated to be in the region of thirty dollars per capita and this is at a time when the overall expenditure on public health is less than ten dollars for most of the African countries. The Health care services come under differing levels of pressure depending on the number of people that seek services, the nature of their requirements due to the epidemic, and finally the capacity to deliver the required care. (the Impact of HIV and AIDS on Africa)

The factors that are critical for resolving the economic crisis in Africa are health, political instability and democracy and in that order too. These articles have provided enough insight to choose these three factors as the major causes for the poor state of the economy of Africa. In the case of health, Malaria and HIV / AIDS are causing severe havoc to the economy. There are few regions of Africa that have escaped the scourge of these two diseases. Of the two the greater threat comes from HIV / AIDS. There was a time when malaria was even more rampant but control measures did ring about a reduction in its impact on the African continent. Therefore it is possible to bring about a control on the disease as well as treat those afflicted with it at a reasonable cost. The problem with HIV / AIDS is that there has been no really reliable means that have been found to treat this disease and the prevention needs the education of the population against this dreaded disease. Political instability has brought with it economic ill health to those countries where this factor is seen. The examples of Zimbabwe and Ivory Coast are enough to show that political instability can lead to severe reduction in economic growth. The introduction of basic forms of democracy in the sub-Saharan region has shown that the interaction between the state and the civic society can bring about economic gains. Should the choice of the factors be reduced to two then health and political instability remain the two most important factors in the reasons for the poor performance of the economy in Africa.

I agree with the commitment by President Bush to assist Africa in its fight with AIDS and HIV. However I would spend less time in talking and more in spending the funds towards the eradication of this scourge from Africa. Planning maybe a necessity but overextending it and expecting the execution of the plans to be implemented to the developed world’s standards is aiming too high. I recommend that the money be equally divided in the treatment of the disease in keeping with WHO plan to use the antiretroviral treatment on three million people. Utilization of these funds available will only increase the scope of people that can be brought under this treatment. The next part of the money will be spent on education people on HIV and AIDS in an attempt to prevent the spread of the disease. The final part of the money will be spent on research in the search for a really effective way to treat HIV and AIDS. In this manner the hundred billion dollars will be divided into three activities and the division will be equal.

To further the economic growth in Africa restructuring reforms should be brought in place and also the prevention of the flight of capital. These articles have clearly shown that those countries that have gone in for structural reforms are in the forefront of the economic recovery seen in some countries in different regions of Africa. The flight of capital has acted as a detriment to economic growth in some of the African countries.

References

Basu, Anupam. Calamitsis Evangelos, a; Ghura, Dhaneshwar. “Promoting Growth in Sub-Saharan Africa. Learning What Works” International Monetary Fund. August 2000. Retrieved at http://www.imf.org/external/pubs/ft/issues/issues23/. Accessed on February 25, 2005

Economic Costs of malaria are many times higher than previously estimated.” Press Release WHO/28. April 25, 2000. Retrieved at http://www.who.int/inf-pr-2000/en/pr2000-28.html. Accessed on February 25, 2005

Accelerating the Pace of Development” Retrieved at http://www.uneca.org/era2003/overview.pdf. Accessed on February 25, 2005

Recent Economic Trends in Africa and Prospects for 2003″ Retrieved at http://www.uneca.org/era2003/chap1.pdf. Accessed on February 25, 2005

The Impact of HIV and AIDS on Africa” AVERT. Retrieved at http://www.avert.org/aidsimpact.htm. Accessed on February 25, 2005

Tren, Richard. “The Economic Costs of Malaria in South Africa: Malaria Control and the DDT Issue” Retrieved at http://www.malaria.org/tren.html. Accessed on February 25, 2005

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