Malaria – the unprofitable disease

WHILE drugs and pesticides led to the eradication of malaria from rich countries in the first half of the 20th century, it continues to cast a shadow over the health and wealth of the developing world.

(Times Online) -- The human cost of 500 million cases and 2.7 million deaths every year aside, malaria is one of the biggest barriers to economic development in sub-Saharan Africa, its heartland. Economists at Harvard University estimate that Africa’s gross domestic product would have been up to 32 per cent higher today had malaria been eliminated from the continent 35 years ago. The UN puts the annual cost to Africa at $12 billion (£7.6 billion).

The disease is still responsible for a “growth penalty” of up to 1.3 per cent in some African countries, according to the World Health Organisation, through lost productivity caused by illness and death, and the extra burden on fragile healthcare systems. In some countries the disease can account for as much as 40 per cent of public health expenditure, up to 50 per cent of inpatient admissions and 50 per cent of outpatient admissions.

It also affects family expenditure, through the cost of mosquito nets impregnated with insect repellant — which have been shown to cut child death rates by 20 per cent — doctors’ fees, drug costs and transport to hospitals.

Malaria can also hold back the development of tourism because of the reluctance of travellers to visit areas in which it is endemic. It encourages subsistence rather than commercial farming, because of the disease’s effect on labour during the harvest season.

Earlier in the century, the disease was successfully controlled using DDT, the chemical pesticide which was sprayed on malarial swamps to kill mosquitoes. The ban on DDT, coupled with rising resistance to the drug chloroquine — which costs just 4p for a course — has led to an increasing malaria problem.

The large pharmaceutical companies invest little in research into malaria because the disease tends to affect poor countries without a market for expensive medication. In a recent survey of the world’s top 20 drug companies conducted by Médecins Sans Frontières, none of the 11 that answered had put a new malaria drug on the market in five years. As a result, only about £130 million is spent annually on studying the disease, almost all of it from the public sector and philanthropic groups such as the Bill and Melinda Gates Foundation.

The United Nations estimates that up to £2 billion is needed annually to fund malaria prevention and research. Scientists hope that the recently started UN Global Fund to Fight Aids, Tuberculosis and Malaria will help to make up the shortfall, but it has so far raised less than a third of its $10 million annual target.