Modeling the synergistic interplay between malaria dynamics and economic growth

The mosquito-borne disease (malaria) imposes significant challenges on human health, healthcare systems, and economic growth/productivity in many countries. This study develops and analyzes a model to understand the interplay between malaria dynamics, economic growth, and transient events. It uncovers varied effects of malaria and economic parameters on model outcomes, highlighting the interdependence of the reproduction number (R0) on both malaria and economic factors, and a reciprocal relationship where malaria diminishes economic productivity, while higher economic output is associated with reduced malaria prevalence. This emphasizes the intricate interplay between malaria dynamics and socio-economic factors. The study offers insights into malaria control and underscores the significance of optimizing external aid allocation, especially favoring an even distribution strategy, with the most significant reduction observed in an equal monthly distribution strategy compared to longer distribution intervals. Furthermore, the study shows that controlling malaria in high mosquito biting areas with limited aid, low technology, inadequate treatment, or low economic investment is challenging. The model exhibits a backward bifurcation implying that sustainability of control and mitigation measures is essential even when R0 is slightly less than one. Additionally, there is a parameter regime for which long transients are feasible. Long transients are critical for predicting the behavior of dynamic systems and identifying factors influencing transitions; they reveal reservoirs of infection, vital for disease control. Policy recommendations for effective malaria control from the study include prioritizing sustained control measures, optimizing external aid allocation, and reducing mosquito biting.

Malaria control and elimination in Kenya: economy-wide benefits and regional disparities

BACKGROUND

Malaria remains a public health problem in Kenya despite several concerted control efforts. Empirical evidence regarding malaria effects in Kenya suggests that the disease imposes substantial economic costs, jeopardizing the achievement of sustainable development goals. The Kenya Malaria Strategy (2019-2023), which is currently being implemented, is one of several sequential malaria control and elimination strategies. The strategy targets reducing malaria incidences and deaths by 75% of the 2016 levels by 2023 through spending around Kenyan Shillings 61.9 billion over 5 years. This paper assesses the economy-wide implications of implementing this strategy.

METHODS

An economy-wide simulation model is calibrated to a comprehensive 2019 database for Kenya, considering different epidemiological zones. Two scenarios are simulated with the model. The first scenario (GOVT) simulates the annual costs of implementing the Kenya Malaria Strategy by increasing government expenditure on malaria control and elimination programmes. The second scenario (LABOR) reduces malaria incidences by 75% in all epidemiological malaria zones without accounting for the changes in government expenditure, which translates into rising the household labour endowment (benefits of the strategy).

RESULTS

Implementing the Kenya Malaria Strategy (2019-2023) enhances gross domestic product at the end of the strategy implementation period due to more available labour. In the short term, government health expenditure (direct malaria costs) increases significantly, which is critical in controlling and eliminating malaria. Expanding the health sector raises the demand for production factors, such as labour and capital. The prices for these factors rise, boosting producer and consumer prices of non-health-related products. Consequently, household welfare decreases during the strategy implementation period. In the long run, household labour endowment increases due to reduced malaria incidences and deaths (indirect malaria costs). However, the size of the effects varies across malaria epidemiological and agroecological zones depending on malaria prevalence and factor ownership.

CONCLUSIONS

This paper provides policymakers with an ex-ante assessment of the implications of malaria control and elimination on household welfare across various malaria epidemiological zones. These insights assist in developing and implementing related policy measures that reduce the undesirable effects in the short run. Besides, the paper supports an economically beneficial long-term malaria control and elimination effect.

Impact of eliminating malaria by 2040 on poverty rates among agricultural households in Africa

Background: Reaching the goal of eradicating malaria by 2040, if achieved, would have a profound effect on farmers’ lives in sub-Saharan Africa. Our objective is to examine how achieving that goal would affect poverty rates of agricultural households. Methods: We analyzed the potential impact of eliminating malaria by 2040 on poverty rates among agricultural households in malarious regions of sub-Saharan Africa. Our model used ten scenarios to examine how the impact of eliminating malaria by 2040 on households’ income would affect the number of individuals living on less than $1.90 (2011 PPP) per day.  Results: We analyzed ten scenarios for malaria’s impact on agricultural household income from 2018 to 2040 for the approximately 324 million individuals in agricultural households in malarious regions of sub-Saharan Africa in 2018. We found that approximately 53 million to 123 million individuals would escape poverty by 2040 if malaria were eliminated by that year. If the malaria burden in agricultural households remained at its current level through 2040, only 40 million individuals would escape poverty by 2040, a decrease of only 24%. Therefore, the impact of eliminating malaria by 2040, relative to the status quo scenario through 2040, is that approximately 13 million to 84 million individuals in agricultural households will escape poverty.  Conclusions: The modeling analysis presented here is meant to be a starting point for additional research into the potential impact of eliminating malaria on the incomes of agricultural households in sub-Saharan Africa. This study could be strengthened with the application of new methods to examine malaria’s impact on the welfare of agricultural households. We recommend the collection and analysis of longitudinal data from agricultural households in future studies of malaria’s impact on these households.