malaria is most entrenched in the poorest countries in the ... events... · countries at risk...
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• 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:[email protected]•Website:www.europeanallianceagainstmalaria.org
ProducedbytheEuropeanAllianceAgainstMalaria,September2007
Members of the European Alliance Against Malaria:
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on,forexample,HIV/AIDS.Theconnectionbetweenthetwodiseaseshasbeendocumented-HIVcanincreasetheriskofmalariaanddeathduetomalaria,whilstmalariacontributestoanincreaseinviralloadamongHIV-positiveadultsthathasthepotentialtoacceleratetheprogressionfromHIVtoAIDS.Clearlythereareimplicationsattheprogrammaticlevellookingatmoreintegratedservicesforpreventionandtreatmentofbothdiseases.
• Globalpartnershipsfordevelopment and access to affordable essential drugs (Goal 8)
Arangeofpublic-privatepartnershipsareworkingonimprovingaccesstoanti-malarialdrugsanddevelopingnewtoolstotacklethedisease.Theseeffortscanserveasabasisforimprovingaccesstootheressentialmedicines.