Tuesday, October 30, 2012

How bad is Malaria?

Worse than you might think



  1. The worst part about Malaria is the continual damage it causes and the inequality of those infected. As Jeffrey Sachs and Pia Malaney point out, there are between 300 and 500 million clinical cases of Malaria per year and of those, between 1 and 3 million result in death. These statistics are horrible but what magnifies the negative impact is the disproportionate affect on children, particularly in topical low-income areas. Pregnant women are also at a greater risk of contracting Malaria and thus passing the disease along to the unborn child. What is striking about Malaria to me is that it has the worst effects on those with the least ability to fight the disease.

    It is hard to prove whether poverty causes Malaria or whether Malaria causes poverty but the two phenomena are closely correlated and highly prevalent in the same areas of the world. The authors indicate that businesses and markets will choose not to expand into regions of the world that increase exposure to Malaria to protect against long-term development consequences. This argument is completely logical however, low-development could just as easily come from businesses choosing not to locate in particular areas. Malaria definitely contributes to lower human capital in the region but there may be a variety of complementary capital considerations influencing businesses decisions not to locate in tropical areas. The market incentives for businesses and the human capital affects in tropical regions seem to encapsulate the harsh realities associated with a low-development trap.

    The silver lining in the case of Malaria appears to be the availability of cost effective solutions like bed nets or controlling mosquitos at the larva stage with chemicals. The fact that Southeast Asia has less of a problem with Malaria than Sub-Saharan Africa may provide hope for the effectiveness of treatment methods.

  2. What was most shocking to me in “The Economic and Social Burden of Malaria” was the significant disparity between the incredible successes in combating this disease in certain areas of the globe as compared with the rapidly increasing disease burden in others. Granted, the article does explain that this uneven distribution is due in large part to variations in climate temperatures and the resulting effects on the life cycle of the parasite and the mosquitos that carry it, however it is still shocking that such progress can be made in the face of such failure. The severity of this issue is clearly demonstrated in quantified terms when the author notes that between 1965 and 1990, the average growth in per-capita GDP for regions with malaria was 0.4% as compared to other countries’ 2.3%. This difference is pretty shocking, and the author explains it through the rationale that causation runs in both directions between poverty and malaria. Though he doesn’t state this explicitly, it seems that this double causality creates a pretty vicious cycle. Poverty restricts personal expenditures on prevention and treatment of the disease, not allowing access to necessary tools such as screen doors or bednets. In the other direction, malaria escalates private medical costs for the prevention, diagnosis, treatment and care of the disease as well as forgone income resulting from hampered productivity. More significantly, malaria hinders human capital development that spurs economic growth. This is probably the most relevant topic to our class as it was also a significant point of discussion in the other article. The high fertility rates resulting from high mortality rates hinder the human capital development of both the parents and children within a family. As the number of children rises, the amount of investment in education per child declines. Additionally, the parents (specifically the mother) are limited in employment choices as a result of the barriers of child rearing. Going even further, the physical symptoms of the disease itself result in a wide range of issues from school absenteeism, to low birth weights, to impaired cognitive development. Each of these issues, as well as others described in the article, severely depress the rate of human capital accumulation. In his conclusion, the author calls for management and containment of the disease. He acknowledges that while eradication may be unrealistic in certain climates, there are numerous cost-effective and incredibly beneficial steps that can be taken to “initiate a virtuous cycle” and even goes a step further to identify high priority targets. While the fight against malaria is incredibly underfunded as compared to its need (as described in the final paragraph), the article does a great job of laying out why the gap between those two levels should be closed.

  3. This article provides some interesting research on malaria and its impacts. In “The Economic and Social Burdens of Malaria,” Jeffery Sachs and Pia Malaney seek to understand the different economic and social impacts of malaria, and how these results do, in fact, hinder economic growth. It seems logical that where malaria is highly prevalent, societies will struggle economically and socially. Sachs and Malaney point out several key areas where malaria takes it toll, including acquisitions of capital, mobility of populations, ability to save, infant mortality, and population growth rates. Sachs and Malaney point out that these factors can hinder countries that may be better off- malaria attacks across income levels and has proved difficult to eradicate.
    I have taken the precaution of taking malaria medicine during several trips, the most recent being my 8 weeks in Tanzania and Kenya. I was diligent about taking my malaria medicine each day this summer, though I found that by the end of the summer, contracting malaria was the least of my worries. I was surprised by the generally casual attitude towards the disease, and the medicine that was available at the small clinic was effective and quick. People got malaria, took the medicine, and a mere 3 or 4 days later were back on their feet. In fact, I was informed that the medicine in this rural Tanzanian village was better than what I would be treated with should I contract malaria in the United States. I was just generally surprised by this, given the number of other basic needs problems that surrounded me and were far from being solved. Malaria seemed to be a controlled and not incredibly detrimental disease for this small population, and I would be curious to see what villagers felt like its effects were. The lack of other basic healthcare and nutrition needs would be compounded if malaria were more of an issue, but I was still surprised, though glad, to find that malaria was less detrimental to this particular area than I expected. This also points out that eliminating malaria will not alleviate all of the problems that Sachs and Luckmann pointed out. It is, however, a step in the right direction of poverty alleviation in many developing countries.

  4. Though some tend to view development within third world countries as an insurmountable challenge, it is astounding how many effects and implications point back to the single cause (or at least factor) of malaria. Sachs acknowledges that a dual causality exists between poverty and malaria in that they both, to a degree, drive each other. The sheer scale of those lost or inhibited by the rampant disease is nothing short of a crisis — 2,000 children per day and over one million total per year — and this fact alone should raise more awareness than currently exists.

    Economically, the human capital costs are no less significant, for they have an even more prolonged effect on the domestic economies of malaria-affected countries. Medical costs are significant, but they are just the beginning. For example, children who lose 10% of their education by missing school due to the illness cannot reach their full educational potential. Families afraid of losing children to malaria have a strong incentive to have more children. And those hindered permanently by the disease or its effects cannot occupy the same jobs they could have were they in full health. These are not simply humanitarian concerns for the countries affected and those who would like to help, but they are also significant long-term economic impairments. Certainly, as Sachs points out, poverty can also have a reciprocal effect on malaria, but the effects of the disease certainly cannot be overlooked.

    A sad irony exists regarding malaria treatment and elimination. Though some of the treatments and solutions are quite cheap — bednets, mentioned above, or individual doses of vaccines once they are created and dispersed — the sheer prevalence of the disease necessitates a significant amount of funding that simply is not available. At least not yet. With raised awareness of the disease's prevalence, as well as its broad implications on human capital and economies, perhaps that deficit can be met.

  5. The worst aspect of the malaria epidemic, in my opinion, is its cyclical nature. Those who are impoverished are less likely to be able to purchase bed nets or immunizations, and at the same time the medical costs, forgone earnings, and loss of human capital that are a result of contracting malaria make people poor. Since a large percentage of those infected are children, school absenteeism is common, and as a result their human capital is not developed to its highest potential, and consequently many children lose the opportunity through education to escape poverty. Poverty compounds the malaria epidemic’s effect on the population, particularly because low-income citizens tend to live in proximity to one another, so there are strong negative externalities associated with living next to others who are likely to be infected.

    Furthermore, those in poverty are likely to have more children, thus resulting in a higher probability of their children becoming infected, and then subsequently often even have more children after some have died from malaria. A drop in fertility rates doesn’t occur until the cycle of poverty is broken, but these high fertility rates are augmenting the effects of the epidemic. Even at the macro level, as the article points out, developed countries are hesitant to trade with developing countries with high rates of malaria infection; therefore, even though it may be a country’s lack of development causing the impoverished conditions that support malaria infection, it is difficult for a country to break out of its underdevelopment if it is known to others as being “infected.” Similarly, immigrants are less likely to move to a county if they know its citizens to be widely infected by malaria, even if the country is in need of workers to help jumpstart its economy. As the article notes, these potential migrants are nervous about contracting malaria as well as bringing the infection back home to their families. Ultimately, overcoming the malaria epidemic requires intentional intervention into the cycle, but there are clear disincentives and generally a lack of opportunities to intervene.

  6. What struck me the most from reading this article was how pervasive malaria is in many areas of the world, namely in sub-Saharan Africa where it is especially prevalent. It is an issue that I was aware was a huge problem, but never realized was as big of a problem as it is. As Sachs explains, estimates of deaths per year from malaria are between one and three million, and these are mostly children. Surprisingly enough with these overwhelming numbers, I actually took a positive outlook on malaria based on this paper. Although it obviously reveals a very painful and dismal situation in the world, I see the malaria problem as an opportunity to save millions of lives a year as well. In addition, it is an opportunity to possibly aid the development of many of the poorest regions in the world.

    This is because there is much potential and room for improvement with this issue. By implementing policies like bednets and insecticides, transmission can be reduced and, consequently, lives saved. As we saw in the video of Esther Duflo’s lecture, heavily subsidizing bednets is a strategy that seems to be working and increasing future purchases of bednets even when they are not subsidized in the future. Developed nations would also be more likely and willing to trade with nations with high malaria rates, for instance, if the disease could be controlled better in these areas. Education returns also seem to be much higher when students are healthy, just as when adults are healthy enough to go to work. Although it is not certain, it seems that there is causation in both directions between malaria and development. This means that lowering malaria rates could potentially increase development, which could then in turn continue to lower malaria rates.

    Looking at regions like sub-Saharan Africa, it can often be very overwhelming and difficult to pin down where to begin in the process of helping. It is hard to know what funding should go toward or what issue should be focused on. It seems what is actually important, however, is that some kind of step is taken, and malaria seems to represent a source that could greatly benefit from funding. As the article explains, malaria is very underfunded in the world. It may seem like a very specific issue to focus on, especially when there are so many areas that need funding in areas such as sub-Saharan Africa. However, it is an issue where there are very clearly benefits of helping and where much progress can be made. If the right funds are made available, a number of treatments can be provided to reduce the burden of malaria, prevent its spread, and, in the process, probably aid in development as well.

  7. Jeffrey Sachs and Pia Malaney try to quantify the costs of malaria beyond typical measures such as the amount spend on healthcare and the amount of days lost to work. Overall, they find a large link between malaria and poverty. For example, growth in GDP per capita has been far slower in countries that suffer from malaria than in countries that do not. Though common statistics on malaria are fairly well known (basic infection rates), I was shocked to learn about some of the other ways through which malaria can poverty. Typically we consider the cost of disease to be the cost of healthcare and days of work lost, but we usually don’t consider some of the other problems associated with human capital accumulation, tourism and the effects on brain development for young. Malaria is particularly bad because it can impair childhood development even in the womb by infecting pregnant mothers and then cause I child to miss important days a school. In Kenya, they estimate that students miss 11% of school days because of Malaria.

    It is impossible to prove causality between poverty and malaria. Given the success of anti malarial campaigns in eradication the disease in wealthy countries like the US, Greece and Spain it is clear that development can help lessen the problems associated with malaria. Thankfully, there are also many inexpensive alternatives that help to decrease malaria transmission, such as bed nets.

    When considering the economic cost of malaria it would also be interesting to look at the effects of malaria on colonization and how higher rates of malaria affected the development of colonial governments. This could possibly make the economic costs of malaria even higher if it lowered the institutional quality of colonial governments.

  8. In the paper "the Economic and Social Burden of Malaria" Jeffery Sachs and Pia Malaney do a great job in enumerating the social damages that this disease can have on an economy. It was striking to see that there are 300 to 500 millions clinical cases of malaria every year. Also, it was surprising to see that we are currently experiencing a rapid increase in disease burden.

    As expected, the authors mentioned that there is a strong correlation between malaria and poverty. The authors do acknowledge that this causality may run either direction or both. However, I was surprised to see that they do not attempt to instrument it in order to find which way the correlation runs.

    In addition to this, it struck me to see that there is not enough research to explain the impact of the disease on human and physical capital. Despite that I do not doubt that malaria has a negative impact on both factors of production, I would have expected this relation to be explained after so many years of research. Finally, I agree with both authors that in order to account for the social costs of the disease, it is important to include the range of costs that are associated with other illnesses.

    To conclude, I think that right now there are two major challenges related to malaria prevention and its costs. First, I think that we need to analyze why certain areas within the tropics such as Florida do not have high contagion malaria rates. Secondly, I believe that it is crucial to find the existing correlation between malaria and physical capital, human capital, migration and trade. Once we understand this relations better, it will be possible to apply the appropriate preventive methods in order to control this disease.

  9. On the surface, 300 million deaths per year and a 60% mortality rate for children under five is sufficiently devastating. But the article points out many of the lesser studied effects of the malaria epidemic. With the help of economically prospering nations, millions of lives could be saved but also the area could be improved economically. Sub-Saharan Africa is relatively ignored by the international community in the areas of: foreign direct investment, travel, and humanitarian aid.

    A global effort to fight malaria would benefit the African countries with warmer climates, in countless ways. Malaria cripples an economy. Malaria decreases the savings rate because of life expectancy and cost for treatment and as Solow proves the savings rate is essential to growth. Secondly Malaria increases fertility rates because parents want to ensure that they have a surviving child, in many cases a surviving male. Because of the increase in child rearing parents are not incentivized to educate their young girls. As we have read in "Half the Sky" this can be crippling to the development of a country.

    Investing in a cure for malaria will help economically, but economic development will also help fight malaria. In international trade we are learning about the outlandish tariffs that the United States imposes to countries in Sub-Saharan Africa. For example, countries such as Ireland and France pay a tariff that is less than two percent while many countries in Africa pay over a 13 percent tariff. These countries are usually exporting relatively cheap goods and a price disparity of that significance kills the chance that Africa has to compete in the market. Africa has a comparative advantage in low-skill labor but instead of allowing them to capitalize on their advantage (which would lead to more FDI and new infrastructure) America has levied high tariffs to "protect American jobs" even though the evidence suggests that high tariffs have led to virtually zero job protection for low-skilled workers. Bill Clinton made some strides in his presidency to lower the tariffs on developing countries to give Africa a place in the global market but there is still much work to be done. It is my position that a lower tariff would give African countries a comparative advantage, increase production, increase FDI, and increase infrastructure and other benefits that come with FDI. All of these positives would help fight the malaria epidemic while improving the development of Sub-Saharan Africa.

    As an economist, this information should be enough to intervene, but then you add the duty of us as human beings to be our neighbors keeper. As a prosperous nation the US has a duty to offer support and lead other countries in the support for relief from an epidemic. Just like the US provides aid to the people who suffer under dictators in Middle-Eastern countries, the suffering in Africa should receive similar attention. There are hundreds of children being killed every day and it is something that should be at the forefront of our foreign policy.

  10. While the effects of malaria on Less Developed Countries are hard to prove, Jeffery Sachs and Pia Malaney do a good job of articulating the argument in a convincing way. Sachs and Malaney argue that malaria hinders development in LDCs in a number of different ways. According to Sachs and Malaney, “Malaria affects almost every aspect of social and economic endeavour, including fertility, savings and investment rates, crop choices, schooling and migration decisions…Suppressing malaria in poor, highly malarious regions, especially in sub-Saharan Africa, offers the potential to initiate a virtuous cycle in which improved health spurs economic growth, and rising income further benefits human health” (Sachs and Malaney 684).

    Malaria increases fertility in LDCs because parents, expecting the likelihood of the mortality of a number of their children, tend to have more children in order to ensure that some will survive to adulthood. This hinders development because, “A high fertility rate among poor households is also likely to lead to reduced investments in education per child, a phenomenon that economists term the ‘quantity-quality trade-off’” (682). This also leads parents to invest less in their daughters’ education because daughters are more likely to spend time in “child-rearing activities” than in the labor force, where they can benefit from the returns to education. In addition, the high fertility rate causes a high dependency ratio, which eats away at household savings. This is shown when Sachs and Malaney say, “If reduced malaria-related infant and child mortality does bring down fertility rates, the the resulting decline in the dependency ratio could lead to a higher savings rate” (684). Malaria also hinders the acquisition of human capital because students are forced to miss school because of illness. This is related to the chapter eight, on human capital and health, in Todaro and Smith which speaks on the complementarity of health and education. Finally, trade and foreign investment in malaria-infested regions suffer because of the health risks. This is shown when Sachs and Malaney say, “Failure of investment is likely to be one of the most costly effects of malaria with respect to long-term growth. Investors from non-malarious regions tend to shun malarious regions for fear of contracting the disease” (684). This is not a lost cause, however, because, “A range of cost-effective approaches is available to reduce the burden of malaria, including case management, the use of insecticide-treated bednets, indoor residual spraying, and environmental control measures such as larvaciding…and filling and draining of breeding sites” (684).

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  12. That a child dies every 40 seconds from malaria is truly a horrific fact. But that there are 300-500 million cases of malaria each year is outrageous to believe. Especially since this is such a deadly disease, particularly in children. The disease itself is bad enough, but coupled with its factor on hindering development in other countries makes it twice as bad. "Where malaria prospers most, human societies have prospered least," says Sachs and Malaney as they introduce the paper. GDP on average grows 1.3% less than in other countries that aren't plagued with malaria like the tropics are. This really is such a geographically specific disease because of the effect that mosquitos play in the transmission of it (since mosquitos thrive in hot and damp conditions). While eliminating mosquitos is an impossible feat, there should be increased efforts in enabling these countries more access to insecticides and bed nets. This would not only help save the lives of children and infants, but could potentially have a positive effect on economic growth in those areas.

    What really illustrates the fascinating aspects of malaria comes from Figure 1 in the reading. It shows the areas of the world where there used to be a risk of malaria: U.S., southern Europe Brazil (not including the Amazon), most of China. These parts of the world have vastly improved their economic conditions since 1946/1966. So while one cannot point to Malaria and be like, "that is the reason countries can't develop," it certainly does seem to be a hindrance to economic growth. This hindrance finds its way down into the familial level in these countries, particularly it seems like with women and children. Because children are the most susceptible to die from the disease, parents have more children to replace the ones they lose from diseases like malaria. This high fertility rate keeps women at home to raise the many children that they bear, which keeps them out of the work force where they could contribute to their country's GDP. Also these higher fertility rates lead to a reduced investment in a child's education according to Sachs. It's this cycle that keeps these countries impoverished as these factors have a sizable impact on economic growth and productivity.

  13. It is not surprising that malaria constitutes a strong, inverse relationship to poverty. Malaria hinders human productivity, household saving, foreign trade and many other crucial components of development. By evaluating the social and the economic impacts of this disease, we see that it plays a large role in the study of Developmental Economics. The detrimental impacts of malaria can begin working before birth, as seen in the fact that an infected child is likely to have immediate mental health complications. In addition, High fertility rates, to ensure the survival of at least one child, reduce investment in individual children. The effect of these limitations, and many others that Sachs and Malaney explore, constrict many areas of this world in a state where development cannot even begin without the eradication of this parasite-like disease. It is almost like regions infected with malaria are utterly removed from the international economic web of trade, aid and investment. Without these things, there is not hope for the regions struggling with Malaria.

    On the other hand, there is great potential for these regions. Here lies a great array of untapped labor and physical capital supply. The only thing standing in the way of this potential return is an entirely treatable disease. I think it should be brought to the world's attention, the possibility for world profit following the eradication of Malaria. This would promote much higher levels of investment in the project to research and implement aid policies. It should be considered that the exclusivity and uniformity of these regions allows this to be a much more simplistic task than the effort of, say, microfinance. A single, successful, case study could solve this problem globally. This is a very simplistic approach; however, if this could instigate the beginnings of effective studies, with modification, this idea could spark profitable development throughout the world, not to mention, sparing many lives in the process.

  14. Given the enormity of the costs that malaria imposes on societies that can handle it the least, I think this is an area where direct foreign aid would be highly effective. In this paper, Jeffrey Sachs and Pia Malaney tell us that the World Health Organization estimates that effective malaria prevention and treatment will cost an additional $2.5 billion per year (for 2007), and $4 billion per year in 2015. The Obama administration's bilateral budget request for aid to Africa in 2012 was $7.8 billion. The money is there, especially when you take into account the aid given by all the other developed countries. The author's make a convincing case for the severity of this problem and the large returns on every dollar invested to alleviate it. Esther Duflo demonstrated in her controlled experiment that the provision of bed nets does not have to be an expensive endeavor and that it can even be self-sustaining after households recognize their value. This paper says that insecticide-treated bed nets reduce all-cause morbidity among children by 60%, a substantial benefit. Direct foreign aid is less than one percent of US GDP, even though most people think its more like 20%. We should reallocate the aid we've already decided to give or increase our aid to Africa in the form of programs focused on alleviating the burden of malaria.

  15. Sachs and Malaney do a great job of outlining and explaining the effects of malaria. Malaria affects 300 to 500 million people every year and one of the main points of this paper is that “where malaria prospers most, human societies have prospered least” (681). Also, there is clearly correlation between malaria and impoverished countries with high rates of poverty and slow economic growth, but Sachs and Malaney make the point that it could be malaria causing the slow economic growth, slow economic growth and poverty causing the spread of malaria, or a combination of both.
    In terms of measuring the effects of malaria, many studies focus on the economic costs of malaria of an individual episode then multiply that amount by the number of cases. However, this technique excludes many other effects that could be caused by the widespread nature of the disease. Changes in household behaviors and macroeconomic aspects such as trade, tourism, and foreign direct investment have been linked to malaria. For example, household behaviors might lead to severe social costs. If a family decides to have more children to increase the likelihood that some will survive, the fertility rates will increase. A high fertility rate might lead to consequences involving education and investment in human capital. Sachs and Malaney mention the “quantity-quality trade off” (683). If a family has a large number of children, it is likely that the parent will invest more in the boys than the girls. Also, related to human capital, malaria significantly reduces a child’s ability to succeed in school if they are infected.
    Outside of household behavior, malaria creates many more difficulties in struggling economies. For example, the long-term impacts of malaria might reduce a family’s ability to save. Also, malaria prevents the mobility of workers, thus creating less job opportunities. Finally, trade, tourism, and foreign direct investment are made much less appealing in a country stricken with malaria. The case of Billiton, the London-based mining company, demonstrates the difficulties brought on by malaria. In two years, 13 expatriate employees died and there were 7,000 more cases within two years. Foreign direct investment, trade, and tourism can be crucial for a country to create and boost economic development. Therefore, a solution to malaria should be sought through the expansion of currently effective malaria control programs.

  16. In “The Economic and Social Burden of Malaria” Jeffrey Sachs and Pia Malaney begin to quantify the cost of malaria. First and foremost, there are 300 to 500 million malaria cases each year; every 40 seconds a child dies of malaria, which leads to 2,000 daily losses. These numbers are shocking to me from the beginning. These numbers alone indicate that malaria is a problem and needs to be eradicated. Malaria is one of the top three communicable diseases. However, the life loss is just one aspect of the burden of malaria. Malaria slows development, increases fertility rate, lowers saving and investment rates, reduces worker productivity, and increases medical cost. Mass death tolls should be a large enough reason to eradicate a problem but it seems to me that Sachs and Malaney know better. Malaria is a problem for those who contract it but it also negatively affects entire countries, continents, and the world.

    Malaria and poverty are both concentrated in the tropical and subtropical zones. Poverty might promote the spread of malaria and/or malaria might cause poverty by slowing economic growth. Malaria can be eradicated by using bednets, insecticides, increasing urbanization, and draining swampland. The countries with malaria need economic development in order to fight against malaria. As malaria is reduced the economy will grow. These two actions will have increasing benefits for the other cause.

    Fertility rates are high in areas with Malaria because people think in terms of survival. Families have more children because they know the chances of children dying from disease. These high fertility rates lead to a reduction in investment in education. Also, daughters’ investment in education falls even more because they are expected to have many children. For those who do go to school, many miss school because of malaria. Now as these children enter the workforce they have less education because of malaria. And once in the workforce they miss work just like they were absent from school because of the disease. Those who do not show up to work and those who died from the disease reduce the workforce and ultimately reduce entire countries’ productivity. Why would anyone invest in these countries?

    Investment lost in countries with malaria impedes their development but it is also

  17. In my opinion, the most disturbing effect of malaria Sachs identifies in this article is its ability to cripple human capital. First, the morbidity and mortality surrounding malaria leads to a directly observable decrease in productivity and an increase in income losses. However, as Sachs mentions, this alone only accounts for a 1% loss in GDP. Even more troubling is malaria's profound effect on education. Malaria results in an increased number of school days lost, which in turn "increases failure rates, repetition of school years, and drop out rates." Moreover, the child mortality surrounding malaria means that many of the resources devoted to developing their human capital will be wasted as many of these children will die. This effect is compounded by the phenomenon of increased fertility rates as a risk-aversion strategy against child mortality, as resources will be spread even thinner across these children.

    And finally, perhaps even more troubling than malaria's effect on education is its effect on cognitive development. Sachs identifies that pregnant women infected with malaria are much more likely to give birth to a child of low birthweight, which is highly correlated to failure in school. He also notes that severe cases of cerebral malaria can drastically impair intellectual functioning. Unfortunately, however, the extent of the widespread neurological damage caused by malaria is likely to be unknown and even underestimated at this time, as studies in respect to its inhibition of cognitive development have been limited. Without stronger attention given to addressing the effects of malaria in respect to human capital, it seems unlikely that Africa will observe significant improvements in the development of its economy.

  18. This article really does a great job of highlighting some of the extremely debilitating effects of malaria on a regions human capital and entire economy. The extent of malaria and the devastation that it causes to populations is clearly evident and Sachs and Malaney attempt to connect the dots between the disease and some of the economic troubles that are seen in regions with heavily concentrated sections of their population infected by malaria. The authors do a good job of explaining how poverty not only leads to higher rates of malaria but malaria often leads to higher rates of poverty as well. Malaria occurs most in tropical regions as the incubation period becomes shorter and the disease is able to survive and thrive in these warmer regions.

    In these regions economies have stumbled and economic growth has been virtually non-existent. The authors illustrates that GDP growth, growth rates, and GNP growth in these regions most directly affected by malaria are all lower when compared to regions with lower infection rates. This comes as no surprise after one understands the other effects both economic and social that correspond to malaria infection. The changes in household behavior that occur as a result in the disease result in major social costs in factors such as schooling, demography migration, and saving. There are also major macroeconomic costs associated with the disease. These costs include the impact on trade, tourism, and foreign direct investment. Thus, it is evident that the disease affects almost every aspect of life in a given region and thus creates an economic and social atmosphere that struggles to develop and continues the spread of malaria and its debilitating effects. In the regions where the transmission of the disease is intense, the cycle creates a set of biological and behavioral responses with a long term effect on economic growth and development. It is also evident that not nearly enough aid is being given to help resolve the malaria problem. Given the vicious cycle that malaria creates across societies it should be a top priority of aid giving countries in helping to improve a region's quality of life and rise economic efficiency.

  19. I am truly shocked by the fact that “every 40 seconds a child dies of malaria, resulting in a daily loss of more than 2000 young lives worldwide”. In fact, the lovely children are the ones who are most affected by the disease. The current situation is calling for attention because population movements, deforestation, global warming, and poor health systems in poor countries are making the situation even more severe.

    As the article has pointed out, there’s a two-way relationship between poverty and malaria. It could be explained that poverty promotes malaria in endemic areas because of poor health systems, and lack of effective treatment. It could also be the other way around that malaria worsens the family’s economic conditions because it impairs human capital, reduce fertility rate and so on. Despite pointing out the possibility of spurious relationship that tropical climates cause poverty and therefore cause endemic malaria, the authors lay out sufficient evidence for both directions of causal relationships between poverty and malaria. Specifically, they focus on social and economic costs, human capital, physical capital, investment, population move, and long-term consequences of the above. As a result, cost-effective treatments are in urgent need, since the level of foreign aid in treatment of malaria is minimal.

  20. Jeffrey Sachs and Pia Malaney's "The economic and social burden of malaria" provides an "all-encompassing" view into virtually all aspects of malaria- from geographic presence to biological inner-workings to the social and economic consequences. They are able to identify different economic paradigms from the "Child-Survivor Hypothesis" to dual causality in respect to poverty and transmission.

    On the surface, resolving such a devastating disease seems overwhelming and, frankly impossible.However, to an acute economic development student- one is able to identify potential for a solution. Africa's tropical and sub-tropical counterparts of Brazil, Indian and South East Asia all suffer from malaria, yet markedly less so. Why? They have developed into hotbeds for global investment, sparking increased government infrastructural capabilities in preventing the disease? How did these regions develop into these pockets of investments? Because investors saw other investors bringing there money into the regions- creating a model of exponential growth. Why did these first investors start investing in the first place? Because they saw micro-changes on a localized level- a new road or an improved government policies that caught their attention. So how does Africa replicate this? By starting small- buying a mosquito net or vaccination. Sub-saharan Africa has the resources to attract such large scale investments- as exemplified by Billiton's $1.4 billion joint venture investment to build an aluminum smelter in Mozambique, it simply needs to remedy malaria from the ground up to bring in similar investments.

    At this point you may counter with- this model is Purely theoretically, highly unlikely to produce similar effects, economically unfeasible and already in motion- all correct. So why do I illustrate such a chain of events? Because curing malaria is not as overwhelming as the article my point it out to be. It starts with the smallest of ripples that ultimately can transform impoverished countries into developed nations. Micro-economies ultimately drive macro changes and can change the world.

  21. The article did an excellent job of highlighting the many problems associated with malaria, particularly in the tropical regions of the world. The one idea that resonated with me was the fact that the correlation between malaria and poverty is a dual sided equation, one with which we cannot prove (at least right now) causality. This raised the question of which is more important to fight - poverty or malaria? Or can we ostensibly fight both at the same time? Learning that malaria was still an issue in wealthy countries, such as the United Arab Emirates, and in wealthy households within these countries, points to the issue of malaria as one that we need to seriously focus on eradicating. There are several ways to do this, as pointed out by the article. Providing people with bed nets, or focusing on insecticide to kill larvae or keep mosquitos out of homes seems like such an easy thing to provide for people, or to incentivize people to buy. This raises the question of why malaria eradication has been such a struggle to fundraise for and focus support for. The paper outlines the history of the fight against malaria, which has had many successes. Malaria is now focused only in tropical regions, and malaria eradication has been successful in places outside of these regions. However, the disease is still rampant within this tropical zone.

    Because malaria has so many economic costs associated with it - including loss of wages, increase in health care spending, and higher infant mortality rates - it would seem the countries and people would have a fundamental interest in working to end the disease. Since this still hasn't happened, it would seem that the benefit of fighting malaria is not on an individual level. But because there are so many problems correlated with malaria, this is an issue we need to face. At a national and international level, we need to push for increased spending and education about the problems of malaria.

  22. It is hard for me to believe that cases of malaria range from 300-500 million per year... that a child dies every 40 seconds. With this in mind it is easy to realize that such widespread disease can wreak havoc on economic circumstances for affected areas. Obviously, this disease can easily reduce the number of people in the workforce via death and illness. It places huge burdens on the populace with high medical costs. The disease can also have lasting medical effects by making children less likely to retain the nutritional benefit of some of their diet. The most interesting point, one that I had not seen before, was that the amount of human capital lost due to children missing school is staggering. "In Kenya it was found that primary school students miss 11% of school days per year because of malaria, and secondary school students miss 4.3% of school days." The last point that really struck me was the reduction in foreign trade and direct investment seen in highly infected areas. Overall, it is surprising how much of an economic impact malaria can have. I never really approached malaria as a problem from this intellectual framework.

  23. The article is informative but it is unsettling that beyond the information, the real problem that remains unanswered is how tropical regions can eradicate malaria with the available resources that they possess and with the lack of information. The majority of countries that still struggle with this depletion of human capital do not have a clear course of action because of incomplete information. Vector control and case management worked for temperate regions because fundamentally, the environment allowed for these efforts. The parasite in Africa is a lot more resistant and deadly because they are prone to attack humans. So, the same vector control that worked in America, for example, may not be applicable to Africa. Perhaps there is already an existing solution that has been adapted to these different regions and it is simply not mentioned in the article. If not, then more research needs to be dedicated to environment specific situations so that the world can strain the causal relationship between malaria and poverty.

    On a different note, the effect of malaria on stunting economic growth is easily comprehensible via the Solow growth model. Sachs and Malany observe that in regions afflicted by malaria, fertility rates are high (and increasing) because parents may want to make up for the fact that children are most often victims of the deadly parasitic disease. When population growth occurs, the nk curve will rotate upwards, which will result in a decrease in income/ output. Larger household sizes will also translate into lower savings because more of the household income must go towards sustaining the numbers and a variety of other expenses. The sy curve will shift downwards. The effect of the two shifts, ceteris paribus, is disastrous for economic growth.

  24. Jeffrey Sachs and Pia Malaney examine the ties between malaria and economics in the paper “The Economic and Social Burden of Malaria.” I found this article to be very interesting. The threat of malaria is so large that it is actually beneficial to have the sickle cell trait – a trait that is potentially fatal. Malaria causes a child to die every forty seconds (680). The economic effects of malaria are extremely broad ranging. What I found to be surprising about malaria was not how widespread it is but the economic tolls it takes. There are medical costs, lost incomes, costs associated with behavioral changes such as moving, and macroeconomic costs such as the negative effects malaria has on trade, tourism, and foreign direct investments. It is not surprising that malaria and poverty are concentrated in the same areas. These countries have lower rates of economic growth. There are many things that can be done to help combat malaria. The use of bed nets is a low cost way to decrease the chance of getting malaria.