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There is a strong link between malaria levels and a country’s economic growth, according to a research report from the World Health Organization (WHO) Commission on Macroeconomics and Health.

The research used a number of mathematical models to correlate epidemiological data for malaria and data on national income, based on gross domestic product per capita, between 1965 and 1990. This shows that those countries most severely affected by malaria are also among the poorest in the world. Moreover, these countries had very little economic growth in the period studied, and more than one third of them had negative economic growth. The report identifies a number of possible explanations for this link between malaria and a country’s poor economic performance.

The key findings include the following:

• Forty-four countries have intensive malaria levels; 35 of these are in Africa. When the 150 largest countries are ranked according to income per capita all but three of these 44 are in the bottom half.
• The richest 31 countries are free of malaria. Income per capita is five times higher in countries free of malaria than those with intensive malaria.
• Countries with intensive malaria in 1965 had much lower economic growth in the period up to 1990, even after factors such as initial income level, overall life expectancy, economic policies and proximity to markets are taken into account.
• Countries such as Greece, Italy and Spain successfully organised malaria eradication programmes in the late 1940s and had rates of economic growth higher than the European average directly afterwards. However, the Mediterranean, which is sub-tropical rather than tropical, is not one of the most severely affected areas of the world.
• Oil rich states such as Oman have not been able to eradicate malaria, which shows that location and climate are more important than national wealth in determining whether a country experiences severe levels of malaria.
• Location, climate and other biological factors, such as the larger number and different types of mosquito species found in Africa, account for the intensity of malaria on that continent. This implies that it is malaria that causes poverty and slow economic growth and not vice versa.

While there is strong evidence of the link between the prevalence of malaria and poor economic growth, the reasons for this link remain unclear. The report indicates a number of explanations but stresses that none of these is conclusive.

• Malaria affects most severely young children and pregnant mothers rather than the working population. It may, however, have life-long effects on cognitive development through the effect of chronic malaria-induced anaemia and time lost from school due to illness. However, the impact of malaria on human productivity cannot be assessed in the current state of research.
• Tourists and foreign investors will want to avoid countries with endemic malaria, and the potential economic benefits to the country are lost.
• The severity of malaria in certain parts of a country will put limitations on internal movement. This means that the transmission of ideas and techniques and the development of transport systems may be stunted by malaria.

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