The economic cost of malaria in Africa.

Although malaria is the major health problem in Africa, there is little research on its economic impact. This study adapts a framework for assessing the economic costs of illness to available data on malaria. Direct costs of illness are the costs of treatment and control activities, and indirect costs are the value of lost time due to morbidity and premature mortality. Direct costs were estimated by applying the average estimated health systems costs per case to the number of cases. Indirect costs were assessed by multiplying adult output per day times the estimated productive time lost through both adult and childhood cases. As data are not available to assess the economic impact of malaria in Africa as a whole, four case studies were performed on countries or regions for which needed data could be found. The four sites (Rwanda, Solenzo medical district of Burkina Faso, Mayo-Kebbi district, Chad, and Brazzaville, Congo) were chosen to illustrate the diversity in kinds of data which can be used (aggregate national health statistics versus household surveys) and in locations (urban versus rural). Costs were calculated for the recent past and were projected to 1995 based on recent epidemiological trends. Estimates for all sub-Saharan Africa were derived from the averages of these sites. In 1987, a case of malaria cost $9.84 (in 1987 US dollars)--$1.83 in direct costs and $ 8.01 in indirect costs. As the average value of goods and services produced per day in Africa was $0.82, this cost is equivalent to 12 days of output.(ABSTRACT TRUNCATED AT 250 WORDS)