Patouillard Edith, Han Seoni, Lauer Jeremy, Barschkett Mara, Arcand Jean-Louis
Department of Health Financing and Economics, World Health Organization, Geneva, Switzerland.
Korea Institute for International Economic Policy, Sejong, Korea.
Int J Health Policy Manag. 2023;12:7132. doi: 10.34172/ijhpm.2023.7132. Epub 2023 Oct 4.
Malaria remains a major public health problem. While globally malaria mortality affects predominantly young children, clinical malaria affects all age groups throughout life. Malaria not only threatens health but also child education and adult productivity while burdening government budgets and economic development. Increased investments in malaria control can contribute to reduce this burden but have an opportunity cost for the economy. Quantifying the net economic value of investing in malaria can encourage political and financial commitment.
We adapted an existing macroeconomic model to simulate the effects of reducing malaria on the gross domestic product (GDP) of 26 high burden countries while accounting for the opportunity costs of increased investments in malaria. We compared two scenarios differing in their level of malaria investment and associated burden reduction: sustaining malaria control at 2015 intervention coverage levels, time at which coverage levels reached their historic peak and scaling-up coverage to reach the 2030 global burden reduction targets. We incorporated the effects that reduced malaria in children and young adolescents may have on the productivity of working adults and on the future size of the labour force augmented by educational returns, skills, and experience. We calibrated the model using estimates from linked epidemiologic and costing models on these same scenarios and from published country-specific macroeconomic data.
Scaling-up malaria control could produce a dividend of US$ 152 billion in the modelled countries, equivalent to 0.17% of total GDP projected over the study period across the 26 countries. Assuming a larger share of malaria investments is paid out from domestic savings, the dividend would be smaller but still significant, ranging between 0.10% and 0.14% of total projected GDP. Annual GDP gains were estimated to increase over time. Lower income and higher burden countries would experience higher gains.
Intensified malaria control can produce a multiplied return despite the opportunity cost of greater investments.
疟疾仍然是一个主要的公共卫生问题。虽然在全球范围内，疟疾死亡率主要影响幼儿，但临床疟疾影响着一生中的所有年龄组。疟疾不仅威胁健康，还影响儿童教育和成人生产力，同时给政府预算和经济发展带来负担。增加对疟疾控制的投资有助于减轻这一负担，但对经济来说存在机会成本。量化投资疟疾的净经济价值可以促进政治和财政承诺。
我们采用了一个现有的宏观经济模型，以模拟减少疟疾对26个高负担国家国内生产总值（GDP）的影响，同时考虑到增加疟疾投资的机会成本。我们比较了两种在疟疾投资水平和相关负担减轻程度上不同的情景：将疟疾控制维持在2015年的干预覆盖水平，这是覆盖水平达到历史峰值的时间，以及扩大覆盖范围以实现2030年全球负担减轻目标。我们纳入了儿童和青少年疟疾减少可能对在职成年人生产力以及通过教育回报、技能和经验增加的未来劳动力规模产生的影响。我们使用来自相关流行病学和成本核算模型对这些相同情景的估计以及已发表的特定国家宏观经济数据对模型进行了校准。
在模拟国家中，扩大疟疾控制可产生1520亿美元的红利，相当于26个国家在研究期间预计总GDP的0.17%。假设更大比例的疟疾投资来自国内储蓄，红利会较小但仍然可观，占预计总GDP的0.10%至0.14%。预计年度GDP收益会随着时间增加。低收入和高负担国家将获得更高收益。
尽管增加投资存在机会成本，但强化疟疾控制仍可产生成倍的回报。
