“Roll Back Malaria, Roll in Development”? Reassessing the Economic Burden of Malaria

Recent efforts to mobilize support for malaria control have highlighted the economic burden of malaria and the value of malaria control for generating economic development. These claims have a long history. Beginning in the early twentieth century, they became the primary justification for malaria‐control programs in the American South and in other parts of the globe, including British India. Economists conducted none of these studies. Following World War II and the development of new anti‐malarial drugs and pesticides, including DDT, malaria control and eradication were increasingly presented as instruments for eliminating economic underdevelopment. By the 1960s, however, economists and demographers began to raise serious substantive and methodological questions about the basis of these claims. Of particular concern was the role of rapid population growth, resulting in part from the decline of malaria mortality, in undermining the short‐term economic gains achieved through malaria control. Despite these concerns, malaria continues to be presented as an economic problem in the work of Jeffrey Sachs and others, justifying massive investments in malaria control. The methodological basis of these claims is examined. The paper concludes that while malaria takes a dreadful toll in human lives and causes significant economic losses for individuals, families, and some industries, the evidence linking malaria control to national economic growth remains unconvincing. In addition, the evidence suggests that there are potential costs to justifying malaria‐eradication campaigns on macroeconomic grounds.