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ACT Now or Later: The Economics of Malaria Resistance

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  • Laxminarayan, Ramanan

    (Resources for the Future)

Abstract

In the past, malaria control efforts in sub-Saharan Africa have relied on a combination of vector control and effective treatment using chloroquine. With increasing resistance to chloroquine, attention has now turned to alternative treatment strategies to replace this failing drug. Although there are strong theoretical arguments in favor of switching to more expensive artemisinin-based combination treatments (ACTs), the validity of these arguments in the face of financial constraints has not been previously analyzed. In this paper, we use a bioeconomic model of malaria transmission and evolution of drug resistance to examine questions of optimal treatment strategy and coverage when drug resistance places an additional constraint on choices available to the policymaker. Our main finding is that introducing ACTs sooner is more economically efficient if the planner had a relatively longer time horizon. However, for shorter planning horizons, delaying the introduction of ACTs is preferable.

Suggested Citation

  • Laxminarayan, Ramanan, 2003. "ACT Now or Later: The Economics of Malaria Resistance," RFF Working Paper Series dp-03-51, Resources for the Future.
    • Handle: RePEc:rff:dpaper:dp-03-51
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    File URL: http://www.rff.org/RFF/documents/RFF-DP-03-51.pdf
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    References listed on IDEAS

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    1. Asenso-Okyere, W. K. & Dzator, Janet A., 1997. "Household cost of seeking malaria care. A retrospective study of two districts in Ghana," Social Science & Medicine, Elsevier, vol. 45(5), pages 659-667, September.
    2. Gomes, Melba, 1993. "Economic and demographic research on malaria: A review of the evidence," Social Science & Medicine, Elsevier, vol. 37(9), pages 1093-1108, November.
    3. Chima, Reginald Ikechukwu & Goodman, Catherine A. & Mills, Anne, 2003. "The economic impact of malaria in Africa: a critical review of the evidence," Health Policy, Elsevier, vol. 63(1), pages 17-36, January.
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    Cited by:

    1. Anderson, Soren T. & Laxminarayan, Ramanan & Salant, Stephen W., 2012. "Diversify or focus? Spending to combat infectious diseases when budgets are tight," Journal of Health Economics, Elsevier, vol. 31(4), pages 658-675.
    2. Marsh, Sally P. & Llewellyn, Rick S. & Powles, Stephen B., 2006. "Social costs of herbicide resistance: the case of resistance to glyphosate," 2006 Conference (50th), February 8-10, 2006, Sydney, Australia 139881, Australian Agricultural and Resource Economics Society.
    3. Laxminarayan, Ramanan & Over, Mead & Smith, David L., 2005. "Will a global subsidy of artemisinin-based combination treatment (ACT) for malaria delay the emergence of resistance and save lives?," Policy Research Working Paper Series 3670, The World Bank.
    4. Schneider, Kristan A. & Kim, Yuseob, 2010. "An analytical model for genetic hitchhiking in the evolution of antimalarial drug resistance," Theoretical Population Biology, Elsevier, vol. 78(2), pages 93-108.
    5. Herrmann, Markus & Gaudet, Gérard, 2009. "The economic dynamics of antibiotic efficacy under open access," Journal of Environmental Economics and Management, Elsevier, vol. 57(3), pages 334-350, May.
    6. Laxminarayan, Ramanan & Parry, Ian W.H. & Smith, David L. & Klein, Eili Y., 2010. "Should new antimalarial drugs be subsidized?," Journal of Health Economics, Elsevier, vol. 29(3), pages 445-456, May.

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    More about this item

    Keywords

    Malaria; mathematical models; drug resistance; bioeconomics;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I19 - Health, Education, and Welfare - - Health - - - Other
    • C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis

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