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Updated 18 February 2013

Waking up to the maths of malaria

To the minerals and mobiles underpinning Africa's pacy growth over the last decade, you may soon be able to add malaria – or at least its absence.

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To the minerals and mobiles underpinning Africa's pacy growth over the last decade, you may soon be able to add malaria – or at least its absence.

Besides the huge human cost imposed on the continent - 90% of the 655 000 deaths estimated worldwide in 2010 – the mosquito-borne disease is an economic millstone, draining public and private resources and hammering productivity.

According to a 2001 study co-authored by US economist Jeffrey Sachs, the disease imposes an annual "growth penalty" of 1.3% points on afflicted states, which includes most of those south of the Sahara apart from South Africa.

In Nigeria, Africa's most populous nation and its biggest oil producer, malaria is responsible for up to 25 work days lost per person per year, or two a month, due to direct infection or the need to stay at home to nurse a sick family member, often for a week or more.

In Zambia, it is the leading cause of absenteeism, accounting for more than twice as many days off as HIV/AIDS, and can consume up to 40% of the public health budget in cash-strapped frontline states. It may not always be thus.

The number of malaria deaths has fallen dramatically in the last decade due to increased aid spending on basic items such as insecticide-treated bed nets and drugs, the World Health Organization (WHO) says.

Malaria related deaths decreased

More exciting, the holy grail of a vaccine against a notoriously adaptable parasite no longer appears unobtainable after an experimental vaccine from GlaxoSmithKline was shown last year to halve the risk of African children getting the disease.

Even before the prospect of a vaccine, companies across Africa were waking up to the commercial sense of investing in a malaria-free workforce – and the results are encouraging governments to get in on the act.

Faced with endemic malaria in the 240 000 population town around its Obuasi gold mine in Ghana, AngloGold Ashanti, the world's third largest bullion producer, launched a multi-pronged campaign of bed-nets, indoor insecticide spraying and drugs that cut infections from 79 237 in 2005 to fewer than 16 000 in 2008.

The program cost the Johannesburg-based firm $1.3 million a year, but over that time the malaria drug bill at the mine's hospital dropped from $55 000 to $9,800 a month, while work days lost each month fell from 6 983 to just 282.

"It really made economic sense because of the absenteeism and the cost of medication," said Steve Knowles, the head of AngloGold's anti-malaria operations.

The Ghana model is now being extended to communities around its mines in Democratic Republic of Congo, Tanzania, Mali and Guinea, bringing as many as 500 000 people under its umbrella.

Beating malaria

Europe's financial crisis and relatively sluggish rich-world growth have left a question mark over cash pools such as the Global Fund to Fight AIDS, Tuberculosis and Malaria that have been complementing state and private sector efforts, threatening to unravel the gains made.

But Knowles said many governments were becoming increasingly aware of the mathematics of beating malaria and starting to put their own program in place.

The prospect of an affordable vaccine is only going to increase the power of that argument for a region forecast to grow at 5.4% this year – even with malaria. Without it, that figure could be knocking on 7%.

"Now that they're seeing the aid funding may not be there, it's a bit of a wake-up call and governments are looking to do it themselves," Knowles said. "What difference will a vaccine make? If it comes through, it's going to be huge."

(Reuters Health, Ed Cropley, June 2012)

Read more:

Malaria in South Africa

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