Epidemiological Impact on the
Economies of Poor Nations of
Africa
Prof. P.E. Mugambi
Retired Professor of Applied Mathematics
Department of Mathematics
Makerere University
Summary

Infectious diseases are a major public-health
problem in the developing world especially
Africa but its economic impact is not well
documented.

Adequately capturing the economic burden of
infectious diseases in poor countries requires
good epidemiological data and a better
understanding of the long-term health and
economic costs.

Prevention and control efforts are scare, and fail
to adequately capture the benefits.
UGANDAN HEALTH STATS (UNICEF)
Major infectious diseases >
Degree of risk
Very high
Drug access
50%
HIV AIDS > Adult prevalence rate
4.1%
HIV AIDS > Deaths
78,000
Hospital beds > per 1,000 people
0.92
Malaria cases > per 100,000
46
Physicians > per 1,000 people
0.08
Life expectancy at birth, years >
49
Total population
Maternal mortality
510 per 100,000
Children living with AIDS (per
4.03388 per 1,000 people
capita)
Diseases for the poor

Many infectious diseases are frequently
referred to as diseases of the poor. At a macro
level, there is clear evidence that the burden of
infectious diseases is greatest among the
poorest countries of the world, especially those
in sub-Saharan Africa

Disease and poverty have taken such a serious
toll on Africa that the death rate is constantly
rising. Not to mention the great population that
is also steady increasing at an alarming rate,
creating more famine and disease to spread
throughout the land.
Economic burden
Information on the economic burden of
infectious diseases in Africa can help to target
interventions efficiently and equitably, and to
justify investment in research and control.

Such data can inform our understanding of the
financial and time burdens of illness episodes,
the determinants of treatment-seeking behavior,
and the differential economic impact on
population subgroups.
Issues related to disease problems
in Africa





Infectious diseases are on the rise and now kill 17 million
people a year, particularly young people in the
developing world.
The concern over new viruses, started with HIV causing
AIDS, has been reinforced as other emergent viral
diseases have been reported, including Ebola and Rift
Valley Fever.
Growing drug resistance, new virulent strains, continuing
poverty, the breakdown of public health measures, and
increased human contact are leading to renewed
outbreaks of other epidemic diseases.
Travel and urbanization are increasing human
vulnerability to epidemics of both old and emerging
diseases.
There is also concern that climate change may have
significant effects on health.
Reduction in Life Expectancy





Tuberculosis is now the world's single largest cause of death from a
single agent. At the rate TB is spreading, it could claim over 100
million lives over the next 50 years. The association of TB with the
AIDS epidemic is one of the main reasons for the increase.
There are presently about 300-500 million clinical cases of malaria a
year, 90 percent in Africa, and malaria deaths rose 5 percent in 1995,
killing 2.1 million people, mostly children.
Global warming could cause another 50-80 million cases as diseasebearing mosquitoes move into new areas.
While life expectancy has generally been increasing for decades,
there has been a sharp reversal in recent years in sub-Saharan Africa.
Causes may include the stresses of economic transition, deteriorating
health care, and possibly the toxic burden of decades of
environmental contamination.
In Africa, the AIDS epidemic is expected to reduce average life
expectancy by almost 8 years (WRI/UNEP/UNDP/WB, 1996).
Disease and Poverty

HIV/AIDS has already destroyed so many lives in Africa since the
1980’s and is continuing to demise a majority of the population.
Sometimes people receive the disease because of the increased
spread of poverty or a traditional family breakdown of support
systems. So many people have contracted the disease but cannot
afford to take on the medical expenses and end up suffering until
their death.

Orphans roam the streets of Africa because many of their family
members have passed away from the disease and they are left to
survive on their own. Africa has the world’s highest and most
rapidly increasing spread of HIV/AIDS with 40% of the population
already contracted the disease being the ages of 15-49 years.
Vultures feasting on
diseases

Some people in Africa do not want the
diseases to be eliminated simply because
they benefit from their existence. E.g.
pharmacists, the doctors, governments,
treatment facilities, local communities and
regional leaders.

The governments receive huge amounts of
donations to fight these diseases every year,
and each year, the funds are diverted. A
campaign to spray using DDT was strongly
objected although this could eradicate
diseases like malaria in no time. Some
health workers are also reluctant to
promote control and prevention measures
against diseases.
Frustrated campaigns

Mark Grabowsky, wrote in Nature 451, 1051-1052 (28 February
2008) that “Several years ago, I was explaining the value of a
measles-vaccination campaign to a doctor at a pediatric hospital in
northern Uganda, where, at that time, measles was endemic. The
proposed campaign would control the disease and potentially enable
the hospital to close the measles ward. The doctor responded that if
there was also a campaign that controlled malaria he could close the
entire hospital"

Individuals too are also frustrating all campaigns, and retarding
prevention measures in rural villages, due to ignorance and
misinformation.
Why Africa is prone to
infectious diseases







Long distances from health centers
Lack of funds to buy medicines
Self medication
Incomplete doses
Lack of drugs in health centers
High consultation fees
Ignorance,-some people don’t understand
why sleeping under mosquito nets prevents
malaria
Key barriers

Effective treatment is often inaccessible or costly for vulnerable
groups.

In many places, health services are of poor quality, with long
waiting times, inaccurate diagnosis, and inappropriate prescription
and advice.

In addition, these services often do not have essential drugs in stock
and, even if they are available, there are often high levels of parasite
resistance to the drugs provided.

People often resort to the private commercial sector, which may be
poorly regulated and offer inappropriate treatment, but where access
costs may be lower.

The coverage of effective prevention is very limited, especially in
areas with the highest transmission.
Most households rely on personal protection measures of limited
effectiveness, such as burning mosquito coils or leaves.

The economic impact of diseases in
Africa




Africa's economic problems have a medical solution. Infectious
disease is much more than a health issue. They cost the continent
billions of dollars a year.
Malaria kills three children per minute. This amounts to a quiet
global catastrophe. Quiet, because it has been taking place for
millennia and become a fact of everyday life. In Mozambique,
malaria patients occupy 40% of the nation's hospital beds. And these
are just the people fortunate enough to make it to a health centre.
Fighting disease must be a central, not ancillary, part of the
economic strategy for Africa - on a par with debt relief and trade
liberalization - if countries in Africa are to achieve the significant
boost in economic growth, that all sides agree is critical to reducing
extreme poverty.
Infectious diseases have crippled African efforts to achieve
economic self-sufficiency for at least the last half-century - predating
the debt crises, corruption and trade matters.
More disease burden

Many infectious diseases, especially Aids and TB, exact a heavy toll
that goes beyond the pain and suffering that victims of these diseases
endure.

The damage also manifests itself in a significant and quantifiable
drag on Africa's GDP. Currently, 300 to 500 million cases of malaria
occur every year. Of the estimated 2.7 million people killed by
malaria every year, 75% are African children under the age of five.

When an individual dies, it takes a minimum of three days to make
funeral arrangements, while the entire village is gathered at the
home. The bereaved are obligated to feed the comforts, and house
them as well. People are forced to borrow funds during times they
are moaning their loved ones. More people take time off from work
for burial ceremonies, while companies suffer shortage of workers
during such times.
Diseases and Global warming:
Global warming makes girls
hot

It was reported in Kenya
that global warming has
stopped circumcisions.

Consequently, young
men are not ready to
marry anyone which is
why the girls marry
diseased older guys.
Uganda and Global
warming

In Uganda, global warming causes a related problem, namely early
marriages. It occurs because rich men are ready to marry young
females. This is a conclusion of a scientific report funded by the
United Nations that has identified "famine marriages", i.e. a new
method for families to earn money and food by selling their
daughters.
Famine marriages

"When people don't have food, they raid and sell
their daughters and animals to get money to buy
food. Whenever they raid, they bring along sick
animals with strange diseases that affect the rest of
the livestock and the young girls are married off to
rich men with a lot of diseases," it was reported by
a local newspaper, The Monitor.
Global warming: disease threat

More countries will be at risk from mosquito-borne diseases like
malaria and dengue due to global warming, according to Global
Health TV.

Rising temperatures could affect many countries that have not
reported an outbreak of malaria in decades.

If temperatures and rainfall rise, mosquitoes would thrive for longer
and breed more prolifically.

The threat of global warming has already sparked concerns in the
Philippines, with health secretary foreseeing "a propensity for
cholera, dengue, typhoid [fever] and malaria".
Way forward

If world leaders and their counterparts in Africa want to
boost GDP, they should consider that diseases like
malaria exact an enormous price not only in lives, but
also in medical costs and lost labor, harming the
economic well-being of entire families, communities and
nations. Malaria shackles the poor to a continuous cycle
of poverty.

The economic, social and development burden is
staggering. According to a Harvard University study
published in 2000, Africa's annual GDP would be 100bn
(£66bn) more than it is today if malaria had been
eliminated 35 years ago - many times more than all the
development aid provided to the continent in any given
year.
Way forward

Meaningful economic development in Africa
cannot occur if addressing infectious disease is
seen as a secondary goal rather than a critical
part of the new vision for economic stability.
This will require those responsible for
implementing a new economic plan for Africa to
broaden their notion of what constitutes a
successful core macroeconomic strategy.
Conclusion

No one would argue with the need to reduce the human
suffering caused by malaria, Aids, TB and neglected
tropical diseases. But it is doubtful that infectious
diseases will receive the attention they merit in the effort
to lift African nations from poverty unless world leaders
firmly link disease burden to economic development.

Failure to do so means that infectious disease will
continue to rob Africa - a continent of more than 800
million people - of its economic potential.
Thank you