This study will undertake a comprehensive and consistent analysis of the economic burden of malaria. It will make use of the work carried out by the malaria control program of the Lubombo Spatial Development Initiative (LSDI) by adding an economic component. The LSDI is a program undertaken by three governments of southern Africa to develop regions of KwaZulu Natal, Swaziland and Mozambique for tourism, industrial investment, and agriculture. Malaria prevalence is currently very high in this region, reaching as much as 86 percent in some areas. As part of the initiative to provide a hospitable environment for economic development, LSDI has undertaken a major malaria control effort, supporting malaria control in Swaziland and KwaZulu Natal and extending it to southern Mozambique. This initiative provides a unique opportunity to assess the economic burden of malaria and the economic benefits of malaria control. The economic study will combine data on malaria prevalence and incidence gathered by the lsdi with data on socioeconomic factors gathered from surveys, government data and other data sources to assess both the micro-economic and macro-economic impacts of malaria before and during the malaria control effort. The study will gather information on the burden of disease at several levels, namely households, schools, communities, businesses, and the government. The factors assessed will include private and non-private expenditures on malaria prevention and treatment, as well as the impact of malaria on productivity, educational achievement, human mobility, trade, tourism, and domestic and foreign investment. Data will be analyzed using a variety of methodological approaches, including the traditional cost-of-illness approach, regression analysis, and contingent valuation. Where possible, the results of these methodologies will be compared and contrasted, and will form the basis for an analysis of methodological issues in assessing disease burden. The study will also carry out cost benefit and cost-effectiveness analyses to facilitate policy decisions about the appropriate use of resources for malaria control, both in the private and the public sectors.
