Workers Day is a time to remember that malaria affects the whole population in endemic countries. The American Association for the Advancement of Science reminds us that, “Malaria is likely … to have a long-term impact on household and community productivity.” The long term effects come in part because malaria interferes with the schooling of children.
Bleakley points out that the connection between malaria and poverty may be a two-way street – malaria depresses productivity. But poverty itself depresses the family’s and the community’s ability to fight malaria. The effects may arise from continued exposure to childhood malaria. While an individual episode as an adult may not have large effects, cumulative exposure may. Bleakley explained that after eradication programs in the Americas, “In both absolute terms and relative to the comparison group of non-malarious areas, cohorts born after eradication had higher income and literacy as adults than the preceding generation.”
In many endemic countries a large portion of the labor force works in the informal sector where issues like absenteeism and lost productivity are least likely to be measured. In these settings, “The burden of malaria is often greatest among the very poor as they are least able to protect themselves and seek treatment. Hence, malaria can exacerbate existing inequalities.”
As Onwujekwe et al. (2004) note, “Malaria is the leading cause of mortality and morbidity in Nigeria, resulting in the decreased productive capacities of households and increased poverty.” This creates inequalities in a household’s ability to acuire and benefit from malaria control interventions.
Likewise, Chuma and colleagues (2006) note that wealthier households are better able to cope with malaria. “The impacts of malaria on household economic status unfold slowly over time. Coping strategies adopted can have negative implications, influencing household ability to withstand malaria and other contingencies in future. To protect the poor and vulnerable, malaria control policies need to be integrated into development and poverty reduction programmes.”
These facts are why advocates for malaria control state that all people in endemic communities, regardless of age or occupation, should have the benefits of free malaria treatment and ITNs/LLINs.