Malaria eradication: the economic, financial and institutional challenge

Area of Science:

• Global Health
• Health Economics
• Public Policy

Background:

• Malaria eradication efforts have historically encountered substantial economic, financial, and institutional obstacles.
• Previous eradication campaigns, particularly in resource-limited settings, provide valuable lessons on implementation difficulties.

Purpose of the Study:

• To review and synthesize evidence on the economic, financial, and institutional challenges of malaria eradication.
• To analyze recent literature on scaling up malaria control and health system strengthening in the context of renewed eradication calls.

Main Methods:

• Literature review of historical malaria eradication efforts.
• Analysis of recent studies on malaria control scale-up and health system challenges.
• Synthesis of economic, financial, and institutional evidence.

Main Results:

• Economic analyses indicate that the benefits of malaria control generally exceed costs, though cost-benefit analyses for eradication versus long-term control are limited.
• Financial cost estimates for malaria control and eradication are scarce and variable, with recent estimates for high coverage being several dollars per capita.
• Key institutional challenges include legal limitations, the effectiveness of local structures, and political sustainability at national and global levels.

Conclusions:

• Renewed calls for malaria eradication and intensified control must address the identified economic, financial, and institutional challenges.
• A comprehensive research agenda is proposed, focusing on allocative efficiency, economic development links, intervention costs, coverage extension, policy implementation, and financing.