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PUBLIC AND PRIVATE ROLES IN MALARIA CONTROL: THE CONTRIBUTIONS OF ECONOMIC ANALYSIS

There has been high profile advocacy and debate about how to increase availability and uptake of effective malaria control interventions. Application of the tools of public economics indicates that market failures occur for a number of effective malaria control interventions due to monopoly, externalities, and information failures, implying a role for public action. However, additional analysis is required to determine the optimal form of public intervention, and how to set priorities. Additional criteria of cost-effectiveness, impact on poverty and catastrophic expenditures, affordability, characteristics of supply and demand, and potential for leakage are invoked to help inform decision making in the field of malaria control policies. Particular emphasis is placed on the connections between public and private actions.

Received August 21, 2003. Accepted for publication February 20, 2004.

Financial support: Kara Hanson is a member of the Health Economics and Financing Program, which is funded by a program grant from the United Kingdom Department for International Development (DFID).

Disclaimer: The facts presented and views expressed are those of the author and do not necessarily reflect the policies of DFID.

Author address: Kara Hanson, Health Policy Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Telephone: 44-20-7927-2267, Fax: 44-20-7637-5391, E-mail: kara.hanson{at}lshtm.ac.uk.

^* Even in this case private benefits from spraying may arise in the form of protection against other nuisance creatures such as bedbugs. However, these are assumed to be small in relation to the public health benefits.

In the case of pure public goods, such as IRS, crowding out is not an issue because no private market will exist.

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