Can Benefits from Malaria Eradication be Increased - Evidence from Costa Rica

Please notice that this research belongs to my PhD thesis. In the two months I will provide further evidence on the channels through which malaria eradication increased the wages of men. The hypothesis is that the increase in years of schooling cannot fully explain the increase in wages of men, instead this increase is explained by health improvements, in an economy with widespread child labor mainly in agricultural activities, where brawn was more important than brain. Malaria is not a disease of the past, and not only a problem of African countries. According to PAHO (2013), Colombia had 6.29 malaria cases per 1,000 inhabitants during 2011, it was the country with the highest annual parasite index (API) in America only succeeded by Guyana (42.17), Suriname (12.55), and Venezuela (8.03). According to the Colombian National Institute of Health (INS) malaria in Colombia it represents a serious public health problem, because about 85% of Colombia's rural area is located below 1,600 meters above sea level and has climatic, geographic and epidemiological conditions suitable for the transmission of the disease. An estimated 25 million people are at risk of getting sick or dying from it. The behavior of malaria morbidity in Colombia over the past three decades has maintained an upward trend, with an average number of cases between 120,000 and 140,000. This is important in a context where many diseases around the world that were thought as extinct are repairing. The literature on the benefits of growing in a cohort with much decreased exposure to malaria has provided very different estimates in terms of human capital accumulation. Bleakley (2010b), Cutler et al. (2010), and Lucas (2010) have found benefits to being born in an environment free of malaria, but their estimates in terms of educational gains have been very different. The same is true for other health interventions carried out in different countries and years (Maluccio et al., 2009; Bleakley, 2007; Baird et al. 2013; Miguel and Kremer, 2004). Bleakley (2010a) and Cutler et al. (2010) have justified these results based on the fact that the added health and productivity could be used in increasing participation in the child labor market. However, not much research has tested the validity of this hypothesis. This paper empirically tests this hypothesis by exploring for the first time the malaria eradication campaign of Costa Rica that began around 1945 and successfully reduced malaria transmission. The history of malaria in Costa Rica can be divided into two episodes. The first one (called ¿during¿ eradication) took place between 1946 and 1963, and successfully lowered malaria rates around the country. However, beginning in 1963, the malaria campaign suffered a funding slowdown and by 1967 there was a new peak in malaria that more than tripled the previous rate. Authorities were not able to control this peak until 1968-70 (the ¿peak¿ episode). Recently malaria eradication has become a policy priority (Millennium Development Goals, UN (2013); Roberts and Enserink (2007)). Malaria control campaigns in Africa have decreased malaria mortality rates by more than 25% globally since 2000 (WHO, 2010), costing US$6.8 billion (WHO, 2012) between 2013 and 2015. As a result, the economic literature has given much attention to estimating the impact of growing in a cohort with decreased exposure to malaria. However, according to the World Malaria Report 2012 (WHO, 2013) after a rapid expansion between 2004 and 2009, global funding for malaria prevention and control leveled off between 2010 and 2012, and progress in the delivery of some life-saving commodities has slowed. These developments are signs of a funding slowdown that could threaten to reverse the remarkable recent gains in the fight against malaria. Unfortunately no academic work quantifies the possible effect of reversion. The Costa Rican campaign suffered a large set back and is studied for the first time to understand the impact of the re-introduction of malaria in an economy, with results that are different from the eradication. This is in line with Javeriana¿s mission which is to pursue a just, sustainable, inclusive, democratic, solidary and respectful society of the human dignity.