Towards An Economics Policy Framework to Combat Malaria, in An Era of Insecticide Resistance

Malaria causes close to half a million deaths per year, the majority of which are in children under five years of age who live in sub-Saharan Africa. Despite significant progress in reducing malaria deaths in the past fifteen years, there is still a long way to go before universal coverage with key interventions like LLINs and IRS is reached, which is an essential step towards achieving malaria elimination. While severe resource constraints pose a fundamental challenge, growing resistance to insecticides used in LLIN and for IRS exacerbates this issue, and threatens to undermine the significant gains achieved to date. This IPPI Policy Brief draws from economic theory to analyse the case of insecticide resistance. It highlights some fundamental trade-offs brought about by the emergence of resistance to insecticides, as well as the lack of data that is necessary to analyse them. The paper also explores how the concept of market failure is applied in the field of malaria control, and where market inefficiencies have not yet been adequately addressed. Overall, while there is no doubt that significant additional funding is needed to combat malaria and hopefully to move closer to its elimination, there is an urgent need to use sound economic analysis to help develop and strengthen a global rationale for further public investment in malaria vector control and to better take account of insecticide resistance in the prioritisation and deployment of national, in-country programmes.