Economic effects of malaria and pneumonia in Madagascar.

Summary Malaria and pneumonia are still public health problems in low-income countries, including Madagascar. However, while malaria has received more attention and strengthened control programs since the creation of the Global Fund in 2002, pneumonia is often neglected. Recently, however, UNICEF, building on the encouraging results achieved at the community level in the fight against malaria, has been pushing for the integration of pneumonia screening and management at the community level. To support this advocacy, impact and cost-effectiveness studies are needed to verify that this strategy is effective and efficient. This is the purpose of Chapter 4 of this thesis, which examines the pilot experience conducted by Unicef in the Antalaha district. We show that this program has had a significant impact on the management of malaria and pneumonia. However, the quality of this management is still being questioned. This indicates that, before deciding to scale up, this program deserves to be revised to improve it. In addition to the loss of well-being, malaria and pneumonia have a financial cost first, and then an economic cost. One of the arguments for advocacy is therefore to show, if there are any, the economic effects of the two diseases. This is the subject of Chapters 2 and 3 with an application to Madagascar. Before that, the theoretical underpinning of the link between health and income or economic development is presented in the first chapter.