The Economic Burden of Infectious Diseases

~Written by Theresa Majeski (                                                                                         

Most of us are aware that infectious diseases exact a large toll on humans around the world. Some diseases kill, others maim, and most cause a loss in productivity while the infected person is too ill to go about their daily life.  We know that many of these infectious diseases occur in lower-income areas of the world. So that begs the question, what kind of impact are these diseases having on the economies of those lower-income countries if their citizens are experiencing a high burden of infectious disease?

Sidenote: When discussing the burden of disease, a key definition to know is DALY. DALY stands for Disability Adjusted Life Year; basically it’s a combo of two other measures of the burden of disease and essentially is thought of a one lost year of healthy life.

So here’s some data the authors of this excellent article, detailing how infectious diseases impact the development of Africa, used from the WHO in 2002 about the global burden of a few well-known infectious diseases:

As you can see, death tolls could be argued to be comparatively small in comparison to the entire world population, but the number of lost healthy years due to these diseases is just staggering.  Although DALYs are a relatively easy way to assess the impact of infectious diseases on a community’s health and therefore indirectly measure a loss in productivity, folks at the UPMC Center for Health Security state that the true economic burden of infectious diseases is hard to estimate. Estimating the economic burden of these diseases requires information on direct healthcare expenses and data on how lost productivity translates into lost dollars. While acknowledging the limitations faced by analyzing such data, folks at the UPMC Center for Health Security have come up with an Infectious Disease Cost Calculator for Dengue and Cholera, with estimates on death costs, healthcare costs, and productivity costs for various countries.

So now we know how many healthy years are lost due to these common infectious diseases and there’s a substantial, although hard to measure, loss of economic productivity. How does poverty fit into all of this? We know that a high burden of infectious disease exists in lower-income countries, but in a classic chicken vs egg scenario; what came first, the poverty or the disease burden?

Based on available and historic evidence, the effects of health on poverty and poverty on health implies a positive feedback system. Bonds, et al. (2009), found that a typical host-pathogen system coupled with simple economic models induces a poverty trap, which illustrates how interactions between people and their environment can give rise to major differences in survival and economic productivity. Since I’m not much of a theoretical model math whiz, I’ll summarize a bit what they found for those of you who are like me (for everyone else, feel free to read the entire paper). Basically, their model found that both of the effects of income on health and health on income are important, but to differing degrees. They emphasize that it may not be key as to which one of the effects is more important, but rather that the combined effects are powerful enough to cause self-perpetuating patterns leading to development or continued poverty. Although it is not an easy task to determine which came first, poverty or infectious disease,  we do know that they feed into each other. What is important is to understand the huge toll infectious diseases take on people and therefore on economies, and to understand that a high disease burden is a huge and complicated challenge for any country to overcome.