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Theses

Paludisme et développement économique

Abstract : This thesis contributes to the literature on the endogenous relationship between the health status of a population and the economic development of a nation. We focus on a wide phenomenon touching many low-income countries: malaria. Firstly, we propose to rethink the economic analysis of malaria by combining economic epidemiology tools with the poverty trap literature. The endogeneity of malaria with respect to households and individuals socioeconomic characteristics and choices remains a particularly relevant and unresolved issue. In spite of massive efforts to generalize efficient prevention (such as ITNs), malaria remains prevalent in many countries. We design a theoretical model of rational preventive behaviors in response to the disease, which includes endogenous externalities and disease characteristics. Two important conclusions emerge from the model. First, agents increase their preventive behaviors when the degree of prevalence of malaria in a society is more severe. This result is consistent with the literature on "prevalenceelastic behavior". Second, we find that multiple equilibria are theoretically possible and so is the existence of malaria traps, defined as any self-reinforcing mechanism, which causes malaria to persist. Two implications discussed in this chapter concern malaria exogeneity for trapped communities and possible mechanisms to get out of the trap (through public policies). For the communities trapped and if the disease affects negatively some economic variables, it is plausible to assume that the disease itself generates the socio-economic obstacles to its control. Secondly, we try to understand the socioeconomic effects of malaria. If malaria deaths and illness occur mostly in young African children, the economic literature on the subject primarily focused on its effects on adult productivity or on private health and public expenditure accumulation related to the disease. The last three chapters of this thesis tackle the question of the economic effects of malaria under a new angle: the effects of the disease on children human capital accumulation, which can potentially have heavy consequences on future generations. A small but growing number of medical studies are drawing an alarming report of the impact of malaria on creative and intellectual development of children. Given the frightening distribution of falciparum malaria, any effect of malaria on cognitive function or educational achievement is likely to result in a massive macroeconomic loss. Our macroeconomic results show that performance of educational systems in countries with intensive malaria is lower than in countries not affected by malaria, other things being equal. These results suggest that the macroeconomic effects of malaria on education are not negligible, taking into account the number of malaria clinical cases worldwide. These results are then confronted to two microeconomic analyses. We start with data from Demographic and Health Surveys. We next move to a longitudinal investigation we carried out in a village in a malaria endemic area in Mali in collaboration with the Malaria Research and Center training. From a methodological point of view, thanks to a multi-disciplinary approach, we improve the measure of malaria indicators generally used in economic studies. The main finding of this thesis relates to the effects of asymptomatic malaria. Asymptomatic malaria is defined as a malariapositive smear for P. falciparum parasitaemia associated with no clinical symptoms. Asymptomatic malaria affects significantly school performances of the children in endemic area. We also show that higher income offers little protection against the negative effects of asymptomatic malaria on education in the village. Our results can lead to change the social and psychological perception of the risks associated with malaria, thus opening promising prospects as regards to malaria eradication and control programs.
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Submitted on : Wednesday, June 16, 2010 - 10:48:53 AM
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Josselin Thuilliez. Paludisme et développement économique. Economics and Finance. Université Panthéon-Sorbonne - Paris I, 2009. English. ⟨tel-00492496⟩

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