The economic burden of illness for households in developing countries: a review of studies focusing on malaria, tuberculosis, and human immunodeficiency virus/acquired immunodeficiency syndrome.
Ill-health contributes to impoverishment, a process brought into sharper focus by the impact of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. This paper reviews studies that have measured the economic costs and consequences of illness for households, focusing on malaria, tuberculosis (TB), and HIV/AIDS. It finds that in resource-poor settings illness imposed high and regressive cost burdens on patients and their families. Direct and indirect costs of illness for malaria were less than 10% of the household income, but still significant when combined with the costs of other illnesses. The costs of TB and HIV/AIDS were catastrophic for households (more than 10% of the income). Health service weaknesses in many countries, including low coverage, user charges, and poor quality of care, contributed to high costs. Poor households in developing countries with a member with TB or HIV/AIDS struggled to cope, highlighting the urgent need for a substantial increase in health sector investment to expand access to preventive and curative health services. Government and non-governmental interventions should also be broadened to encompass measures that reduce the substantial indirect costs associated with diseases such as malaria, TB, and HIV/AIDS.
School of Development Studies, University of East Anglia, Norwich, United Kingdom. s.russell@uea.ac.uk
Steven
S
Russell
D000163:Acquired Immunodeficiency Syndrome / Q000191:economics*; D017281:Cost of Illness; D003906:Developing Countries / Q000191:economics; D005191:Family Characteristics; D006801:Humans; D008288:Malaria / Q000191:economics*; D014376:Tuberculosis / Q000191:economics*