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

Bibliographic Data

ID23320995
AuthorsSteven Russell (0000-0001-8423-5891, University of East Anglia)
Year2004
Volume71
Issue2_suppl
Pages147-155
Publication date2004-08-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Tropical Medicine and Hygiene (JOURNAL)
Journal identifiersISSN: 0002-9637 • E-ISSN: 1476-1645
PublisherAmerican Society of Tropical Medicine and Hygiene (PUBLISHER • US)
DOI10.4269/ajtmh.2004.71.147
LanguageDE
Citations received89

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.