Impacts of infectious diseases on poverty : What do we know and what way forward?

Abstract: Combating infectious diseases and poverty are hot topics on the world development agenda. The vicious cycle of ill health and poverty is reinforced by a “medical poverty trap” relating to households being impoverished due to escalating illness-related out-of-pocket costs, especially in combination with loss of income due to incapacity to work. Evidence-based knowledge on the impacts of ill health on household welfare is essential to design adequate interventions and evaluate their efficiency. This thesis presents the findings of a critical review of studies assessing the impacts of infectious diseases on households’ ability to utilize their resources and generate income in rural Sub-Saharan Africa. The review revealed a dearth of relevant studies (merely 15), poor methodological quality in short-term geographically limited surveys, and large diversity in study design obstructing comparison of results and extraction of general conclusions. Major research obstacles are discussed and recommendations for coordination, standardization and scaling up of data collection that allows adequate impact assessment are suggested. Experimental intervention studies are recommended to improve quality and efficiency of interventions and guide prioritizing processes prior to large scale implementations to avoid waste of time and resources. The linkages between infectious diseases and poverty are complex and multifaceted and thus imply multi- and interdisciplinary research approaches. Collaboration between various disciplines like health sciences, economics, geography and sociology give opportunities of linking data in innovative ways to provide new insights and perspectives that have the potential to analyse the impacts of infectious diseases on poverty in a more comprehensive manner. Methodological standardisation and consensus will enable us to accumulate comparable results and scale up research and thereby contribute to foundation of efficient interventions to accomplish sustainable improvements in health and significant reductions in poverty.