Although malaria is a largely preventable and treatable disease, it is a significant cause of mortality, morbidity, and productivity loss in Malawi. This study estimates that in 2019, malaria generated health and productivity losses equivalent to MWK 94,770 million – or 1.7 per cent of GDP. Increasing insecticide resistance and less than optimal (60%) care-seeking behaviour represent two of the most pressing issues facing the country when it comes to reducing the burden of malaria. The main policy recommendation from this cost-benefit analysis is that the National Malaria Control Program (NMCP) should fully adopt piperonyl butoxide (PBO) insecticide-treated bednets (ITNs) and rollout community-informed mass media to increase the rate at which people seek formal care when they, or their children, have fever. PBO ITNs have been shown to have a greater effectiveness against mosquitos compared to the ITNs that Malawi has used in the past.

This study conducted cost-benefit analyses on several interventions. The combination of the two interventions would have the largest absolute impact on malaria burden in the country. We do not overemphasize differences in the point estimates of the respective BCRs, since each comes with substantial uncertainty.