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Economic impact of a cholera epidemic on Mozambique and Bangladesh

Introduction
As a highly infectious, acute disease, cholera spreads very quickly within and between regions and countries. According to the WHO, there are an estimated
3-5 million cases and 100,000-200,000 deaths due to cholera every year. Outbreaks vary in intensity: incidence rates typically vary from below 0.1% to around 0.4%, case fatality rates range from 0.5% to 10% and epidemics last from a couple of months to more than one year.


The disease is transmitted through the consumption of contaminated water and food, and as a result, is much more prevalent in developing countries where
access to improved water is limited. Around 75% of the population can be infected but show no sign of illness, resulting in the disease spreading when people travel between regions. Prompt treatment coupled with access to safe water and proper sanitation and health education can greatly limit the impact of the disease. With adequate treatment, the case fatality rate for those infected is around 1%, but this can rise dramatically if no treatment is administered or if distribution is inefficient. For instance, the WHO reports a case fatality rate of 6% at the beginning of the 2009 epidemic in Zimbabwe. Therefore, access to treatment and the underlying water infrastructure and education levels determine both the infection and death rates present within a country, and thereby the social and economic costs of a cholera outbreak.


In this report, using historical benchmarks of previous cholera epidemics as reported in the literature and documented by the International Vaccine Institute (IVI), we estimate the economic impact of a cholera outbreak in Bangladesh and Mozambique. We use Oxford Economics macroeconomic model to capture the main channels of transmission, including demand and supply effects. Since Oxford Economics’ model does not include Bangladesh and Mozambique, we use models for India and South Africa and scale the shocks according to the economic features of Bangladesh and Mozambique. India and South Africa share many similar economic features that imply that the transmission of the shock through the economy is likely to be similar to what would happen in Bangladesh and Mozambique.