Socioeconomic and demographic effects of malaria eradication: a comparison of Sri Lanka and Sardinia.

The relationship between disease control, population growth and economic development is examined through a comparison of changes subsequent to malaria eradication campaigns in Sri Lanka and Sardinia. Both islands were similar in terms of malaria morbidity and mortality rates as well as a history of massive malaria eradication campaigns using DDT immediately after the Second World War. The critical comparative distinction is that Sardinia had a much lower population density than Sri Lanka. In both cases, the anticipated effects of malaria control were increased agriculture production in endemic zones coupled with a relief of population pressure in non-malaria areas. This has not happened. Patterns of demographic change, marked by sharp declines in general mortality and accelerated population rates, are similar in both cases. Malaria control has resulted in economic development in neither case, however, and this is explained using ecological and political-economic analyses.