The authors explore the two-sided link between malaria morbidity and Gross Domestic Product (GDP) per capita growth. Climate significantly affects cross-country differences in malaria morbidity. Tropical location is not destiny, however: greater access to rural health care and greater income equality are associated with lower malaria morbidity. But the interpretation of this link is ambiguous: does greater income inequality allow for improved anti-malaria efforts, or does malaria itself increase income inequality? Allowing for two-sided causation, the authors find a significant negative causal effect running from malaria morbidity to the growth rate of GDP per capita. In about a quarter of their sample countries, malaria is estimated to reduce GDP per capita growth by at least 0.25 percentage point a year.
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