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The macroeconomic impact of a dengue outbreak: Case studies from Thailand and Brazil

Author

Listed:
  • Kinga Marczell
  • Elvis García
  • Julie Roiz
  • Rameet Sachdev
  • Philip Towle
  • Jing Shen
  • Rosarin Sruamsiri
  • Bruna Mendes da Silva
  • Riona Hanley

Abstract

Background: Dengue is spreading in (sub)tropical areas, and half of the global population is at risk. The macroeconomic impact of dengue extends beyond healthcare costs. This study evaluated the impact of dengue on gross domestic product (GDP) based on approaches tailored to two dengue-endemic countries, Thailand and Brazil, from the tourism and workforce perspectives, respectively. Findings: Because the tourism industry is a critical economic sector for Thailand, lost tourism revenues were estimated to analyze the impact of a dengue outbreak. An input-output model estimated that the direct effects (on international tourism) and indirect effects (on suppliers) of dengue on tourism reduced overall GDP by 1.43 billion US dollars (USD) (0.26%) in the outbreak year 2019. The induced effect (reduced employee income/spending) reduced Thailand’s GDP by 375 million USD (0.07%). Overall, lost tourism revenues reduced Thailand’s GDP by an estimated 1.81 billion USD (0.33%) in 2019 (3% of annual tourism revenue). An inoperability input-output model was used to analyze the effect of workforce absenteeism on GDP due to a dengue outbreak in Brazil. This model calculates the number of lost workdays associated with ambulatory and hospitalized dengue. Input was collected from state-level epidemiological and economic data for 2019. An estimated 22.4 million workdays were lost in the employed population; 39% associated with the informal sector. Lost workdays due to dengue reduced Brazil’s GDP by 876 million USD (0.05%). Conclusions: The economic costs of dengue outbreaks far surpass the direct medical costs. Dengue reduces overall GDP and inflicts national economic losses. With a high proportion of the population lacking formal employment in both countries and low income being a barrier to seeking care, dengue also poses an equity challenge. A combination of public health measures, like vector control and vaccination, against dengue is recommended to mitigate the broader economic impact of dengue. Author summary: Dengue is a viral illness spread by mosquitoes in Southeast Asia and South America, and about half of the world’s population is at risk. Burden-of-illness studies on the economic impact of dengue typically focus on medical costs. However, the impact of this infectious disease extends far beyond healthcare costs. This study evaluated the impact of dengue on gross domestic product (GDP) based on approaches tailored to two dengue-endemic countries, Thailand and Brazil. The analyses estimated that the dengue outbreak in 2019 had a profound impact on Thailand’s tourism industry, reducing GDP by an estimated US$1.81 billion, equivalent to 3% of annual tourism revenues or 0.33% of total GDP. Dengue also impacted Brazil’s workforce in 2019, leading to an estimated 22.4 million lost workdays, of which 39% were associated with the informal sector, and reducing GDP overall by US$876 million (0.05% of total GDP). Informal workers are vulnerable to dengue-related financial burdens, and a low income can be a barrier to seeking medical care for dengue. This study highlights the broader economic impact of dengue beyond healthcare costs and underscores the importance of a combination of public health measures, such as vector control and vaccination.

Suggested Citation

  • Kinga Marczell & Elvis García & Julie Roiz & Rameet Sachdev & Philip Towle & Jing Shen & Rosarin Sruamsiri & Bruna Mendes da Silva & Riona Hanley, 2024. "The macroeconomic impact of a dengue outbreak: Case studies from Thailand and Brazil," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 18(6), pages 1-23, June.
    • Handle: RePEc:plo:pntd00:0012201
    DOI: 10.1371/journal.pntd.0012201
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