The Epidemic Effect: Epidemics, Institutions, and Human Capital Development

Belinda Archibong, Francis Annan, and Uche Ekhator-Mobayode


Epidemics can negatively affect economic development except mitigated by global governance institutions. We examine the effects of sudden exposure to epidemic disease on human capital outcomes using evidence from the African meningitis belt. Meningitis shocks reduce child health outcomes, especially in periods when the World Health Organization (WHO) does not declare an epidemic year. These effects are reversed when the WHO declares an epidemic. Children born in meningitis shock areas during a year when an epidemic is announced are 10 percentage points (pp) less stunted and 8.2 pp less underweight than their peers born in non-epidemic years. We find suggestive evidence for the crowd-out of routine vaccination during epidemic years. We analyze data from World Bank projects and find evidence that an influx of health aid in response to WHO declarations may partly explain these reversals.

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