Int. J. Environ. Res. Public Health 2011, 8 926 imbalance, and limited knowledge of safety [13]. We estimated the average prices of such drugs in Table 5 based on the reported drugs prices by the WHO [45] and the transportation costs (about 25% of the price) to reach the demand points [4]. The total outpatient costs (Table 6 column 3) for each individual country are calculated under minimal climate change projection scenarios (scenario 1). Similarly, average inpatient costs (Table 6 column 4) are calculated using information from studies conducted in Senegal and Kenya [46,47]. The cost projections indicate that the vast majority of the countries studied will see an increase of their costs of fighting the disease. We find that the predicted treatment costs, particularly the inpatient costs, as a percentage of 2000 health expenditure per 1,000 people, increase by more than 20% for countries such as Burundi, Cote D’Ivoire, Malawi, Rwanda and Sudan. Since most of the reported cases are severe cases (particularly children under five), the projected cost in malaria treatment will be most likely close to the inpatient treatment cost estimates. Tables 5. Outpatient and inpatient unit treatment cost in 2004 USD. Drug prices Artesunate Artesunate-Mefloquine Artemether-Lumefantrine Artesunate-Amodiquine Mean outpatient cost Hospitalization treatment cost Kenya Senegal Mean Inpatient cost Price($) Test($) Transport($) Total( $) 0.54 0.36 0.15 0.08 1.39 1.39 1.39 1.39 0.48 0.44 0.38 0.37 2.41 2.18 1.92 1.83 2.08 64.00 70.00 67.00 Table 6. Estimated inpatient and outpatient treatment cost under climate change scenario 1. Algeria Benin Botswana Burkina Burundi Central Afr. Rep. Chad Cote d'Ivoire Djibouti Egypt Ethiopia Ghana Guinea Malawi Projected cases per 1,000 people under Scenario1 0.02 41.17 1.14 25.49 42.55 −47.88 1.33 252.40 23.77 0.01 10.57 96.03 59.12 217.00 Treatment costs per 1,000 people (in 2004 USD) Outpatient(a) Inpatient(b) 0.05 1.63 85.76 2,758.58 2.36 76.08 53.08 1,707.60 88.63 2,851.00 −99.73 −3,208.11 2.78 89.33 525.71 16,911.11 49.50 1,592.37 0.01 0.35 22.02 708.40 200.02 6,434.28 123.14 3,961.17 451.96 14,538.70 Treatment costs (in percentage of 2000 health expenditure per 1,000 people) Outpatient (%) Inpatient (%) 0.0 0.0 0.3 8.1 0.0 0.0 0.1 3.2 0.6 20.4 −0.2 −6.4 0.0 0.2 0.7 21.4 0.1 2.5 0.0 0.0 0.1 3.7 0.2 6.3 0.2 5.2 1.1 35.5