In endemic areas, as much as 60 percent of schoolchildren's learning may be impaired. Nearly 60 percent of miscarriages are due to malaria. In some parts of the world strains of malaria have developed resistance to the four leading antimalarial drugs. Malaria is a major killer of refugees in Africa. The cost of malaria control and treatment drains African economies.
Endemic countries have to use scarce hard currency on drugs, nets and insecticides.
Malaria-endemic countries are some of the world's most impoverished. In Thailand, malaria patients pay nine times their average daily wage for care. A malaria-stricken family spends an average of over one quarter of its income on malaria treatment, as well as paying prevention costs and suffering loss of income. Workers suffering a malaria bout can be incapacitated for 5 to 20 days. Malaria-afflicted families on average can only harvest 40 percent of the crops harvested by healthy families.