Anticipation and response: pandemic influenza in Malawi, 2009

Sambala, Evanson Z.; Manderson, Lenore

Malawi is a land-locked country across the East African Rift Valley, bordered by Mozambique in the south and east, Zambia to the west and Tanzania to the north and northeast. The country has an estimated population of 17.2 million (2015), and while characterised as a developing market economy, it is consistently among the poorest nations in the world, with a GDP of around USD 900 per capita per annum. Health expenditure per capita per annum is around USD 29 (2014), accounting for 8.4% of total percentage of GDP; this amount is insufficient to meet the costs of essential health services provided by the MoH. The health system is therefore dependent on donor aid and there is no public social health insurance system. As a least-resourced country, Malawi provides a significant case study to assess how severely limited budgets constrain pandemic preparations and the response actions that arise from such efforts.