The burden of malaria is problematic in many developing regions, but it is especially high in Sub-Saharan Africa. Despite cheap and effective methods of prevention, malaria is still an issue affecting economic, social, and political circumstances in Africa. There are not many ways that malaria directly affects democratization. What malaria does impact are economic development, school attendance rates, cognitive and learning ability, infant mortality, and fertility rates, all of which have a more direct impact on democratization.
There have been several studies that prove the economic burden of malaria is extensive. Malaria impedes economic growth by depressing human capital accumulation and disabling the working class, resulting in a loss of personal income and productivity. It also impacts international trade and foreign direct investment because many countries do not want to risk contact with countries of high malaria transmission. How does this impact democratization? The link between economic development and democracy has been studied in-depth and although the relationship is not perfect, there is some evidence that suggests economic growth facilitates the ability to democratize. Countries with high malaria transmission had an average of .4% economic growth, whereas other countries averaged 2.3% growth between 1960 and 1990. This would give non-malaria countries an easier transition to democracy because they have a better chance of financially supporting liberalization. In addition, the loss of income and increased individual spending on healthcare because of the disease can hinder the creation of a middle class, which is historically where liberalization occurs.
Malaria also directly affects social circumstances that in turn affect democratization. The disease is most prevalent and most deadly in young children. There have been studies that demonstrate there is a strong correlation between high infant mortality and political instability. This makes malaria an important indicator because it is the cause of about 25% of child mortality in Sub-Saharan Africa. High rates of child mortality and infant mortality also tend to create a correlating increase in fertility rates, which in turn leads to higher numbers of children and less education for each of them because the family does not have enough money to send them to school. Students with the disease who can afford to go to school are likely to miss days of school due to the illness. In addition to school attendance, there are certain strands of malaria (called cerebral malaria) that have permanent, negative impacts on cognitive and learning abilities that limit the potential of many children. Education and literacy rates are important indicators of the sustainability of democracy. In general, countries with low levels of education have either not been able to become democracies or they have been unable to stay democratic long-term.
Malaria is a continuing cause of morbidity and mortality in Africa and, although it may not directly affect the adoption or continuation of democracy, it has the ability to inhibit important indicators of democratization. Areas with high malaria prevalence are more likely to be economically stagnant, more likely to have high child mortality and birth rates, and more likely to have limited rates of education and literacy. These indicators, especially when combined, make it unlikely that a country will be able to truly democratize.
Democratization in Africa 
While I agree with your analysis, I do wonder how large development organizations play into this. On one hand large organizations involve themselves in this issue seeking to alleviate human suffering and loss of productivity due to malaria. Where this is lacking is in the investment into preventative measures like a malaria vaccine. Not to be too cynical, but funding seems to flow away from research into the diseases of the poor and towards the ailments of civilization. Is there a place for larger organizations like Gates and government development agencies to leverage the drug companies in speeding up the creation of less profitable, but more necessary, vaccines and drugs?
Interesting piece, Margaret. How do you think we could properly test this hypothesis in order to make sure that some other factors aren’t more prevalent explanations? Also, Robert Mattes has done some interesting preliminary research on the impact of HIV/AIDS on the health of democracies in Southern Africa. It appears that legislators themselves have been hard hit by the disease. It’s worth taking a look.
Sorry my comment is coming late, but this is a really interesting post. You’ve considered a relationship that is probably not considered so often in the field of democratization, even in Africa. In addition to malaria, I believe HIV/AIDS has certainly had an impact on democratic development in the region (as Annie references above). But it has had both positive and negative impacts. I think the negative impacts are more obvious (decreased economic output effects democratic liberalization, etc). Less obvious are the positive impacts. In South Africa, the Treatment Action Campaign became a bedrock for the flourishing of other civil society organizations, thus contributing to democratic development during the transition from apartheid. Also to be considered is that HIV/AIDS has distorted the demographic makeup of many African countries. Young people make up a majority of the population in many countries (many of them HIV/AIDS “orphans” themselves), and they have likely demanded a greater response to the epidemic from their governments than older generations (just my own hypothesis).