Abstract
This paper develops an economic epidemiological framework that endogenizes the susceptible population by integrating utility-maximizing individual choices regarding preventive and curative care with aggregate disease dynamics and income growth. Unlike classical biological models, this approach treats the proportion of the population vulnerable to malaria as a behavioral response to prevailing disease prevalence, prevention costs, and the perceived productivity losses of infection. The resulting behavioral margins create a non-linear transmission map characterized by multiple stable equilibria, which can trap economies in a Neo-Malthusian poverty cycle of high endemicity and low productivity growth. Calibrated to sub-Saharan African data, the model highlights a critical “risk compensation” effect, where public vector control is partially offset by a reduction in private preventive investment. Ultimately, the analysis reveals that while single-lever interventions—such as prevention subsidies or awareness education—can reduce equilibrium prevalence, only a coordinated, integrated policy package combining subsidies, education, and aggressive vector control can push an economy across the critical threshold required to achieve a malaria-free equilibrium and unlock higher long-run growth trajectories.