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Democracy, Natural Resources, and Infectious Diseases: the Case of Malaria, 1990–2016

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Abstract

Recently, work on the natural resource curse thesis has extended to testing the effects of natural resources on public health. Focusing on the case of malaria, this paper examines the effects of the interaction between resource dependence and political institutions on malaria management. To be more specific, this work argues that in a resource-abundant state, democracy plays an active role in providing health goods to the general public and allocating government funds to public health. Democracies also combat corruption behaviors and diversify economies in a more effective way than their autocratic counterparts. By testing a series of interaction effects between natural resources and democracy, this paper finds a positive and robust effect of democracy on the reduction of malaria death rates in resource-rich states, based on data on malaria deaths during the period of 1990–2016. Resource-rich dictatorships demonstrated the worst performance in malaria control compared with resource-rich democracies and resource-poor democracies and dictatorships. This empirical evidence has policy implications for resource management, public health, and infectious disease control and prevention.

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Notes

  1. HIV/AIDS had 36.7 million reported cases and caused 1 million deaths in 2016, while TB’s figures were 10.4 and 1.7 million, respectively (WHO 2017b).

  2. The six regions in Table 1 come from WHO definitions.

  3. There is no denying that resource abundance may result in the suspension of democratic transitions, leading to the topic of this paper being endogenous. However, this paper avoids dealing with this endogeneity issue by treating political performance as existent, as Arezki and Gylfason (2013) and Bhattacharyya and Hodler (2010) did in their paper.

  4. The “taxation effect,” a term coined by Ross (2001; 332–333), proposes that a lower tax burden gives political leaders more policy space by reducing the demand for accountability from the government.

  5. For example, in Wigley’s (2017) discussion of oil wealth and child mortality, the author’s observation regarding how oil wealth affects political leaders’ tenure shows there should be no difference between different regime types:

    It is argued that access to oil revenues enhances the ability of incumbent elected leaders to secure reelection. Thus, access to non-tax revenues enhance the ability of autocratic and democratic leaders to stay in power. ... governments in resource-poor countries have a greater incentive to invest in public goods such as health and education. (Wigley 2017; 143, emphasis added)

  6. The “try harder” statement means democratic leaders will exert every effort to deliver public goods. As Bueno de Mesquita et al. (1999; 799) observed, “leaders in states with large winning coalitions cannot easily compensate for policy failure by doling out private goods, they need to succeed in foreign and domestic policy.”

  7. Figure 1 in the Supplementary Materials summarizes the global relationships between democracy and health expenditure per head (1a), and health expenditure as a % of government spending (1b), respectively, between 1990 and 2016. Both figures clearly show that the more democratic a country is, the more it spends on health.

  8. Due to missing values, the statistical results report on 149–156 political entities.

  9. A further examination of alternative regimes and resource indicators is introduced in the “Robustness Checks” section, including data sources, measurement methods, descriptions, and discussions of statistical results.

  10. Therefore, the Hausman test which is claimed standard when specifying whether the RE model is appropriate or not was not conducted as recent evidence shows this test is mis-specified (Baltagi 2013; Bell et al. 2019; Bell and Jones 2015).

  11. The simplest description of reverse causality is that instead of the explanatory variable(s) causing variations in outcomes, outcomes cause variations in explanatory variables. This study examined the effects of democracy and natural resources on malaria management, but we must consider that malaria management may affect democratic quality. For instance, Butler (2005) and Mattes (2003) determined that HIV/AIDS, another major infectious disease, had a profoundly negative effect on democracy in Southern Africa.

  12. Summary statistics are presented in the Supplementary Materials Table 1 and the Pearson’s correlation matrix of all time-varying covariates is in the Supplementary Materials Table 2.

  13. Depletion and Polity × Depletion’s descriptive statistics are presented in Supplementary Materials Table 1 (Summary Statistics).

  14. The method used for generating the marginal effects plots was exactly the same as that for Figs. 2 and 3 in this section: first holding depletion and then polity at its mean value.

  15. The threshold value of high income was not fixed. In 1990, it was 7620 USD or higher and in 2017, it became 12,235 USD or higher. I checked each year’s threshold value to classify these two income groups.

  16. The full list of countries and their abbreviations in World Bank (2017); WHO (2016a; 12, Table 2).

  17. According to World Bank’s (2017) Rents data and Marshall et al.’s (2017) Polity2 scores in 2015.

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Acknowledgments

Earlier versions of this paper were presented at the 2018 Annual Meetings of the Western and Midwest Political Science Associations. The author is grateful to Abhit Bhandari, Yen-Ling Chung, Christopher Klyza, Chia-Yi Lee, Howard Liu, Tsung-Han Tsai, Szu-Ning Ping, Yi-Ting Wang, and conference participants for suggestions and comments.

Funding

This paper is partially funded by the Ministry of Science and Technology of Taiwan under Grant Numbers MOST106-2410-H-004-103 and MOST107-2410-H-004-133-MY2. All errors are my own.

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    Wen-Yang Chang

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Chang, WY. Democracy, Natural Resources, and Infectious Diseases: the Case of Malaria, 1990–2016. St Comp Int Dev 55, 354–380 (2020). https://doi.org/10.1007/s12116-020-09311-8

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