Malaria and Tourism
Tourism brings an estimated R20 billion per year into the South African economy, second only to the
manufacturing and mining industry in its contribution to the Gross Domestic Product (GDP). The number of tourists that visit South Africa has grown by 40% since 1994. The number of jobs in the trade, catering and accommodation sector of the economy grew by 9% in 2000 as a result of the growth
in the tourism sector (Department of Environmental Affairs and Tourism Annual Report, 1999/2000).
Malaria has hampered the development and growth of the region
as the fear of contracting malaria is a major deterrent to many tourists.
It is therefore important to have effective malaria control in order for tourism
and associated development to take place in this region. The LSDI Malaria
Control Programme has initiated a study that aims to determine the influence
of malaria on tourism and establish the perceived risk associated with malaria
within the area.
Malaria and Tourism Study
Tourist facility owners and managers have been the first focus area in this study, with a questionnaire
being widely distributed to determine the influence of malaria on tourism and the effects of malaria control on development in the area. By capturing such data, annual comparisons can be made to determine the
influence of malaria on the tourism industry.
Perceived malaria risk by tourists is believed to be an important
factor that has an influence on the tourism industry. Tourists that
visit the area will therefore be the second focus area in this study. The
risk factor as defined in this study is the possibility of contracting malaria
whilst visiting a tourist facility in the area. This has been undertaken by
- Gathering all existing tourism data relevant to the study.
- Identifying and mapping all existing and new tourist facilities within the LSDI area to display their
geographical distribution with respect to malaria risk.
- Developing a questionnaire aimed at the tourist facility owners or managers to obtain information on the impact of malaria on tourism.
- Developing a questionnaire aimed at tourists to obtain information on their perception of malaria risk while on vacation in the region.
- Distributing the questionnaires to tourist facilities and a representative sample of both local and
international tourists that visit facilities in the region.
- Using existing malaria incidence data as a back-drop against which to display malaria tourist facilities and monitor changes over time.
- Distributing small-scale malaria maps to all tourist facilities in the LSDI region.
- Undertaking comparative studies prior to and after spraying in southern Mozambique to determine the effects of the intervention on tourism in the region.
A tourism survey (86 tourist facilities) conducted in the LSDI
area during 2000/2001, found that malaria was perceived as the principle negative
determinant on bed occupancy. Cancellations were recorded from tourist facilities
in all the districts of the LSDI during the 2000 malaria season, with an average
cancellation figure of 44% being recorded in southern Mozambique. This was
largely due to the floods early in 2000 resulting in tourists being concerned
about a possible malaria epidemic which was widely reported on in the press.
All tourist facilities visited in the 2000/2001 study were revisited in January/February
2003 to assess changes in attitude that might have taken place. Local (82)
and international (58) tourists were interviewed in July in KwaZulu-Natal
as part of the second round data collection.
A similar study to determine the influence of malaria on tourism and to assess
the risk perception of facility owners and managers was carried out in January
and July 2003 in Mpumalanga Province, sampling 86 facilities. Local (82) and
international (58) tourists were interviewed in July in Mpumalanga to assess
their risk perception in regard to malaria.
Malaria cases in KwaZulu-Natal decreased dramatically from
41,077 during the 1999/2000 season, to 1,688 in the 2002/2003 season. It is
anticipated that the malaria case reductions in Swaziland, South Africa and
southern Mozambique will have a positive influence on tourism in the Lubombo
The figures below indicate the location of the tourist facilities
with regard to small scale variations in malaria incidence in KwaZulu-Natal
Province, and show the decrease in case incidence from 1999/2000 to 2002/2003.
In the 1999/2000 malaria season, 33% of tourist facilities were in areas of
> 25 malaria cases per 1000 people, and 67% were in areas where less than
25 malaria cases per 1000 people were recorded.
A major reduction in malaria cases in the 2002/2003 malaria
season was achieved. In the 2002/2003 malaria season, none of the tourist
facilities were in areas of > 25 malaria case per 1000 people, and 98%
were in areas where the malaria incidence was very low, with 0.001-5 cases
per 1000 people being recorded. The reductions in the 2002/2003 malaria season
indicate the positive effect of the regional approach to malaria control in
the Lubombo corridor. It is essential that this information is made available
through all media to encourage tourists to visit the area.
Tourist Information Booklets
Close co-operation between the malaria control authorities
in Jozini and the Medical Research Council has led to the development of a
GIS-based malaria information system. These data clearly outline that many
of the earmarked tourist
development nodes are relatively malaria free, information that is not generally
available to the public. Malaria distribution/risk data is currently made
available to tourists at the district level. Data from the highest risk district
in South Africa show that if mapped as 200 district sub-divisions, malaria
is far from evenly distributed at this level. Some large areas are practically
malaria-free while areas such as those adjacent to Ndumu Game Reserve have
more than 500 malaria cases per 1000 head of population. Data at this scale
are vital to dispensing appropriate information on malaria risk to tourism
facilities. The MRC is continually updating detailed maps showing risk levels
and risk periods at tourist destinations.
Information on personal protection and prophylactic measures
is available in a booklet.
The southern African Malaria Initiative whose steering committee is comprised
of members from South Africa, Mozambique, Swaziland and Botswana, concluded,
at a recent regional meeting, that the drawing up of such information
booklets was of regional importance. The booklet is currently being updated
and will be distributed early in 2004. A malaria update including risk maps
was made available to all facility owners in KwaZulu-Natal during 2003 and
at the Tourism Indaba, and these were also made available to tourists following