Does Macroeconomic Instability Undermine Infectious Disease Prevention? Evidence from HIV/AIDS and Tuberculosis in Developing Countries

Does Macroeconomic Instability Undermine Infectious Disease Prevention? Evidence from HIV/AIDS and Tuberculosis in Developing Countries | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Does Macroeconomic Instability Undermine Infectious Disease Prevention? Evidence from HIV/AIDS and Tuberculosis in Developing Countries ATANGANA ONDOA Henri, NGACHILI NJIKAM Youssouf This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9305688/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Developing countries continue to experience recurrent macroeconomic instabilities, characterized by growth volatility, fiscal imbalances, high inflation, and rising public debt, which collectively weaken governments’ capacity to sustainably finance health systems and effectively implement infectious disease prevention strategies. This study examines the impact of such instabilities on the prevention of HIV/AIDS and tuberculosis—two major sources of morbidity and mortality—using a panel dataset covering 150 countries over the period 2000–2023. To address key econometric challenges, including endogeneity, unobserved heterogeneity, and the dynamic nature of health outcomes, the analysis relies on the System Generalized Method of Moments (System GMM) estimator. The empirical findings reveal a significant and negative relationship between macroeconomic instability and the effectiveness of preventive health efforts, showing that periods of instability lead to reduced public health investments, weakened implementation of prevention programs, and increased population vulnerability to infectious diseases. By providing an integrated empirical framework that connects macroeconomic conditions with health outcomes, this study contributes to bridging the gap between macroeconomic and health economics literature. It also offers important policy implications, emphasizing the need to strengthen macroeconomic stability, ensure predictable and sustained health financing, and enhance the resilience and governance of health systems in order to improve the effectiveness and sustainability of infectious disease prevention strategies in developing countries. JEL Classification : I18, O11, C23 Development Economics Macroeconomic Instability Prevention HIV/AIDS Tuberculosis Panel Data Developing Countries Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9305688","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":616760059,"identity":"458600ee-bb1e-45f2-b44c-5aa3037fd2f7","order_by":0,"name":"ATANGANA ONDOA Henri","email":"","orcid":"","institution":"University of Yaoundé II","correspondingAuthor":false,"prefix":"","firstName":"ATANGANA","middleName":"ONDOA","lastName":"Henri","suffix":""},{"id":616760060,"identity":"cfbde229-c950-468c-89e7-8711f2eedb6d","order_by":1,"name":"NGACHILI NJIKAM Youssouf","email":"data:image/png;base64,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","orcid":"","institution":"University of Yaoundé II","correspondingAuthor":true,"prefix":"","firstName":"NGACHILI","middleName":"NJIKAM","lastName":"Youssouf","suffix":""}],"badges":[],"createdAt":"2026-04-02 17:02:12","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9305688/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9305688/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106094988,"identity":"3ff68265-9e62-4e9b-ba7d-01df94619eb1","added_by":"auto","created_at":"2026-04-03 11:43:53","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":717533,"visible":true,"origin":"","legend":"","description":"","filename":"HEALTHARICLE.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9305688/v1_covered_99658a45-5d21-44cb-85f2-261415cfdf37.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eDoes Macroeconomic Instability Undermine Infectious Disease Prevention? 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