Malaria tends to have a negative correlation with national income per capita. Many existing studies emphasize how falling rates of malaria can enhance economic development due to the beneficial effect on human capital. This paper emphasizes that causality may also run in the opposite direction, in particular, that higher incomes—arising for reasons having nothing to do with human capital—may allow for increased prevention and treatment of malaria, and therefore contribute to the negative correlation. We analyze the malaria-income relationship for 100 endemic countries over a 17-year period using a simultaneous equations model that accounts for reverse causality and incidental associations. For most countries, income growth has been the most important driver of the negative correlation between malaria and income. Although reducing malaria may be its own reward, it takes much more than reductions in malaria to foster development. This holds widely for different samples of countries.