Deworm The World Initiative

Tablets Against Worm Infections

1.5 billion people worldwide are infected with worms. Worm infections can have severe health effects, especially for children.[^1] "Deworm the World" is working successfully to eliminate the entirely preventable health issues caused by parasitic worms.

Worm infections can affect children for the rest of their lives. If they lack access to deworming tablets during their school years, they can earn up to 29% less in adulthood due to school absences caused by illness.[^2] This reduces their chance of lifting themselves out of poverty.

The Deworm the World Initiative advocates for extremely cost-effective school-based deworming programs and supports governments in their implementation and evaluation. This allows children to be dewormed for a complete year for less than a dollar. One child. One dollar. One year.

The Problem

The worm diseases schistosomiasis and helminthiasis are considered “neglected tropical diseases.” When people wade or bathe in waters contaminated with schistosome larvae, these larvae, which can grow into parasites up to 2 cm long, burrow through the skin. Helminthiasis is caused by contact with soil or plants contaminated with feces. Here, too, larvae of parasitic worms enter the body, either through the skin or orally.

People living in extreme poverty are most affected by worm infections. Although effective treatment is very affordable, they often cannot even afford this.

The WHO estimates that approximately 240 million people are infected with schistosomiasis worldwide, and 700 million live in areas where these worms are present.[^3] For helminthiasis, the estimated number is 1.5 billion affected individuals.[^1] Schistosomiasis is responsible for over 20,000 deaths annually, while up to 135,000 people die each year from helminthiasis-related complications.[^4]

This has lasting consequences, not only for the health but also for the educational attainment of affected children. A 2011 study showed that adults who did not participate in school-based deworming programs as children earned 17% to 22% less than their peers and had a third more days absent due to illness.[^2]

The Solution

The Deworm the World Initiative collaborates with governments to conduct deworming programs in schools. This approach has proven highly effective and efficient. Schoolchildren usually receive deworming tablets twice a year under supervision, which reliably frees them from parasites.

Since the medications have virtually no side effects, all children at the respective schools receive the tablets—whether they are infected or not. This eliminates the need for costly pre-screening. According to the research institute GiveWell, the total cost per treatment ranges from $0.11 in India to $0.49 in Kenya (80% of Deworm the World’s budget is spent in these two countries).[^5]

Deworm the World not only supports the preparation and implementation of these programs but also the subsequent evaluation, ensuring the programs are properly executed and continuously improved.

The Impact

Numerous scientifically recognized studies confirm that Deworm the World’s deworming programs significantly reduce the number of infected children. The effect strengthens the longer the treatment period. In Kenya, for example, the number of infected children dropped by over 80% in just four years.

The exceptional cost-effectiveness of deworming is not only due to the immediate health benefits for children. More importantly, the treatment improves their long-term living conditions, as it enables them to attend school more regularly. A 2003 study showed that school absence was reduced by 25% due to deworming programs.[^6]

In a globally recognized study in Kenya, the effects of deworming programs on income and quality of life were examined over a period of more than ten years. Two groups of children were compared: one that had participated in a school-based deworming program and another from the same region that had not. Boys who were treated had significantly higher incomes in adulthood, held better jobs, and worked 17% more per week than men who had suffered from worm infections as children. Dewormed girls were 25% more likely to attend secondary school.[^7]

The Organization

The Deworm the World Initiative was founded in 2007 by two of the world’s leading scholars in evidence-based development cooperation, Michael Kremer and Esther Duflo. Since 2013, the initiative has been part of the nonprofit organization Evidence Action, based in the USA with offices in Kenya and India. Each year, more children are reached than the year before—280 million children were reached in 2017 alone.

GiveWell has listed Deworm the World as a “Top Charity” since 2013. The effectiveness of the approach has been confirmed in numerous independent studies. The organization stands out for its high transparency, cost-effectiveness, and growth potential. GiveWell estimates that Deworm the World will need an additional $14.7 million from 2019 to 2021 to launch new programs in Nigeria and Pakistan, expand existing programs in India and Kenya, and invest in team capacity.

Frequently Asked Questions

What are neglected tropical diseases?

Neglected tropical diseases (NTDs) are tropical diseases that mainly affect extremely poor people. Due to their low income, these individuals are not a lucrative market for pharmaceutical companies, resulting in limited research investment. Additionally, they often lack the political influence to persuade their governments to allocate more resources to combat these diseases.

How often are deworming programs conducted?

Each deworming program is adapted to the needs of the respective population. According to WHO recommendations, in regions where over 50% of the population is affected by worm infections, deworming is conducted twice a year. In regions where the rate is 10-50%, it is conducted once a year. These programs are always carried out in close coordination with the respective national authorities.

How are the costs of $0.11 (India) and $0.49 (Kenya) per treatment calculated?

The $0.11 and $0.49 per treatment per child represent the weighted average costs of Deworm the World-supported treatments from 2014 to 2017 in these countries.

These costs include medication, distribution, and all Deworm the World expenses for administration, management, and evaluation, as well as the financial contributions of participating governments, which are not covered by Deworm the World.

The calculations can be reviewed in detail here.

Website: www.evidenceaction.org/dewormtheworld

Sources

[^1]: Fact sheet: Soil-transmitted helminth infections. World Health Organization. Link February 2018.

[^2]: Sarah Baird et al. Worms at Work: Long-run Impacts of a Child Health Gains. Link March 2011.

[^3]: Schistosomiasis. World Health Organization. Link.

[^4]: Sara Lustigman et al. A Research Agenda for Helminth Diseases of Humans: The Problem of Helminthiases. PLoS Neglected Tropical Diseases. Link April 2012.

[^5]: Top Charities - Deworm the World Initiative. GiveWell. Link November 2018.

[^6]: Miguel, E. and Kremer, M. Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities. Econometrica, 72: 159-217. Link March 2003.

[^7]: Sarah Baird et al. Worms at Work: Long-run Impacts of a Child Health Investment. Quarterly Journal of Economics: 131(4): 1637-1680. Link November 2016.