Deworm the World

The problem

The worm diseases schistosomiasis (also known as bilharzia) and helminthiasis belong to the so-called “neglected tropical diseases”. When people wade through water contaminated with schistosomal larvae or bathe in it, the larvae of the worms, which later grow up to 2 cm long, bore through the skin. The disease helminthiasis is caused by contact with soil or plants that are contaminated with feces. Here too, nematode larvae enter the human body, either through the skin or orally.

People living in extreme poverty are particularly vulnerable to worm infections. Even though effective treatment is extremely inexpensive, they often don’t have the money to pay for it.

According to estimates by the World Health Organization (WHO) around 250 million people needed preventive treatment against schistosomiasis in 2021, of which around 75 million people were treated. Schistosomiasis is thought to be responsible for at least around 12,000 deaths every year.^[3] It is estimated that as many as 135,000 people die each year as a result of helminthiasis infection.^[4]

Even if the disease is not fatal, the health effects can be painful and serious. Affected children suffer particularly badly. Their physical development is severely impaired. Helminthiasis can lead to malnutrition and vitamin deficiency. The consequences: Growth disorders and anemia. Chronic immune reactions also increase susceptibility to other infections.

This has lasting consequences, not only for health, but also for the educational level of the children affected. According to a 2011 study, the income of adults who had not participated in school-based deworming programs as children was between 17% and 22% lower than that of their peers. Their sickness-related absenteeism was a third higher.^[5] Another ten years later, the consumption expenditure of adults who had participated in deworming programs was still 14% higher, and their hourly wage was 13% higher.^[6]

The solution

Deworm the World carries out deworming programs in schools in collaboration with government agencies. This approach has proven to be particularly effective and efficient. As a rule, schoolchildren take deworming pills twice a year under supervision, which reliably rid them of the parasites.

Because the drug has virtually no side effects, all children in the schools receive the pills, whether they are infected or not. This eliminates the need for costly pre-treatment screening, which would be significantly more expensive than the treatment itself. According to the research institute GiveWell, the total cost per treatment ranges from $0.35 in India to $0.66 in Kenya (these two countries account for the majority of Deworm the World ‘s budget).^[7]

Deworm the World supports not only the preparation and implementation of the programs, but also the subsequent evaluation. This not only verifies that the programs have been implemented correctly, but also lays the groundwork for continuous improvement.

The impact

Several scientifically recognized studies have shown that the Deworm the World deworming programs can significantly reduce the number of infected children. The longer the period over which the pills are administered, the greater the impact. For example, the number of infected children in Kenya fell by over 80% after just four years.

However, the outstanding cost-effectiveness of deworming measures is not only based on the fact that the children are healthier in the short term. Rather, their living conditions also improve in the long term, as the treatment enables them to finally attend school regularly. For example, a study in 2003 showed that deworming programs reduced school absenteeism by 25%.^[8]

A study in Kenya, which received worldwide attention, also investigated whether and how deworming programs affect the subsequent income and quality of life of those affected or treated. Two groups were compared over a period of twenty (!) years: A group of children who had participated in a school-based deworming program and another group of children in the same region for whom this was not the case. After ten years, the boys who had been treated had significantly higher incomes, better jobs and worked 17% more per week than those who suffered from worm infestation as children. Girls who had been dewormed had a 25% higher chance of making it to secondary school.^[9] Another ten years later, the consumption expenditure of adults who had participated in deworming programs was still 14% higher, and their hourly wage was 13% higher.^[10]

The organization

Deworm the World was launched in 2007 by two of the world’s leading scientists in the field of evidence-based development cooperation, Michael Kremer and Esther Duflowhich was awarded the Nobel Prize in Economics in 2019. Since 2013, the programme has been part of the non-profit organization Evidence Action based in the USA with offices in various African countries and India. Since 2014 Deworm the World has carried out over 2 billion treatments. By 2023, Deworm the World had reached over 195 million people in India, Kenya, Nigeria and Pakistan. By 2042, the initiative will have generated $23 billion in productivity gains. ^[11]

The effectiveness of the approach has been proven in numerous independent studies. The organization itself is characterized by a high level of transparency and cost-effectiveness. It also has potential for growth.

GiveWell has recommended Deworm the World since 2013 and has listed the initiative as a “Top Charity” until 2022. Due to an adjustment of the evaluation criteria, GiveWell no longer recommends the Deworm the World program as one of the current four “Top Charities”. However, GiveWell’s rating as an outstandingly good aid organization remains undiminished, which is why we continue to present Deworm the World as one of our “Top Charities”.