The Government of Pakistan has initiated the “Deworm Islamabad Initiative,” targeting 570,000 children aged 5-15 in Islamabad who are at risk of infection with intestinal worms. Trained school teachers administered free-of-cost deworming medicine (mebendazole), which is universally recognized as a safe and cost-effective treatment.
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There is a difference between a low-cost program and a cost-effective program. Implementing a low-cost program is not sufficient - we want to ensure that the impacts of the program are measurable and that the benefits outweigh the costs - this is what makes a program truly cost-effective. Putting these two parts of the equation - costs and benefits - together, we can estimate the value for money of our program.
India’s National Deworming Day (NDD), initiated in 2015, is the world’s largest single-day public health intervention, providing children between the ages of 1-19 with free deworming tablets. As part of Evidence Action’s technical assistance to the Government of India and select state governments for the August NDD treatment round, we are collaborating on several tailored strategies to target hard-to-reach children, including migrant workers in the north-eastern state of Tripura.
At Evidence Action, we determine impact based on data, and in partnership with governments, we reached over 280 million children in 2017 alone through our Deworm the World Initiative. Our focus on scale means we rarely have the opportunity to zoom in on an individual’s experience. So in February, we jumped at the chance to visit these two girls, who we first met on a deworming day in Kenya back in 2013.
2017 Deworm the World Initiatives Milestones: What We've Achieved This Year
Parasitic worm infections disproportionately affect people living in poverty, especially those who are difficult to reach with mass drug administration. Evidence Action is committed to supporting innovations that enable treatment for all children at risk of worm infections regardless of their circumstances.Here’s a look at some targeted strategies implemented in Kenya to improve coverage of hard-to-reach children over the past year.
To comprehensively determine the burden, intensity, and geographical distribution of STH in Pakistan and to inform an appropriate treatment strategy, Evidence Action’s Deworm the World Initiative collaborated with Interactive Research and Development (IRD), the Indus Hospital, and the Institute of Development and Economic Alternatives (IDEAS) to conduct the first nationwide STH survey in Pakistan in late 2016.
Photo impressions from the preparation for the last National Deworming Day round in India. Community mobilization and promotion of the Deworming Day is important to increase coverage and get community and political buy-in for the largest, single-day community health program in the world.
National Deworming Day India - A Successful Partnership Between the Government of India and Evidence Action
Earlier this year, India held the largest public health event conducted in one day: The country dewormed 179 million children in almost all states and Union territories, according to the government’s latest figure. Deworming took place in 810,000 government schools, 800,000 preschools (anganwadi centers) and, for the first time, in 170,000 private schools. School-based deworming leverages anganwadi workers and teachers to deliver safe, simple treatment for parasitic worms.
Evidence Action’s Deworm the World Initiative is the principal technical assistance provider to the Government of India’s National Deworming Day and our team was instrumental in making it happen.
On April 28 and 29, more than 700,000 primary school children across four provinces in northern Vietnam will line up in their classrooms to receive a deworming tablet. 8.5 million children in Vietnam are at risk of parasitic worm infections that can harm their health, development, and school participation.
We are excited to announce that Evidence Action’s Deworm the World Initiative supports the Government of Vietnam as it strengthens and improves school-based deworming to keep children healthy and in school. Read more about out partnership there, and about what we are doing.
It takes a community of committed people to reach millions. Our Deworm the World staff and partners in Ethiopia and Kenya, through a pioneering international collaboration, are working together to ramp up a successful national school-based deworming program in Ethiopia.
The case for mass school-based deworming in endemic countries stands on two legs: First, the body of rigorous evidence that supports mass deworming as a cost-effective intervention. Second, mass treatment without first testing for infection is cheap, safe, and an efficient strategy for reaching lots of kids quickly. Claims in a recent paper by Calum Davey and colleagues and the Cochrane Review by members of the same research group that have been picked up in the press are based on flawed analysis, and could threaten an emerging public health success story.
What does it take to become a global leader in tackling debilitating parasitic worms in children? Speed and willingness to learn from other countries who have already done it.
This is the story of Ethiopia where in January of this year, the Federal Ministry of Health announced a national school-based deworming program that will treat over 80% of at-risk children for parasitic worms (namely, soil-transmitted helminths and schistosomiasis) by 2020. In the course of the next five years, the Ministry of Health will collaborate with teachers and health extension workers to distribute over 100 million worm treatments to at-risk children in all corners of this vast country.
Today, Evidence Action, together with more than 90 other organizations, co-signed an open letter to the leaders of the G7 countries to urge them to support ending neglected tropical diseases including parasitic worms. Despite growing awareness about the human and economic costs of neglected tropical diseases, there is a $220 million global annual funding gap for treatment. This stands in the way of reaching the 2020 treatment targets the World Health Organization has established. Read the letter here.
Evidence Action’s Deworm the World Initiative calculates what it costs to deworm a child in the countries that we work in. You might have seen the ‘cost per child per year’ to treat for parasitic worms cited in our materials and that of others.
So how do we calculate that cost? In the spirit of transparency (and in hopes of clearing up any misconceptions about how we determine our supported deworming programs’ cost per child), let’s talk costing! Here is how we calculate the cost per child/per year for deworming.
Evidence Action is pleased to announce that we have joined the STH Coalition, a new group of organizations focused on reducing the public health threat of soil-transmitted helminths (STH) worldwide. Soil-transmitted helminths --intestinal parasites such as roundworm, hookworm, and whipworm-- affect the health, education, and livelihoods of over one billion people worldwide. The World Health Organization has set a target of reaching 75% of all at-risk children by 2020; yet only 32% of children received deworming drugs in 2012. Given the magnitude and complexity of the challenge, we at Evidence Action believe that a cross-sectoral, collaborative approach to addressing STH is essential.