Our Fight Against Worms
A nine-time GiveWell top charity, our Deworm the World Initiative combats worm infections by working with governments to deliver mass school-based deworming programs.
Since 2014, we have supported governments to implement high quality programming, helping treat over 280 million children in 2019. Deworming is proven to improve the nutrition, cognition, school attendance, and long-term economic prospects of children.
The Solution: A Simple Treatment
Parasitic worm infections, technically known as soil-transmitted helminths and schistosomiasis, spread primarily in areas with inadequate sanitation – affecting poor communities around the world. These infections interfere with children’s nutrient uptake, often leading to anemia, malnourishment, and impaired mental and physical development. As a result, infection means that children are less likely to attend school, adversely affecting educational outcomes. Regular treatment with a simple pill is universally recognized as a safe and effective solution to combat these infections.
Our Deworm the World Initiative helps bring the treatment for free to children at their schools instead of placing the burden on the families to obtain it. We partner with governments to regularly treat all at-risk children in places where at least 20% are infected with worms, as recommended by the World Health Organization. School-based deworming works by freeing children from worm infection, improving their health and enabling them to attend school regularly.
MIT’S ABDUL LATIF JAMEEL POVERTY ACTION LAB (J-PAL) LISTS MASS SCHOOL-BASED DEWORMING AS A “BEST BUY” IN BOTH EDUCATION AND HEALTH.
Impact at Scale
Our program has scaled rapidly: we’ve gone from reaching 35 million children in 2014, to reaching over 280 million in 2019, by supporting governments to conduct school-based deworming. Providing regular treatment has reduced worm infections in these geographies, improving life outcomes for hundreds of millions of children.
The Evidence Base
“A SIGNIFICANT BODY OF EVIDENCE SHOWS THAT DEWORMING WORKS TO IMPROVE CHILDREN’S HEALTH, WELL-BEING, EDUCATION, AND LONG TERM ECONOMIC FUTURE.” — WHO, 2016
Independent rigorous research, including by Nobel Laureate Michael Kremer, shows that deworming leads to significant improvements in nutrition, cognition, school participation, and future earnings. Here is a summary of key research findings:
- A meta-analysis found that deworming programs lead to an average weight gain of 0.3kg in children, equivalent to moving a three-year-old from the 25th to the 50th percentile of WHO child growth standards.
- Children who were less than one year old when their siblings received deworming treatment show significant cognitive gains comparable to between 0.5 and 0.8 years of schooling.
- A randomized controlled trial in Western Kenya found that children who received deworming had a 25% reduction in school absenteeism, when compared to those who did not.
- Following those same children in Kenya, researchers found that receiving two to three additional years of deworming increased their income by 13% and consumption by 14% two decades after treatment. More details on this study can be found in this blog.
- A study using historical data from the United States in the 1910s found that parasitic worms could have explained as much as 22% of the early income gap between the North and South.
How We Support Governments
OUR GOVERNMENT PARTNERSHIPS WORK THROUGH A TECHNICAL ASSISTANCE MODEL, WHEREIN WE SUPPORT GOVERNMENTS TO DESIGN AND DELIVER HIGH-QUALITY PROGRAMS.
Instead of building a delivery infrastructure from scratch and operating it ourselves—which would be costly and inefficient—we leverage existing government infrastructure, and build support systems to increase the impact.
We get involved from program inception—advocating with policymakers about the need and importance of school-based deworming—and with their buy-in, collaborate to co-design the program, iterate to improve it, and ensure program goals are met.
We create a set of systems to help governments launch, scale, and sustain high-quality deworming programs, and rigorously monitor and assess them to enable regular improvements.
With this model, we have achieved unparalleled impact at a lower cost than virtually any other organization conducting deworming programs.
Our Technical Assistance Model
Click below to learn more about how we partner with governments
1. POLICY AND ADVOCACY
We advocate with governments to launch deworming programs, and work collaboratively with ministries of health and education to establish effective policies and governance structures. We support alignment of school-based deworming with other health and education priorities to enable long-term political and resource commitments, and share global best practices to improve cost-effectiveness and results.
2. PREVALENCE SURVEYING AND MAPPING
Guided by World Health Organization protocols, we work with epidemiologists and local partners to assess worm prevalence and intensity through field surveys. We use the survey results to support the development and implementation of appropriate treatment strategies. Once deworming programs are in place, we support governments to assess the impact of sustained mass treatment on worm infection.
3. PROGRAM PLANNING AND MANAGEMENT
We work closely with government partners to design their deworming program, develop operational plans and budgets, coordinate logistics, and provide on-the-ground support to ensure a high quality outcome.
4. PUBLIC AWARENESS AND MOBILIZATION
We work with governments to develop locally appropriate campaigns that educate children and communities about the negative effects of worms, the importance of being dewormed, and behaviors to prevent infection. These campaigns increase acceptance and participation in deworming.
5. TRAINING AND DISTRIBUTION CASCADE
We support governments to design and coordinate an efficient multi-tier training and distribution cascade that is tailored to the local context, ensuring that knowledge and program materials are relayed from the national or state level all the way to the teachers responsible for administering deworming drugs.
6. DRUG MANAGEMENT AND COORDINATION
We help governments evaluate appropriate treatment strategies, support drug procurement including through global pharmaceutical donation programs, and facilitate the development of robust protocols for tracking drug inventories and responding to adverse events.
7. MONITORING AND EVALUATION
We help governments design monitoring systems to measure effectiveness in achieving intended program results. We also conduct independent monitoring to validate program results, and evaluate the impact of programs in reducing worm prevalence and intensity.