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Reductions in Total Deworming Treatment Figures Represent Progress Toward Deworm the World’s Goal: Here’s Why

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In 2019, our Deworm the World Initiative supported treatment of over 280 million children—around one-quarter of the total at-risk child population globally—according to the treatment figures reported by our government partners. In 2020 this dropped to 177 million due to the impact of the pandemic on school-based deworming programs. Though programs are now back on track, we’re not likely to see figures as high as 280 million again—here’s why this is an achievement to celebrate.

Our Deworm the World Initiative provides robust technical assistance to governments for school-based deworming programs, with the goal of eliminating intestinal worms as a public health problem among children. We measure progress toward this goal in geographies where we operate through two outcomes: 1) Decreased worm burden; and 2) Increased government ownership and capacity to deliver school-based deworming programs.

While both of these outcomes are critical, the first in particular is easily quantified: we periodically measure reductions in worm burden through field surveys. In order for the worm burden to decrease, consistent rounds of treatment reaching high numbers of at-risk children are essential—it is for this reason that we regularly report on the number of children treated with our support as key data points. We present the same treatment figures as reported by each government with which we partner, after each treatment round.

In 2019, we supported deworming of over 280 million children for the third consecutive year—around one-quarter of the total at-risk child population globally. We are incredibly proud of this achievement, and have great confidence that the high treatment figures within our long-standing programs are resulting in fewer worm infections.

In 2020, however, our treatment figures were far lower at 177 million—the pandemic had a significant effect on treatment last year, and has impacted our reach this year as well. We have been pleased to support governments in getting programs back on track—and yet we expect that treatment figures will remain lower than their peak, both in 2021 and years to come. The reason for this decline is closely linked to our objectives of decreasing worm burden and increasing government ownership and capacity.

Following six years of technical support across national and state governments in India—helping to launch and scale India’s National Deworming Day—the capacity of the national government to fund and coordinate a national mass deworming program has reached a level that no longer requires planning support from Evidence Action. As a result, as of September 2021, we will report treatment figures within those states we directly support, rather than the figure reached by National Deworming Day nationally. Even though our state level partnerships treat the majority of India’s worm burden, we estimate that this will reduce the number of children treated with our support per year in India by around 92 million. We applaud the Government of India for their continued national commitment to deworming—it is because of this commitment, as evidenced by their financial investment in National Deworming Day, that deworming is now a core health service provided to children nationwide.

Yet this progress toward institutionalizing deworming is only half of the story—fewer worms are also a critical part. The success of our partner governments in reaching large numbers of at-risk children over several years is substantially reducing the worm burden—in fact we have the data from recent surveys to prove it. In India, field surveys across 14 states all measured reductions in worm prevalence, nine with substantial reduction including Chhattisgarh (a state we support), which saw a significant drop in prevalence from 74.6% in 2016 to 13.9% in 2018. In Kenya, overall national prevalence for any STH infection across all at-risk counties reduced from 33.6% in 2012 to 12.9% in 2017. Further reductions are forecasted, and while it is important to maintain consistent deworming for several years, once the prevalence of infection is at very low levels, it is possible to treat less frequently—and potentially cease mass treatment altogether in certain circumstances.

It is crucial that we not put the gains made to date at risk by stopping deworming too soon—worm infections can rebound easily. We are working closely with our partner governments, and global leaders in epidemiological modeling, to carefully plot when and where treatment strategies can change. We will be supporting governments to make these changes. We foresee that fewer children may require regular treatment—or that treatment may become less frequent—in the years to come. And though our reported treatment figures may be lower as a result, it is a reflection of the significant impact of our Deworm the World Initiative. A generation of children will have better health, education, and long-term wellbeing because of it.

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