More than 400 million school-age children in developing countries are infected with parasitic worms. The worms cause anemia, malnutrition and other sicknesses that lead these children to be too tired to concentrate in class or attend school at all. There is, however, an inexpensive and safe solution: mass, school-based deworming programs.
“One of the most cost-effective ways of getting more children in poor countries into school is deworming them with one or two tablets a year, which costs pennies per dose,” says Kristin Forbes, professor of global economics at the MIT Sloan School of Management and a founding member of Deworm the World (DtW), a group that organizes and supports deworming activities around the world.
DtW, which was founded in 2007 by Forbes and other colleagues at MIT and Harvard, has evolved into a major force in improving the health and education of children in the developing world. This year, the group, which works with the World Bank, local governments and other NGOs, will deworm 20 million children in 25 countries around the globe.
Symptoms of worm infections include: fever, vomiting, a swollen belly, fatigue and listlessness. “Worms infect a quarter of all children in the developing world and this is a state of life for them,” says Forbes. “The children don’t appreciate what the worms are doing to them. They think it’s normal to be sluggish, to constantly have stomach problems, and to always have blood in their urine.”
But once children are dewormed — a process that involves a teacher administering tablets orally once every six or 12 months, depending on the prevalence — life for these children takes a dramatically positive turn. “Parents of children in the villages that we’ve dewormed are amazed,” says Forbes. “They say: ‘I never knew my children could be so energetic.’ The kids say: ‘I never knew I could feel this healthy.’”
According to the group’s data, deworming reduces school absenteeism by 25 percent, and children who have been dewormed are 13 percent less likely to be illiterate. “These kids are attending school more often, and they’re better able to focus,” says Forbes. “This has a big impact: children grow up to be healthier, and better educated, which means they can be more productive members of their communities.”
DtW began as an initiative by several Yong Global Leaders, a group created by the World Economic Forum, including Forbes, Esther Duflo, Professor of Economics at MIT, Rachel Glennerster, Executive Director of the Abdul Latif Jameel Poverty Action Lab (J-PAL) at MIT, and Michael Kremer, Professor of Developing Societies at Harvard, who has done a lot of research in this area.
The group studied the problem with the assistance of J-PAL, a network of academics who use randomized evaluations to answer questions around poverty alleviation, and raised seed money from the Kingdom Foundation.
In September 2008, DtW signed a big agreement as part of the Clinton Global Initiative to use 300 million tablets to deworm children in 19 countries. Later that year, it helped start a project in Ethiopia that dewormed a million children. In 2009, it helped Kenya’s Ministry of Education launch a massive project that treated 3 million children and worked with the government of Andhra Pradesh in India to treat 2 million children. Last year DtW dewormed 13 million children.
Most of DtW’s programs take place in Africa and India. This year the organization will start school-based programs in Ghana and Nigeria and in two additional areas of India (Bihar and New Delhi). It also hopes to expand its work mapping worm prevalence around the world and examining the longer-term effects of deworming programs by evaluating standardized test scores of students in areas that have been dewormed.
“We continue to focus on what works — and especially what is most cost effective — before we get too big,” says Forbes. DtW’s goal has been to keep the average cost below $0.50 per child dewormed. Recent programs have far exceeded that goal — with an average cost of $0.36 per child dewormed in Kenya and $0.18 per child in Andhra Pradesh. “By keeping costs down, we will be able to not only reach even more children, but also show donors the incredible impact they can have for each dollar contributed.”