300 million people in the developing world are seriously ill from intestinal worms

Dec 4 2004

300 million people in the developing world are seriously ill from intestinal worms. Treatment is cheap and effective—and if successfully delivered with other public-health measures could make a substantial contribution to achieving many of the world’s Millennium development Goals (MDGs), concludes the lead editorial in this week’s issue of THE LANCET.

The editorial comments: ‘Getting the treatment to those who need it can be done through maternal, child-health, and antenatal clinics, and school-health programmes. Specific directed interventions at other at-risk groups, such as adolescent girls, are also needed. In addition to regular treatment, prevention of transmission has to be tackled by provision of safe water supplies, sanitation facilities, and promotion of hygiene measures, such as handwashing, use of latrines, and encouraging footwear.’

Deworming programmes would have a substantial impact on public health in developing countries and relates directly to the MDGs. The first MDG—the eradication of extreme poverty and hunger—is described as a good example. ‘Deworming in childhood leads to improvements in intellectual development that are related to income in adulthood. Hungry children become more malnourished when infected with worms. The impact on goals 2 and 3—universal primary education and promotion of gender equality—is also clear. An investment of as little as $3·5 per child on helminth control translates to an extra year of schooling gained. School enrolment by girls increases with deworming programmes, and their dropout and retention rates improve. Of the estimated 562 million school-age children in the developing world, worm infections cause about 200 million years of lost primary schooling.’

The editorial concludes: ‘The evidence for substantial public-health benefits and reductions in global burden of disease from deworming is overwhelming. Moreover, there are simple, effective, safe, and cheap treatments already available. The challenge is to get the treatments to those who need them. [MDG] Goal 8—develop a global partnership for development—could not be more appropriate here. Systematic delivery of deworming drugs in sustainable ways will only be possible with the help of industry and funders to supply the drugs, health and community systems to deliver them, and political will to achieve such partnership. Commitment from WHO together with the Commission for Africa could do much towards reaching goal 8. Maximising the potential links between deworming programmes and other mass-treatment programmes (such as those for onchocerciasis, lymphatic filariasis, measles, trachoma, and malaria) is one way to build a sustainable development strategy for the poor. Thinking beyond deworming is essential for the health of the world’s poorest people.’