By Michael Kremer, Gates Professor of Developing Societies, Harvard University
Over 400 million school-age children are infected with parasitic worms worldwide, which harm their health and development, and limit their access to and ability to benefit from the education system. In 2001, the World Health Organization (WHO) set the goal of treating 75% of school-age children at risk of infection by 2010. However, by the fall of 2006, only 10% of these children were receiving regular treatment.
There is a safe, simple, and cost-effective solution: school-based deworming. It has been shown to reduce absenteeism by 25%, and at a cost of less than US$0.50 per child per year. Deworming is one of the most cost-effective methods of improving school participation ever rigorously evaluated. There are more schools than clinics; there are more teachers than health workers. Schools offere a unique opportunity to deliver medicine to an institution where most children are gathering in any case. It is clear that the most effective way to reach the highest number of children is through the existing and extensive infrastructure of schools. With minimal training and support from local health services, teachers can deliver this simple intervention to large numbers of school-age children in a sustainable fashion.
Given the strength of the evidence, school-based deworming is an education policy priority. Deworm the World was launched as an initiative of the Young Global Leaders Forum of the World Economic Forum, Davos 2007, to address why so few children are being reached and what are the barriers to effective, sustainable implementation at scale.
One barrier was that well-designed health programs in schools simply did not have access to deworming tablets. Deworm the World has coordinated the donation of deworming tablets from one of our key partners, Feed the Children, that will reach around 20 million children in 26 countries around the world in 2009.
Ministries of Education, working together with Ministries of Health, are making this happen.
In 2009, the Government of Kenya allocated $1,000,000 to the Ministry of Education to scale up the national, school-based deworming program. Using new, strategic targeting technology, the program has reached over 3 million children across the country—thus, reaching most of the country’s at-risk children in the first year at a cost well under 50 cents per child. The government has committed funds to continue the program in 2010 and beyond. Deworm the World provided catalytic support to the program, costs amounting to a fraction of the government-funded operational costs. We are continuing to provide ongoing support to the program at ever-reducing cost. Over the coming weeks, the government will announce the great success of the first round of this program . . . watch this space.
Similarly in Andhra Pradesh, India, the Ministries of Health and Education are working together to launch a statewide, school-based deworming program later this month, targeting over 2 million children in their pilot phase also at a very low-cost. Other states in India are now recognizing deworming as an important education intervention and are looking to implement similar programs.
For less than $200 million per year, every infected child could be treated through schools, with immediate impacts on their health, education, and long-term productivity. If there ever was a best buy for the education sector, deworming is surely one.
Deworm the World is a global coalition of partners wanting to support governments and all other stakeholders to develop sustainable, scaled, school-based deworming programs. Come join us.
Michael Kremer is the Gates Professor of Developing Societies in the Department of Economics at Harvard University and Senior Fellow at the Brookings Institution. He is a Fellow of the American Academy of Arts and Sciences, a recipient of a MacArthur Fellowship and a Presidential Faculty Fellowship, and was named a Young Global Leader by the World Economic Forum. Kremer’s recent research examines education and health in developing countries, immigration, and globalization. He and Rachel Glennerster published Strong Medicine: Creating Incentives for Pharmaceutical Research on Neglected Diseases in 2004.
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