The Problem Intestinal worms and parasites. Worms and other parasitic infections (a type of neglected tropical disease) affect around two billion people worldwide. The majority of these individuals most live on less than $2 a day. Three hundred million of these people--roughly the population of the United States--suffer from severe illness, and half of those are school-aged children. The World Health Organization estimates that schistosomiasis alone kills up to 200,000 people a year. Those who work in agriculture or lack access to clean water supplies are at increased risk for schistosomiasis infection. These infections can cause a range of serious health problems that include malnutrition, impaired cognitive and physical development, and blindness. Parasitic infection can also increase the morbidity and mortality of malaria, tuberculosis, and HIV/AIDS. Parasitic worms and other neglected tropical diseases have been demonstrated to reduce the number of years children spend in school--damaging their educational prospects, reducing their future earnings, and ultimately harming developing economies.
The Solution Cost-effective deworming school programs. SCI works with national governments to create and scale mass school-based deworming programs, which have a strong track record of success. These programs provide school children with pills that protect against the most prevalent neglected tropical diseases. These programs are highly cost-effective, generally at around 73 cents per child per year.
How SCI is different from other charities SCI oversees and implements effective deworming initiatives from end-to-end, and monitors every step of the implementation process. SCI acquires deworming pills from pharmaceutical companies, and works with governments, NGOs, and local health authorities to implement effective school distribution programs. SCI also train teachers and trusted community members to administer the treatments to vulnerable communities.
What does my donation help pay for? Pharmaceutical companies donate most of the deworming medicines, and have committed to provide enough medication to treat up to 100 million children per year--more than double SCI’s treatment scale in 2014. Individual donations help SCI fund dispensation, training, data collection, and advocacy.
How many people does SCI help? Since its inception in 2002, SCI has successfully delivered over 140 million treatments against schistosomiasis and even more against soil transmitted helminths (intestinal worms). SCI facilitated 40 million treatments in 2014 alone, projects that it will treat 50 million children a year by the end of 2015, and intends to expand coverage to 60 million children per year by 2017.
Which diseases do SCI’s treatments target? The Rapid Impact Package targets the seven most neglected tropical diseases, namely ascariasis, hookworm infection, trichuriasis, lymphatic filariasis (LF), onchocerciasis, schistosomiasis, and trachoma.
What are neglected tropical diseases (NTDs)? These diseases are a constellation of parasitic and bacterial infections that have life-threatening effects for those afflicted. Although NTDs have largely been eliminated in the developed world, they continue to affect the world’s most marginalized communities. Because they only affect the poorest of the poor, there is little incentive for companies to develop new diagnostic tools, drugs and vaccines for them. Additionally, endemic countries have limited resources to invest in health, and competition for funds is often fierce. Worse still, the stigma associated with debilitating and deforming diseases can make the afflicted reluctant to seek effective medical treatment.
Can NTDs be eliminated? Yes. Through the support from SCI and other partners, serious schistosomiasis morbidity was eliminated in Uganda, and in areas where transmission occurs on small bodies of water, disease prevalence was reduced from about 100 percent in 2003 to less than 10 percent in 2010.
How much confidence do you have in SCI's work, given recent debate over the benefits of deworming? In July of 2015, a re-analysis of an influential study on deworming was released, kicking off an ongoing debate about the benefits of mass deworming (a partial timeline of this debate is available here). Generally speaking, there appears to be a division between the health community (which is more skeptical about the benefits of mass deworming) and the development economics community (which is more enthusiastic). Each community has its own standard analytical methodology, and these different methodologies lead to different interpretations of the data. In addition to following the public discussion, The Life You Can Save has had conversations with various experts on deworming to improve our understanding of this issue. A common thread in these talks has been the observation that there are important differences between schistosomiasis and other intestinal worms. Simply put, schistosomiasis causes particularly severe health issues. Unlike soil-transmitted intestinal worms, schistosomiasis worms live a long time (up to 20 years) and the eggs they lay build up in victims' organs. As a result, prolonged schistosomiasis infections can lead to fibrosis of the liver and bladder, and even death due to burst varices (dilated blood vessels). In light of these differences, we believe there is a stronger case for eliminating schistosomiasis than soil-transmitted worms. Moreover, this case can be made simply on the basis of the health benefits of schistosomiasis eradication and is less reliant on the potential knock-on benefits to school attendance and performance. SCI concentrates primarily on schistosomiasis (though they will also provide medicine for other types of worms as a synergistic health intervention), and going forward SCI expects the bulk of its budget to be spent on schistosomiasis eradication. We are confident that SCI will conduct these efforts in a cost-effective manner, having received donations of hundreds of millions of tablets of praziquantel (an anti-schistosomiasis medicine). Therefore, we continue to rate SCI as one of our recommended charities.
Is my donation tax-deductible? UK donors can claim Gift Aid on their donations and US donors can claim tax relief by donating to SCI via GiveWell. Canadian donors giving over $5,000 can donate tax-deductibly via GiveWell, subject to a 10 percent deduction for costs incurred by Tides Canada. Australian donors can make tax-deductible donations via Effective Altruism Australia. Donors in other EU countries may be able to claim tax-deductions through the methods described here.