SCI Foundation
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SCI Foundation

SCI Foundation, formerly the Schistosomiasis Control Initiative (SCI), works with Ministries of Health and Education in sub-Saharan African countries to support programs controlling and eliminating two types of parasitic worm infections: schistosomiasis and soil-transmitted helminthiasis. The majority of programs treat school-aged children, but can also include at-risk adults.

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Founded
2002
Over
980M
treatments delivered/supported
US$0.43
average cost per annual treatment
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The problem: intestinal worms and parasites

Schistosomiasis (shis-toe-so-my-a-sis) and soil-transmitted helminthiasis (STH) are both what the World Health Organization calls “neglected tropical diseases,” which affect the poorest and most marginalized communities in the world. Schistosomiasis is carried by freshwater snails and transmitted through contaminated water during everyday activities, such as bathing, fishing, and washing clothes in lakes, rivers, or ponds. STH is caused by a group of intestinal parasites, and is transmitted through soil contaminated with human feces.

The World Health Organization estimates that 206 million people are affected by schistosomiasis and 1.5 billion are infected with STH [1] [2]. Infection with these parasites can result in anemia, blood in urine, abdominal pain, and genital discomfort. These symptoms can lead to impaired cognitive development and reduced school attendance; longer-term effects include stunted growth, internal organ damage (such as liver fibrosis), increased risk of HIV infection, and bladder cancer.

The World Health Organization estimates that 206 million people are affected by schistosomiasis and 1.5 billion are infected with STH.

The solution: cost-effective school deworming programs

Mass deworming programs — typically run by national governments — provide those living in at-risk communities the medication needed to treat STH and schistosomiasis infections. These programs have a strong track record of success and are highly cost-effective, generally at around 43 cents per child per year. 

How SCI Foundation works

SCI Foundation does not have country offices or local staff. Rather, they work directly with government programs to help deliver services through existing health care systems. By providing technical support, SCI Foundation can remain agile and responsive, and focus on building capacity and maximizing efficiency. Plus, working in partnership increases their organizational cost effectiveness, while reducing duplicative efforts.

What makes SCI Foundation so effective

Cost-effectiveness

Pharmaceutical companies donate the majority of treatment medicines. The average cost per treatment is only US$0.43. 

Designed for scale

SCI Foundation has supported the delivery of over 300 million treatments for schistosomiasis and STH since it was founded in 2002.

Compounding impact

In Kenya, one research study found that treating schistosomiasis and STH increased school attendance by up to 25%, led to improved academic performance, and in the long term, led to better health, better jobs, and 21–29% increased earning.  This evidence is only from one study from a context where worm intensity was unusually high, but it offers the possibility that deworming could have such longer term impacts. [3] [4]

SCI Foundation’s accountability

SCI Foundation is a model of nonprofit transparency, publishing information and reports about their support of treatment programs.

They combine the best of public and private healthcare, partnering with pharmaceutical companies, national governments, and local health authorities to support the design and implementation of treatment programs. They are recommended as a top charity by rigorous charity evaluator GiveWell, and have received an A or A+ rating from the UK government’s Department for International Development (DFID) for the past 5 years. [5]

Frequently Asked Questions

Individual donations to SCI Foundation fund all aspects of treatment delivery including training, logistics, advocacy, social mobilization, and monitoring and evaluating activities. Donations are not used to procure treatment medicines — the majority are donated by pharmaceutical companies. 

SCI Foundation does not have local offices in target countries and therefore does not have additional overhead costs. When SCI was still housed within Imperial College, overheads/management fees were approximately 15%.  As a stand-alone entity, SCI Foundation is aiming to streamline its operations.

Since its foundation in 2002, SCI Foundation has supported delivery of over 300 million treatments for schistosomiasis and STH. Each year, SCI Foundation facilitates delivery of approximately 50 million treatments to those at risk and aims to support countries reach all  communities in need of treatment.

Treatment programs target schistosomiasis and STH. In certain countries where programs are integrated to control and eliminate all neglected tropical diseases, SCI Foundation also supports treatment of onchocerciasis, lymphatic filariasis and trachoma.

These are a diverse group of treatable and preventable infectious diseases. They affect the poorest and most marginalized communities in the world, placing a heavy burden on over 1 billion people. NTDs impact life expectancy, education, and economic opportunities, costing developing economies billions of dollars each year. Although they are biologically diverse, the World Health Organization have grouped these diseases together to underscore the importance of their impact of health and development of the most disadvantaged populations. [6]

In 2012, the World Health Assembly affirmed the feasibility of eliminating schistosomiasis, and urged endemic countries to intensify control programs and initiate elimination campaigns where appropriate through preventive chemotherapy, strengthened health sytems, provision of water and sanitation, as well as hygiene and snail control. In the same year, the WHO published guidance on eliminating STH as a public health problem in children.

SCI Foundation is committed to supporting the delivery of treatment as one of the key strategies for elimination of SCH and STH. SCI Foundation is also working in partnership with other sectors that are important in disrupting the life cycle of these parasites, such as Water, Sanitation and Hygiene, to leverage resources to high risk areas.

Every country program is tailored to meet the specific population needs. How often treatment is given is based on the proportion of the population infected, which is determined through existing information and data, as well as through mapping surveys. Where disease prevalence is high, treatment is recommended to be given to all at-risk populations annually for schistosomiasis and twice yearly for STH. [7]

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. 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. [8] [9] [10]

In addition to following the public discussion, we’ve had conversations with various experts on deworming to improve our understanding of this issue.

Three points stand out. First, everyone agrees that deworming treatments reduce worm loads, creating immediate health benefits. Second, deworming treatments are so low cost that we think they are worth supporting even though the evidence that they improve longer term life outcomes is limited.  Third, a common thread in these talks is the 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 an infected person’s 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). Recent data has also suggested a link between schistosomiasis and an increased risk of HIV infection.[11]

In light of these differences, we believe there is a strong case for eliminating schistosomiasis. SCI Foundation concentrates primarily on schistosomiasis (though they will also provide medicine for other types of worms as a synergistic health intervention), and going forward SCI Foundation expects the bulk of its budget to be spent on schistosomiasis control and elimination. We are confident that SCI Foundation will conduct these efforts in a cost-effective manner, having received donations of hundreds of millions of tablets of praziquantel, an anti-schistosomiasis medicine. [12] We continue to rate SCI Foundation as one of our recommended charities.

 

We recommend SCI Foundation because it has consistently been named a GiveWell grantee.

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