Business & Economics

Deworming makes history: From research to action in India

Ted Miguel

Last week, the government of India announced that over 17 million children in the State of Bihar were treated this year for debilitating intestinal worm infections. This is the world’s largest such program to date, and it is important news for at least two reasons:

1. Millions of children will now benefit from more primary schooling, because deworming will make them healthy enough to attend school.

2. Within the academic world, we have witnessed how rigorous research– when translated into policy– can improve millions of lives.

Intestinal worms affect 1 in 4 people worldwide, primarily the poor. Children who are infected suffer from malnutrition, anemia, stunted growth, and less education (because they are often too sick to go to school). A simple drug treatment is available, and it costs less than 50 cents per child annually. But logistical hurdles, combined with a lack of political will, have stymied the scale-up of treatment for years.

This is where research has played an essential role.

In the late 1990’s, Michael Kremer (of Harvard) and I decided to evaluate the education impacts of school-based deworming campaigns, in a randomized study in western Kenya.

The results were impressive, and they even caught the attention of Kenyan politicians.

We found that school absenteeism fell by 25% for children offered free deworming treatments. In the study, even children who did not receive the drugs themselves benefited, because their treated friends and family did not have worms to pass on, breaking the cycle of infection transmission. We were able to demonstrate that, compared to other education-promoting interventions (including scholarships, school meals, and subsidized uniforms) deworming programs provide a greater boost to school attendance at lower cost.

Perhaps more remarkable, we followed up with study participants one decade later and found that the (now) young adults who had received deworming early in life earned over 20% more each year. They also worked more hours each week than their counterparts, who had not been dewormed through the program.

How did we get this critical information into the right hands? It required numerous meetings with government officials, community leaders, and high-level politicians. We sought out media coverage in Kenya, and partnered with local child advocates and political allies. And in 2008, partly in response to our research, a new non-profit organization called Deworm the World (DTW) was created, to help expand access to deworming for young people worldwide.

DTW works with governments and NGOs to design and launch new school-based treatment campaigns. To date, the organization has provided technical assistance to 27 countries, resulting in the deworming of 37 million children across the globe. DTW tirelessly focuses a spotlight on deworming among governments, donors, and the international media.

Here at Berkeley, the Center of Evaluation for Global Action (CEGA) is partnering with DTW to promote further translation of our research into policy change like the recent achievement in India. In fact, CEGA helps to publicize the findings of 24 faculty members throughout the University of California. As a group, the Center’s researchers are conducting rigorous evaluations of nearly 60 economic, health, education, and agriculture programs in low income countries on all continents.

I currently serve as the faculty director of CEGA, and I have seen how powerful our center-based approach can be. We are doing much more than just writing up the usual research papers and conference presentations. Through CEGA, the international development research community at U.C. has found a voice with policymakers, NGOS, and foundations, all with the goal of improving the lives of millions of people in the world’s poorest societies.

As the world’s premier public research university, the University of California, Berkeley has a unique obligation to aid the disadvantaged, by generating and disseminating rigorous research that speaks to their problems. The recent policy breakthrough in India highlights the value of translating such research into action.

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Comments to "Deworming makes history: From research to action in India":
    • Avinash Chandra

      Health and education are two most important intervention that we need to make to help societies break the vicious cycle of poverty – more so in a country like India that aspires to prosper on the back of a strong demographic dividend. This sounds like a solution that attacks both the problems – health and education – in one go. I come from Bihar and can attest that this is a great move by Prof. Miguel and his team. Kudos for going beyond research to implement it in a setting where the impact would be tremendous.

      [Report abuse]

    • Sherman

      It is good to know, professor Miguel, that economists as yourself are actively engaged in global health, which has direct and important correlations to economic growth and stability in any regions of the world.

      [Report abuse]

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