Nicholas Kristof on Worms

If you take seriously our obligation to address the problems of the poorest of the world's poor, Nicholas Kristof od the New York Times is a must read. Why? Because he focuses on the reality of the problems of the poorest of the poor.

His most recent column is an excellent example. He notes that while AIS is a huge issue in Africa, there are other health problems that affect far more people that are being ignored:

AIDS is the disease in the global spotlight, capturing celebrity attention and billions of dollars in treatment programs — and that’s terrific, because it still kills almost three million people a year. But it’s also time to recalibrate our efforts and devote more money to other ailments.

Some 40 million people have H.I.V. or AIDS, and 600 million have hookworms. Here in Congo, one study found that 82 percent of children have worms, and partly as a consequence 70 percent are anemic.

It often costs hundreds of dollars a year to treat a person with AIDS, continuing for as long as the person lives. But it costs 3 cents per year per person for medicine to prevent elephantiasis, which is caused by worm-like creatures and is on my personal top-three list of diseases never to develop.

. . .

Justine Nyinobajambere, 30, can barely walk, because both feet are leathery, pus-oozing stumps with flies feasting on them. She has already lost two of her four children, perhaps in part because her deformity makes it difficult to get food and water for them. All that suffering could have been prevented for 3 cents a year.

In addition, the disease is spread by mosquito bites, so the bed nets and mild DDT spraying that protect against malaria also help prevent elephantiasis.

I’m not criticizing the AIDS effort at all. Indeed, there should be an even bigger push for AIDS prevention measures such as condoms, education, male circumcision and drugs to block transmission in childbirth. All those steps are incredibly cost effective and should be expanded.

But Western support for health in poor countries right now has to be broadened to include more attention to malaria and especially to what are called the neglected tropical diseases.

The Global Network for Neglected Tropical Diseases estimates that more easily preventable and treatable ailments, including worms, elephantiasis and trachoma, kill 500,000 people annually. Indeed, ordinary worms kill 130,000 people a year, through anemia and intestinal obstruction.

More generally, these diseases prevent children from achieving their intellectual or physical potential.

“Why are millions of kids getting enough to eat but are still malnourished?” asks Josh Ruxin, who runs the program in Rwanda against neglected tropical diseases. “Because they have worms.”

These ailments together can be prevented or treated for just 50 cents per person per year.

“This is a chunk of global health that we can fix for almost nothing,” says Michael Kempner, chairman of the board of the Sabin Institute, which hosts the global network. (The network is an outgrowth of Bill Clinton’s work on international health.)

The benefits are also economic. One study found that chronic hookworm infections in childhood reduced future earnings by 40 percent. And a landmark study in Kenya found that deworming reduced school absenteeism by one-quarter.

Indeed, the cheapest way to increase school attendance in poor countries isn’t to build more schools, but to deworm children. Yet almost no government aid goes to deworming.

Read it all here (subscription required).