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Escaping the Parasite Poverty Trap: Understanding the scale of the problem

Davos January 2008

"This will not, I’m afraid, be a talk for the faint-hearted."

The aim today is to spell out just how parasites cripple the health, well-being and productivity of millions of people on our planet.
And that’s simply not possible without going into sometimes distressing detail.
It’s detail, of course, which is a sad fact of life for around one third of the world’s population.
Some 2 billion people are infected with parasitic worms at any time at a dreadful cost to themselves and their societies.
There is nothing new, of course, about this menace which, in itself, has fuelled a sense of pessimism even inevitability.
Parasitic worms such as the soil transmitted helminths - better known as round worm and hookworm - and schistosomiasis, also known as bilhartzia have probably been around as long as mankind itself.

But what’s changed is we now know far more about their devastating impact, particularly on children - and above all, have the mean easily and cheaply to rid children of these devastating parasites with just a couple of pills a year.

I want to concentrate today on the impact of these parasites on children.
For while parasitic worms affect all age-groups, children are particularly at threat. The evidence shows
• they are more likely to be infected with parasitic worms than adults
• that they will have more parasites in their body at any one time,
• and when attacked, the damage to children is particularly damaging and long-lasting.
For parasites attack children just at the time when their bodies, their minds and their social and economic skills are developing - keeping them out of education, undermining their life chances and deepening the cycle of poverty.
The scale of the problem is huge. Over 400 million school-age children are infected worldwide.
Many will have parasites throughout their body.
An autopsy of a 2 year old girl in South Africa found nearly 800 worms in her intestines alone.
What do parasitic worms do to a child?
• They can enter through the skin - burrowing in after contact with infected soil or water - as the children play barefoot.

• or they are swallowed accidentally through contaminated food or contact with hands which can’t be kept clean without access to clean water.

• Some species latch onto the intestines of a child, sucking important nutrients from a child’s system—literally eating the food that the child needs for its own development.

• Other species make their way to the lungs and then on to other organs.

• Once there, these parasites can cause blood loss from the intestines, bladder, liver and other organs and blood vessels.

• They can cause ulcers or prevent organs working properly by lumping together into balls or tumours.

More commonly, they will cause persistent stomach cramps, diarrhoea, vomiting and blood in the urine, worsening the problems of malnutrition.
Almost one third of children world wide, of course, have their development stunted from chronic malnutrition.
Part of the problem is that they don’t get enough to eat, or enough of the right food.
But parasites are also part of this vicious equation, preventing the children benefiting properly from the food they do eat by causing vomiting or diarrhoea or feasting themselves on the nutrients.
They also worsen the damaging lack of iron in many diets, - problem exacerbated by the internal bleeding and anaemia caused by the parasites.
Given all these problems is it any wonder that parasitic worms have a very damaging impact on school attendance and education.
All mothers know the problems of young children slightly under the weather who simply can’t face school.
But what if you had a child who doesn’t want to make the often tiring journey to school or can’t concentrate on what they are being taught because there are parasites throughout their body burrowing into their liver and causing internal bleeding?
It is no surprise that children who haven’t been treated for parasites stay at home 25 percent more than children who have been treated.
By being sick and staying away from school, they don’t just miss out on education but miss out on their future, damaging both their opportunities and the strength of their communities.
There are, of course, many important challenges which we must tackle if we are to combat global poverty.
In many cases, the solutions are difficult, complex and will take decades. But that’s not the case with parasitic worms.
Here we have the solution. It is cost-effective and available.
We know what success looks like because we have eliminated parasitic worms from a region before.
In the south of the United States, for example, the Rockefeller Foundation took on the task of eradicating parasitic worms in the early part of the 20th century.
They succeeded and the benefits for the children and region as a whole were dramatic.
Others on this panel will talk more about why mass school based treatment is the most effective approach to addressing the problems I have outlined.
But before I hand over to Gene Sperling who will talk about the evidence on the link between parasitic worms and education, and the effectiveness of school based treatment I want to leave you with this thought.
It costs just 50 cents to treat a child for parasitic worms—to stop the parasites that are causing children to bleed from the inside out.
Can we really in the 21st century stand by and see the potential of hundreds of millions of children wasted for the sake of 50 cents?
Thank you.