President Joe Biden’s decision to donate 500 million COVID-19 vaccines to other countries by June 2022 is an important step in restoring the United States’ global reputation. Another, parallel foreign policy solution could perhaps achieve even more. It’s simple, inexpensive, and could improve the health and wellbeing of billions of people, especially children.
Inexpensive treatments – starting at 50 cents per child – can prevent neglected tropical diseases (NTDs) such as intestinal worms, which are among the most common diseases affecting the world’s poorest and most marginalized people.
New evidence confirms that ensuring widespread access to NTD treatments brings clear health and humanitarian benefits while bringing remarkably high – and sustainable – economic returns to society. As many nations turn inward, the United States should seize the opportunity to expand its support for proven, cost-effective solutions to global health problems.
As the COVID-19 pandemic ravages developing countries, infecting hundreds of thousands of people every day and driving many into poverty, more than 1 billion people – almost a seventh of the world’s population – continue to suffer from tropical diseases such as elephantiasis, trachoma, river blindness and intestinal worm infections, the severe Cause pain, illness and long-term disability.
In fact, the pandemic has exacerbated the damage caused by these diseases by making mass treatment efforts difficult, including those in schools that have been closed for long periods in many countries.
In children, the effects of NTDs are particularly acute: infections cause malnutrition, impair intellectual and cognitive development, and stunt growth. These diseases undermine productivity and growth and impede progress towards global health and development goals. However, these diseases are largely preventable and most can be treated with a few simple and inexpensive pills.
Compared to the tremendous effort required to develop and deliver the COVID-19 vaccine, one might think that governments would view NTD treatment as a quick, obvious win. At the moment, however, the opposite is the case.
Rising demands on government budgets from the pandemic are forcing many to cut support for NTDs, halting – and possibly reversing – hard-won advances. The UK government, long-time world leader in foreign aid, recently announced that it would cut 90 percent of its funding for these diseases as part of budget cuts caused by the financial double-blows of the pandemic and Brexit.
As a result, millions of people will go untreated and, tragically, many drugs that are already in the country will be phased out on shelves due to the lack of funds to distribute them. The consequences will be catastrophic for the world’s most vulnerable populations.
The United States is already a leader in the treatment of NTDs. It has provided $ 988 million to this program since 2006, helping deliver 2.8 billion treatments worldwide. Now the Biden government should encourage other wealthy countries to deepen their investments. This will have a significant impact on long-term social and economic outcomes and enable a faster and fairer recovery from the current global pandemic.
Take intestinal worms, which are among the most common and treatable NTDs. These worm infections can have lifelong health consequences, including stunted growth, weakness, anemia, and adverse immunological effects.
Starting in 1998, Nobel Prize winner Michael Kremer and I were studying a public health program in Kenya that treated tens of thousands of school children for intestinal worms. In a randomized controlled trial, we compared schools that offered treatment with otherwise identical schools that did not. We found that treating children for worms reduced absenteeism from elementary school by 25 percent – showing that a simple health intervention had a huge impact on education.
We then tracked a representative sample of these children over the age of 20 to gather information about their income, standard of living, and other life outcomes. The results are amazing.
Our new study, published this spring, found that those who received additional deworming treatment at school (who are now in their late 20s and early 30s) reported 13 percent higher hourly wages and 14 percent higher expenses than those who did who did not receive the treatment. More of them also moved to large urban areas, which gave them better economic opportunities.
These results suggest that the more we invest in treatment now, the higher the dividends later. Generations of children growing up without worm infections can attend more school and earn higher incomes – ultimately experiencing less poverty and driving global economic growth.
This return on investment is increasingly recognized by governments. Countries like India, Kenya, Nigeria, Ethiopia and Pakistan have mass deworming programs that reach hundreds of millions of children each year. Even so, more than 800 million children remain at risk of parasitic worm infections.
Despite governments’ commitment to these cost-effective programs, some require outside funding and support. We have the evidence of economic benefits and we have also developed a new open policy tool to help decision-makers understand the costs and benefits of treatments and inform programmatic investments.
Over the past two decades, governments, nonprofits, and private donors have made tremendous strides against intestinal worms and other NTDs using extremely cheap and inexpensive treatments. As a result, we are closer than ever to defeating these widespread diseases. But we’re not there yet.
The US must step up efforts to combat these debilitating infections and prevent longer-term setbacks in global health and economic systems. Beyond vaccine diplomacy, there is a real opportunity for the Biden government to fill the critical gap in NTD investment.
Governments around the world have been made acutely aware of how diseases – like COVID-19 – are affecting the health, economies and general well-being in their countries. You have the opportunity to look beyond the pandemic to widen support for affordable treatments that are improving hundreds of millions of lives.
Edward Miguel is Oxfam Professor of Environmental and Resource Economics and Faculty Director of the Center for Effective Global Action at UC Berkeley.