Feature Medicine in Developing Countries

Deworming debunked

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.e8558 (Published 02 January 2013) Cite this as: BMJ 2013;346:e8558
  1. Nigel Hawkes, freelance journalist
  1. 1London, UK
  1. nigel.hawkes1{at}btinternet.com

Deworming undoubtedly improves child health but it is claimed to have far wider benefits. Nigel Hawkes finds the evidence behind these claims is often equivocal

At first sight, treating children in poor countries for intestinal parasites seems like a no brainer. Who’d hesitate to provide the few pennies it costs to deworm a child in India, Africa, or other areas where infestations are endemic?

So obvious are the benefits, however, that many well meaning individuals and institutions may have been guilty of overstating them. Deworming has been hailed as a panacea: a simple, cheap, and effective way of improving growth, raising brain power, and improving the educational and employment prospects of millions of children.

Its supporters are many. At the 2008 Davos economic summit, Cherie Blair, wife of the former prime minister Tony Blair, dressed up as a worm and chased a bunch of delegates pretending to be children, a gimmick inspired by the charity Deworm the World. Tony was apparently unimpressed: “Every time I mention the subject to my husband,” Cherie confided to Time magazine, “he looks very distressed and runs out of the room.”1

If you counted the international organisations that support deworming as a development rather than as simply a health initiative you would quickly run out of fingers: the World Bank, the World Health Organization, the Bill and Melinda Gates Foundation, the US National Institutes of Health, the Copenhagen Consensus, Innovations for Poverty Action, the Centre for Effective Global Action, the Abdul Latif Jameel Poverty Action Lab, and, of course, Deworm the World. Surely such a lengthy and impressive list of supporters must know it really works?

Missing evidence

Not if you read the latest revision of the Cochrane review on the subject, published in July this year by a team from the Liverpool School of Tropical …

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