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Deworming and Development: Asking the Right Questions, Asking the Questions Right

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  • Donald A P Bundy
  • Michael Kremer
  • Hoyt Bleakley
  • Matthew C H Jukes
  • Edward Miguel

Abstract

Two billion people are infected with intestinal worms. In many areas, the majority of schoolchildren are infected, and the World Health Organization (WHO) has called for school-based mass deworming. The key area for debate is not whether deworming medicine works—in fact, the medical literature finds that treatment is highly effective, and thus the standard of care calls for treating any patient known to harbor an infection. As the authors of the Cochrane systematic review point out, a critical issue in evaluating current soil-transmitted helminth policies is whether the benefits of deworming exceed the costs or whether it would be more prudent to use the money for other purposes. While in general we think the Cochrane approach is very valuable, we argue below that many of the underlying studies of deworming suffer from three critical methodological problems: treatment externalities in dynamic infection systems, inadequate measurement of cognitive outcomes and school attendance, and sample attrition. We then argue that the currently available evidence from studies that address these issues is consistent with the consensus view expressed by other reviews and by policymakers that deworming is a very cost-effective way to increase school participation and has a high benefit to cost ratio.
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Suggested Citation

  • Donald A P Bundy & Michael Kremer & Hoyt Bleakley & Matthew C H Jukes & Edward Miguel, 2009. "Deworming and Development: Asking the Right Questions, Asking the Questions Right," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 3(1), pages 1-3, January.
  • Handle: RePEc:plo:pntd00:0000362
    DOI: 10.1371/journal.pntd.0000362
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    1. Edward Miguel & Michael Kremer, 2004. "Worms: Identifying Impacts on Education and Health in the Presence of Treatment Externalities," Econometrica, Econometric Society, vol. 72(1), pages 159-217, January.
    2. Hoyt Bleakley, 2007. "Disease and Development: Evidence from Hookworm Eradication in the American South," The Quarterly Journal of Economics, Oxford University Press, vol. 122(1), pages 73-117.
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    Cited by:

    1. Sarah Baird & Joan Hamory Hicks & Michael Kremer & Edward Miguel, 2016. "Worms at Work: Long-run Impacts of a Child Health Investment," The Quarterly Journal of Economics, Oxford University Press, vol. 131(4), pages 1637-1680.
    2. Diane Coffey & Michael Geruso & Dean Spears, 2018. "Sanitation, Disease Externalities and Anaemia: Evidence From Nepal," Economic Journal, Royal Economic Society, vol. 128(611), pages 1395-1432, June.
    3. Rodolfo Manuelli & Emircan Yurdagul, . "AIDS, Human Capital and Development," Review of Economic Dynamics, Elsevier for the Society for Economic Dynamics.
    4. Amrita Ahuja & Sarah Baird & Joan Hamory Hicks & Michael Kremer & Edward Miguel & Shawn Powers, 2015. "When Should Governments Subsidize Health? The Case of Mass Deworming," World Bank Economic Review, World Bank Group, vol. 29(suppl_1), pages 9-24.
    5. Owen Ozier, 2018. "Exploiting Externalities to Estimate the Long-Term Effects of Early Childhood Deworming," American Economic Journal: Applied Economics, American Economic Association, vol. 10(3), pages 235-262, July.
    6. Rodolfo E. Manuelli, 2011. "Disease and Development: The Role of Human Capital," 2011 Meeting Papers 605, Society for Economic Dynamics.

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