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

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Listed:
  • Bleakley, Hoyt
  • Miguel, Edward
  • Kremer, Michael R.
  • Jukes, Matthew
  • Bundy, Donald A. P.

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.

Suggested Citation

  • Bleakley, Hoyt & Miguel, Edward & Kremer, Michael R. & Jukes, Matthew & Bundy, Donald A. P., 2009. "Deworming and Development: Asking the Right Questions, Asking the Questions Right," Scholarly Articles 4460861, Harvard University Department of Economics.
  • Handle: RePEc:hrv:faseco:4460861
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    File URL: http://dash.harvard.edu/bitstream/handle/1/4460861/2627944.pdf
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    References listed on IDEAS

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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. Rodolfo Manuelli, 2011. "Disease and Development: The Role of Human Capital," Working Papers 2011-008, Human Capital and Economic Opportunity Working Group.
    2. Rodolfo E. Manuelli, 2011. "Disease and Development: The Role of Human Capital," 2011 Meeting Papers 605, Society for Economic Dynamics.
    3. 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.
    4. Diane Coffey & Michael Geruso & Dean Spears, 2016. "Sanitation, Disease Externalities, and Anemia: Evidence From Nepal," NBER Working Papers 22940, National Bureau of Economic Research, Inc.
    5. Rody Manuelli, 2015. "AIDS, Human Capital and Development," 2015 Meeting Papers 1193, Society for Economic Dynamics.
    6. Ozier, Owen, 2014. "Exploiting externalities to estimate the long-term effects of early childhood deworming," Policy Research Working Paper Series 7052, The World Bank.

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