2019 Nobel laureate Michael Kremer emphasizes WASH and deworming benefits

On 30 September 2021, the World Health Organization (WHO) hosted Professor Michael Kremer, the 2019 Nobel laureate in economics,¹ at its headquarters in Geneva.

© WHO / 2019 Nobel Laureate in Economic Sciences, Michael Kremer.

During his visit, Professor Kremer gave two virtual presentations: one on the “relationship between water, sanitation and hygiene (WASH) improvements and child mortality”; the other on “meta-analysis and public policy: the case of mass drug administration for helminths”. 

Addressing diarrhea and gastrointestinal diseases

Professor Kremer spoke of the correlation between water quality, access to water and child survival in developing countries. Diarrhoea and other gastrointestinal diseases claim the lives of more than 1.6 million children every year.

He added that there is strong evidence to suggest that access to improved water quality is critical to reducing communicable diseases and that young children stand to benefit most from access to clean water. A meta-analysis of 48 studies revealed that water treatment reduces the odds of all-cause child mortality by 25-32%.

Professor Kremer also presented a study on different methods of treating drinking-water in the absence of centralized services, the more efficient method being the provision of free coupons to mothers after childbirth to access dilute chlorine solution.

Economic benefits of deworming

On the long-term economic benefits of deworming children regularly, Professor Kremer presented a study showing that 2-3 years of deworming results in 13% gains in earning and consumption expenditures, dewormed children have a higher rate of shifting from agricultural to non-agricultural activities and are able to obtain better wages.

More than 25% of the world’s population are affected by soil-transmitted helminth infections, largely due to lack of access to sanitation and contamination of soil with human faeces. A study² found that deworming treatment of mothers during pregnancy reduced by 14% the risk of their child dying within the first 4 weeks after birth; treating pregnant women with anthelminthic medicines can also avoid low birthweight.

Professor Kremer also presented a revision of meta-analysis conducted by the 2016 Cochrane review³ that demonstrated the benefits of deworming on weight and mid-upper arm circumference, height and hemoglobin, which he said confirms the validity of the WHO’s recommendations on deworming children who are exposed to or at risk of soil-transmitted helminthiases⁴.

Meeting with the Director-General

Professor Kremer paid a courtesy call to WHO’s Director-General, Dr Tedros. 

© WHO / Dr Tedros Adhanom Ghebreyesus WHO Director-General and the 2019 Nobel Laureate in Economic Sciences, Michael Kremer.

During discussions on the global response to the COVID-19 pandemic, Professor Kremer briefed Dr Tedros on his recent work on “dose stretching” to improve vaccination coverage.