Evening Seminar 5 July 2016 Prof. Tim Allen of LSE
Deworming Delusions: Mass Treatment for African Parasites in a Biosocial Perspective
Recent debates about deworming school-aged children in East Africa have been described as ‘The Worm Wars’ on a World Bank website.The stakes are high. Deworming has become one of the top priorities in the fight against infectious diseases. Leading economists and epidemiologists have vigorously promoted the idea, claiming that it has the potential to end poverty, They cite historical examples from the USA, Japan and elsewhere, and give particular emphasis from data collected in Kenya since the end of the 1990s, and published in a key article in 2004. Staff at the World Health Organisation, the Gates Foundation and the World Bank (among other institutions) have endorsed the approach, and school-based treatments are a key component of large-scale mass drug administration. The current, integrated approach to mass drug administration has emerged as the largest global health programme that the world has ever seen.
However, biosocial research in Uganda and Tanzania suggest that things are not as straightforward as has been claimed. Drawing on anthropological field research at sites spread across the region, and engaging with both biological and social evidence, this seminar shows that assertions about the effects of school-based deworming are over-optimistic. The results of the much-cited study on deworming Kenyan school children, which has been used to promote the intervention, are flawed, and a systematic review of randomised controlled trials demonstrates that deworming is unlikely to improve overall public health. Also, confusions arise by applying the term deworming to a variety of very different helminth infections and to different treatment regimes, while local level research in schools reveals that drug coverage usually falls below target levels. In most places where data exist, infection levels remain disappointingly high. Without indefinite free deworming, any declines in endemicity are likely to be reversed. Moreover, there are social problems arising from mass drug administration, which have generally been ignored. There is no doubt that curative therapy for children infected with debilitating parasitic infections is appropriate, but overly positive evaluations of indiscriminate deworming are counter-productive.
In presenting the material Prof. Allen will also reflect on the the challenges and opportunities associated with doing critically-engaged ethnographic fieldwork on such an important and widely promoted intervention. He will pose several controversial questions about the nature of evidence, about how evidence relates to policy choices, about the ways in which large grants shape the evidence that is collected and the way it is presented, and about why it is possible to treat African children in schools without their parents’ permission (something that is unlikely to be considered ethical in other parts of the world).
Professor Tim Allen is Director of the Firoz Lalji Centre for Africa and Head of the Department of International Development at the London School of Economics and Political Science. He has carried out long-term field research several African counties, mostly in East Africa. His publications include the bestselling textbook, Poverty and Development (Oxford University Press 2000), as well as books and articles on ethnic conflict in Europe, media coverage of wars, links between culture and development issues, mass forced displacement, and global health. His latest books have been Trial Justice: The International Criminal Court and the Lord's Resistance Army (2006), and The Lord’s Resistance Army: Myth and Reality (2010). In recent years his research has focussed on justice and accountability in African war zones, and social aspects of Neglected Tropical Disease control. He has published extensively on the latter in collaboration with Dr Melissa Parker of the London School of Hygiene and Tropical medicine, focussing in particular on mass drug administration in endemic populations of East Africa. In addition to academic work, he has worked as a consultant with numerous international organisations, including UNDP, UNICEF, UNRISD, MSF, LWF, Save the Children, World Vision and DFID. He is also a broadcaster and has presented or contributed to numerous radio and television programmes, mostly for the BBC. He has been elected as a Fellow of the Academy of Social Sciences.
Date: Tuesday, 5 July 2016
Time: 18h15 - 19h45 (light dinner served from 17h45)
Venue: Lecture Theatre 1A, Neville Alexander Building*, University Avenue South, Upper Campus, UCT
RSVP: (for catering purposes): firstname.lastname@example.org
*previously the Graduate School of Humanities Building
Lecture Theatre 1A, Neville Alexander Building*, University Avenue South, Upper Campus, UCT