Mass Deworming: A Case Study for Poor Development Ethics

Soil-transmitted nematode (STN) infections represent a significant global health burden, affecting almost one billion people in the developing world. STNs are intestinal parasites, including roundworm, whipworm and hookworm, which primarily infect vulnerable populations. The global health community’s approach to the control of STN infections has been the adoption and implementation of mass drug administration programs using benzimidazole drugs. The objective of this thesis is to analyze the adoption of mass deworming programs from scientific, political and ethical perspectives. Using techniques in molecular biology, the benzimidazole drug target of one species of hookworm was characterized with the purpose of adding necessary information to the literature on hookworm pathology. The absence of these data in the existing literature pointed to broader questions about the policies and evidence base for the modern implementation of mass drug administration programs. This thesis analyzes the policy guidelines for mass deworming projects and the ethics of deworming as a popular Western development initiative. Evidence is presented to support the conclusion that mass deworming can be considered a case study for poor development ethics.