Paper short abstract:

Mass distribution of tablets is an ineffective way to treat parasitic infections. However, deworming has been promoted. An economist involved in promoting deworming was awarded a Nobel Prize. Evidence has been set aside. Ignorance has been optimised. This paper asks why and how that has occurred.

Paper long abstract:

Based on a social experiment about deworming of pupils in a group of schools in Western Kenya, a hugely influential article was published by two economists in 2004. The article is repeatedly cited to support mass drug administration for worm infections in Africa and elsewhere; and one of the authors subsequently established an organisation called Deworm the World. However, ethnographic work on deworming has demonstrated that, in practice, treatment coverage is much lower than supposed. Moreover, a reanalysis of the Kenyan data showed that the findings that had been presented were flawed. This prompted a fierce debate known as 'worm wars'. Although random control trials have confirmed that deworming in ineffective, it has continued on a massive scale, and one of the authors of the Kenyan article has been awarded a Nobel Prize for his achievements for indicating solutions to African poverty. Evidence has been promoted and maintained in ways that do not describe realities on the ground. Ignorance has been optimised. This paper asks why and how that has occurred.