Challenge
Globally, up to 1.2 billion people, a third of whom are children, are infected or at-risk of being infected with soil-transmitted helminths (STH), also known as intestinal worms. The populations most at risk of the infection are those living in the poorest areas of tropical and subtropical countries of the world where the high humidity, warm soil, and inadequate sanitation support the life-cycle of the worms. The public health significance of STH infections lies in the chronic and disabling effects such as abdominal pain and distension, intestinal obstruction, iron-deficiency anemia, and increased susceptibility to other serious infections. In severe cases, the disease may lead to death.

Diseases caused by STH infections can have lifelong consequences for children. These diseases can interfere with children’s physical and cognitive development at a critical stage of their lives. Furthermore, these diseases may ultimately have socio-economic consequences such as poor school attendance and performance and decreased productivity in adulthood.

In 2001, the World Health Assembly passed a resolution to eliminate STH as a public health problem by ensuring access to single-dose deworming drugs for the regular treatment of high-risk groups, particularly school-aged children. The resolution also called for treatment to be complemented by the simultaneous implementation of plans for basic sanitation and adequate water supplies. For the most recent year with complete data, 2005, the World Health Organization (WHO) estimates that, fewer than 20 percent of children had been reached with deworming drugs. (Click here for WHO Weekly Epidemiological Record article.)

Johnson & Johnson Donation
Recognizing that STH infections is a major public health problem for children and is compounded by limited access to effective treatment, particularly in the poorest countries, Johnson & Johnson has committed to donate mebendazole, a broad-spectrum anti-parasitic drug, for the treatment of infected and at-risk children. Johnson & Johnson partnered with the Task Force for Child Survival and Development (”The Task Force”) to develop Children Without Worms a multi-disciplinary program to address the treatment and prevention of STH infections in this vulnerable population. A total of 50 million doses of mebendazole are available for donation in 2007.

Strategic Approach
To achieve its vision and mission, Children Without Worms leverages the donation of mebendazole from Johnson & Johnson to promote comprehensive and sustainable control of STH that entails: regular mass deworming of at-risk children, hygiene education; and environmental sanitation. The program's vision and mission are presented below.

Vision
All the world’s children free of intestinal worms so they can grow, play, learn and enrich their communities.

Mission

1. Reduce and control the global burden of childhood STH infections through equitable access to the donation of quality mebendazole.
2. Catalyze the development of effective strategies for the treatment, control and prevention of STH infections in order to enhance health and education.
3. Contribute to the empowerment of communities to achieve sustainable control of STH infections.
4. Mobilize multisectoral coalitions of partners at global, national and local levels for STH control.

Children Without Worms also works toward achieving its vision and mission by donating mebendazole to national STH control programs that combine mass treatment with prevention through hygiene education and sanitation improvements. By advocating and fundraising for improvements in hygiene and sanitation, the program envisions an ultimate shift in emphasis from regular mass deworming to reduction of transmission and the elimination of perpetual treatment.

An independent, authoritative body of experts called the Mebendazole Advisory Committee (MAC) advises the Task Force and Johnson & Johnson on technical and strategic aspects of the program, and recommends policies and procedures to ensure safe and effective use of the donated mebendazole.

The program works together with partners, including governments of STH-endemic countries, nongovernmental organizations (NGOs), the World Health Organization, the World Food Program, and the United Nations Children’s Fund (UNICEF), to achieve its vision and mission.