title: A call to strengthen the global strategy against schistosomiasis and soil-transmitted helminthiasis: the time is now.
abstract: In 2001, the World Health Assembly (WHA) passed the landmark WHA 54.19 resolution for global scale-up of mass administration of anthelmintic drugs for morbidity control of schistosomiasis and soil-transmitted helminthiasis, which affect more than 1·5 billion of the world's poorest people. Since then, more than a decade of research and experience has yielded crucial knowledge on the control and elimination of these helminthiases. However, the global strategy has remained largely unchanged since the original 2001 WHA resolution and associated WHO guidelines on preventive chemotherapy. In this Personal View, we highlight recent advances that, taken together, support a call to revise the global strategy and guidelines for preventive chemotherapy and complementary interventions against schistosomiasis and soil-transmitted helminthiasis. These advances include the development of guidance that is specific to goals of morbidity control and elimination of transmission. We quantify the result of forgoing this opportunity by computing the yearly disease burden, mortality, and lost economic productivity associated with maintaining the status quo. Without change, we estimate that the population of sub-Saharan Africa will probably lose 2·3 million disability-adjusted life-years and US$3·5 billion of economic productivity every year, which is comparable to recent acute epidemics, including the 2014 Ebola and 2015 Zika epidemics. We propose that the time is now to strengthen the global strategy to address the substantial disease burden of schistosomiasis and soil-transmitted helminthiasis.
authors.affiliation: Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA; Division of Epidemiology, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: nathan.lo@stanford.edu.
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Lo
authors.affiliation: Children Without Worms, Task Force for Global Health, Decatur, GA, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Addiss
authors.affiliation: Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development, National School of Tropical Medicine at Baylor College of Medicine, Houston, TX, USA; Department of Biology, Baylor University, Waco, TX, USA; James A Baker III Institute for Public Policy, Rice University, Houston, TX, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hotez
authors.affiliation: Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Charles H
authors.initials: CH
authors.lastname: King
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: J Russell
authors.initials: JR
authors.lastname: Stothard
authors.affiliation: United States Agency for International Development, Global Health, Washington, DC, USA.
authors.forename: Darin S
authors.initials: DS
authors.lastname: Evans
authors.affiliation: Center for Tropical and Emerging Global Diseases and the Department of Microbiology, University of Georgia, Athens, GA, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Colley
authors.affiliation: Global Public Health, Johnson & Johnson, New Brunswick, NJ, USA.
authors.forename: William
authors.initials: W
authors.lastname: Lin
authors.affiliation: Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Jean T
authors.initials: JT
authors.lastname: Coulibaly
authors.affiliation: Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Amaya L
authors.initials: AL
authors.lastname: Bustinduy
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Raso
authors.affiliation: Division of General Medical Disciplines, Stanford University, Stanford, CA, USA; Center for Health Policy and the Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA, USA.
authors.forename: Eran
authors.initials: E
authors.lastname: Bendavid
authors.affiliation: Department of Medicine, University of Toronto, Toronto, ON, Canada; Division of Internal Medicine and Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, ON, Canada.
authors.forename: Isaac I
authors.initials: II
authors.lastname: Bogoch
authors.affiliation: Schistosomiasis Control Initiative, Imperial College London, London, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Fenwick
authors.affiliation: Global Schistosomiasis Alliance, Chavannes de Bogis, Switzerland.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Savioli
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: David
authors.initials: D
authors.lastname: Molyneux
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.affiliation: Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Andrews
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D000871:Anthelmintics / Q000627:therapeutic use*; D014943:Global Health / Q000191:economics* / Q000592:standards; D017408:Guidelines as Topic; D006373:Helminthiasis / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D009017:Morbidity; D019057:Quality-Adjusted Life Years; D012552:Schistosomiasis / Q000188:drug therapy / Q000191:economics / Q000453:epidemiology* / Q000517:prevention & control; D012987:Soil
chemical_list: D000871:Anthelmintics; D012987:Soil