Cambodia reaches key target against parasites.

The Partners for Parasite Control was launched and a measurable global target was set after resolution 54.19 was endorsed by every Member State at the World Health Assembly in 2001, which urged seriously tackling schistosomiasis and soil-transmitted helminths. The partnership is composed of various United Nations agencies. World Health Organization (WHO) Member States, research institutes and a multitude of non-governmental organizations, some of which provide training, while others raise funds or create advocacy materials. The global target against which each country's progress is measured is that at least 75 per cent of all school-aged children at risk of morbidity from intestinal parasites be reached regularly and treated by the year 2010. To reach that goal, another "subgoal" was set that requires that all health services in endemic areas be stocked with the drugs to treat them. WHO acts as the secretariat for the group, as well as the lead technical agency.

The partnership is open to all interested parties that are engaged or wish to engage in parasite control, thereby enabling them to respond to country demands rapidly. Its roles are to: provide a platform to share the latest technical and scientific as well as practical programmatic information on control programmes; provide field, laboratory and health education materials and training, where necessary; track the progress each endemic country is making; generate concerted actions from the local to the national and international levels: and step up international advocacy for parasite control.

With the recent completion of its latest treatment campaign against intestinal parasites, Cambodia on 2 July 2004 reportedly became the first country to reach six years ahead of schedule the WHO anti-parasite global target by protecting three out of four school-aged children. Five years ago, more than 70 per cent of Cambodian children were infected with intestinal worms. They weigh less than healthy children and have a much higher chance of becoming anaemic. Once anti-parasite treatment is administered, they show a dramatic increase in their short- and long-term memory, as well as in their reasoning capacity and reading comprehension, and school absenteeism drops by as much as 25 per cent.

According to reports from more than 6,500 schools where the campaign took place, more than 75 per cent of the country's nearly 3 million school-aged children have been treated. "Cambodia's experience provides hard evidence that it is completely within the realm of possibility to protect the vast majority of children against parasites. Cambodia has done it, and so can other countries", said Dr. Lorenzo Savioli, WHO Coordinator of Parasitic Diseases Control.

Cambodia's success follows a progressive expansion to the national level, which now involves a twice-yearly anti-parasite campaign. Drugs are administered across all 24 provinces by thousands of teachers who distribute the pills in classrooms. The campaigns were conducted by the Ministry of Health, Education and Sport, with the support of WHO, together with the United Nations Children's Fund, the Japanese Embassy in Cambodia, and the Sasakawa Memorial Health Foundation.

Anti-parasite pills cost only about two cents per tablet. "That's a very small price to pay for helping to control a public health problem", said Dr. Savioli. WHO hopes that Cambodia's early success will generate momentum for other countries to combat parasitic infections. "Cambodia undoubtedly wins the race to reach the 2010 anti-parasite target", he commented. "Now, it is up to other countries to duplicate their success formula."

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Intestinal worm infection affects at least 2 billion persons worldwide and is a significant public health threat in regions where sanitation and hygiene levels are inadequate. These worms can be contracted when skin comes into contact with contaminated water or soil, or through ingestion. Heavy infection can impede intellectual and physical development. Symptoms include fever, chills and muscle aches, and if left untreated, leads to irreversible organ damage. Treatment is with cheap single-dose, effective drugs taken three times a year or once every two years, depending on the prevalence of infection in the area.

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Reported by Erika Reinhardt