Need for a paradigm shift in soil-transmitted helminthiasis control: Targeting the right people, in the right place, and with the right drug(s)

Despite decades of debate regarding the most effective approach to control STH globally, few changes have occurred in the structure of the global control program. Multiple global deworming campaigns, multi-stakeholder declarations, regional and national meetings, and research have all suggested that innovative, targeted approaches are needed to complement school-based deworming. Huge progress has been made, but despite this, millions of people remain at risk of morbidity from intestinal parasite infections. While some might argue that nothing presented here is new, our point is that the time and context have changed. Through the World Health Assembly, endemic countries have endorsed the WHO NTD Road Map goal of eliminating morbidity from STH by 2030 and are poised to implement it. Deworming as a public health intervention is an effective preventive therapy for people living in endemic areas of the world. For deworming to remain effective, it is time to update policies and practices such as the guidelines for coadministration of preventive chemotherapy for NTDs and ensure that current epidemiologic trends are incorporated into program design and planning. We can only ensure that the right people can benefit in the right places by carefully revising our approach. The global STH—and indeed the global NTD—community must commit to working together to make this happen.