Insights from The Life You Can Save’s evaluation of Unlimit Health: why deworming remains one of the best investments in global health

In 2026, The Life You Can Save (TLYCS) conducted an in-depth, evaluation of Unlimit Health’s mass deworming programmes.

One objective of this evaluation was to assess the economic impact that Unlimit Health’s mass deworming had in reducing schistosomiasis—and the results are compelling.

Across three countries, the evaluation confirms what global health experts have long recognised: supporting large‑scale deworming remains one of the most cost‑effective, high‑impact ways to improve children’s health, education, and long-term economic prospects.

Parasitic diseases’ drain on health, education, and economic potential

Schistosomiasis (SCH) and soil-transmitted helminth (STH) infections disproportionately affect children in the world’s poorest communities. These parasitic diseases:

• Increase child mortality
• Reduce school attendance and cognitive performance
• Cause anaemia, malnutrition, and stunting
• Lead to chronic organ damage
• Limit long-term economic productivity

Left untreated, these infections can trap families and entire regions in cycles of poverty.

But they are inexpensive, and very effective to treat.

What the TLYCS evaluation found

TLYCS analysed Unlimit Health-supported mass drug administration (MDA) campaigns in Madagascar, Ethiopia, and Côte d’Ivoire, covering 5.3 million children in Madagascar, 11.3 million children in Ethiopia and 7.5 million children in Côte d’Ivoire.

The evaluation measured impact using Disability-Adjusted Life Years (DALYs) averted, a global standard for quantifying reductions in disease burden. This is measured by doing a calculation of the number of years living with a disease or disability that the intervention averted, in the communities that received treatment.

Cost-effectiveness

Deworming is already known as one of the world’s most cost-effective health interventions—and Unlimit Health’s results strengthen this case.

The TLYCS analysis rates Unlimit Health’s SCH interventions as “highly cost-effective”, showing that in Madagascar, it cost just $36 to prevent a year of poor health, and in Ethiopia, $87—far below what is typically considered good value in global health.

For context, the World Health Organization considers interventions costing under $100 per DALY to be highly cost-effective. Interventions that cost less than 3x average per capita income are still considered cost-effective.*

Why are costs so low?

• Deworming drugs cost as little as $0.02 each
• Praziquantel, used to treat schistosomiasis, costs only a few cents—often donated
• Delivery mechanisms leverage existing school and community systems

High benefit-to-cost ratios

TLYCS highlights that the returns from deworming far exceed the investment. Children who avoid heavy worm infections, stay in school longer, experience better overall development and earn higher incomes as adults.

For donors, this means a small contribution generates decades of impact across health, education, and economic domains.

Proven capacity to deliver at scale

TLYCS emphasises Unlimit Health’s strong capacity and track record to operate at scale in partnership with ministries of health.

• Over one billion treatments delivered across endemic countries
• 30 million treatments provided in 2024 alone, reaching 21.3 million people
• Deep integration with government health systems
• Robust monitoring through coverage surveys and treatment impact assessments

This embedded approach ensures that every investment strengthens national capacity and accelerates progress toward disease elimination.

Sustainable change through strong systems

While annual MDA remains essential to maintain low infection levels, Unlimit Health is committed to more than just treatment delivery.

TLYCS notes Unlimit Health’s sustained work in:

• Strengthening local health systems
• Supporting strategic planning with Ministries of Health
• Integrating behaviour change and social assessments
• Ensuring programmes evolve through data-driven decision-making

By empowering national governments and communities, Unlimit Health supports progress toward long-term, sustainable reduction in transmission.

An opportunity for donors

TLYCS notes that funding constraints—not technical barriers—are the primary limitation stopping deworming programmes from reaching full scale.

“Where resources have been injected – for example, through donor-funded initiatives in sub-Saharan Africa – we have seen rapid expansions of deworming coverage and corresponding drops in disease prevalence”.

The good news?
Because deworming is inexpensive and highly effective, additional resources can translate directly into millions more treatments and rapid reductions in disease.

For donors, this creates one of the rarest opportunities in global health:

• Very low cost per person treated
• High and well-documented impact
• Strong government partnerships
• Proven scalability
• Long-term economic benefits
• Clear pathway to disease elimination

Your support can drive impact

Unlimit Health’s programmes continue to deliver exceptional value—transforming the health and futures of millions of children at a cost that is a fraction of most health interventions.

*The cost per DALY averted was the highest in Côte d’Ivoire (US$273). Considering the WHO-CHOICE GDP per capita threshold, the intervention was cost-effective in all three countries.