Smart Philanthropy - From hookworm to bookworm

"I resolved to stop accumulating and begin the infinitely more serious and difficult task of wise distribution", said Andrew Carnegie, self-made steel tycoon and one of the greatest philanthropists of all time. Over 125 years later, philanthropists are still grappling with one question: how do you make a real, sustainable difference?

When Carnegie penned those words back in 1889, the world was, arguably, a simpler place. While many of today's issues – lack of access to economic opportunities, basic healthcare and education – ­are similar, advancements in science, medicine and communications mean that not only do we have far more effective tools at hand but we are also far more aware of the sheer scale and scope of the challenges faced by those less fortunate.

In some respects, today's philanthropists are spoiled for choice. But too often they find it's much harder to put their money to work for a good cause than it was to earn it in the first place. Effective, impactful philanthropy demands an intimate understanding of the situation. But it takes time, expertise and resources to establish facts, select programmes and partners, and monitor and measure results. Just because something seems like a good idea, it doesn't mean it is, and it's easy to mistake short-term fixes for long-term, sustainable solutions. And often it is the less well-known, less ‘sexy’ ideas that will have the most impact.

Let me explain what I mean, using one of our programmes here at the UBS Optimus Foundation as an example. If, say, you wanted to help lift children out of the cycle of poverty in developing countries, the obvious solution would be to give them access to a good education and probably a healthy, nutritious diet.

There is nothing wrong with that; in fact, there are many great programmes, including some here at the UBS Optimus Foundation, doing just that. However, they're not enough by themselves.

And why not, you might ask, when there are nearly 70 million school-age children not able to attend school and nearly 40% of children worldwide who are poorly nourished?

And I would answer that these programmes are addressing important issues that are symptoms but not actually tackling the root causes of those symptoms.

Let's take a step back to consider.

Have you ever considered that there may be other factors quietly preventing a child from being able to learn, or even absorb the nutrition from the food they eat? It's easy to overlook, but these factors may reduce the impact of your investment if children are not able or equipped to learn. One such hidden challenge is a child being infected with a parasitic worm. Not such an appealing topic, I think you'll agree, but stay with me.

Today, around 400 million school-age children worldwide are infected with parasitic worms, with fewer than 15% having access to treatment and even less having access to education about how to prevent these infections and stay healthy.

Children in developing countries can pick up infections through eating unwashed food grown in soil contaminated by worm eggs, by playing football or cards in contaminated dirt, by walking barefoot on soil containing larvae and by drinking or bathing in water containing parasitic agents.

Put simply, they are at high risk for infection simply by behaving like all kids do.

What happens to these children?

Their physical and mental growth suffers because worms lead to under-nutrition, which in turn affects their cognitive ability and intellectual development. The worms reduce the body’s ability to capture and retain nutrients. They reduce children’s appetites, so they eat less and become more malnourished as a result. Iron-deficiency anaemia is also an issue. And research has also shown that worms can worsen the effects of HIV, tuberculosis and malaria, accelerating disease progression and inhibiting the body’s ability to absorb life-saving drugs against these infections.

Children who are chronically undernourished and anaemic are less able to explore the world around them and take advantage of learning opportunities. Worse, they may be too weak to attend school. The social and economic costs of worm infections are also high. Poor health, combined with low school grades, harms children's life chances and impacts a country's economic productivity. Indeed, studies of hookworm eradication from the American South suggest that, before public health campaigns began in the early twentieth century, hookworm was responsible for around 20% of the difference in incomes between northern and southern American states. While the economic costs of worm infections in developing countries are hard to quantify, they are likely to be large.

So if you only support education programmes in a country affected by worm infections, your investment may not have the desired effect, simply because the children are too ill to learn. Knowing this, you may have decided that the best investment you could make in a child's future is not building a school, or training teachers, but rather funding programmes that can reduce worm infections. It's relatively quick and easy to implement; the costs are low at less than 50 cents a year per child, and the benefits can be immense. In fact, deworming programmes are considered a “best buy” by a World Bank Study.

And yet, this still is not enough. And why, you might ask, becoming frustrated that I insist you think further about disgusting parasitic worms. And who really wants to think about that if they don't have to do so?

If you fund only a deworming programme but do not then fund access to clean water and good sanitation, as well as a system of ongoing health education, you will ensure that many children and adults continue to get reinfected on a yearly basis and will continually need to take medication over their entire lives.

But what if you could fund a programme that combines an intervention that immediately deals with the infection (like deworming tablets) along with engaged health education that gives communities and children the tools that they need to prevent reinfection (like building durable, acceptable latrines in their community, and educating them in tangible, relatable ways as to how infections can spread and be prevented)?

I am immensely proud of the work that we do at the UBS Optimus Foundation. This is just one example of the kind of programme we fund, and it demonstrates that engaging in effective philanthropy demands an intimate understanding of the situation. And that's where we come in. We carefully consider the social, economic and cultural nuances of a programme to ensure it will be welcomed and will address specific, known needs in ways that are both respectful and effective. We monitor, measure and communicate results regularly so clients have a clear sense of the impact their donation is having on the ground. And the advice and guidance we give to our programme partners provide them with the confidence to press ahead and transform their good ideas into great programmes.

I started by referencing Andrew Carnegie, who is well known for his support for public libraries around the world. It may be a little presumptuous, but I'd like to think he would be pleased that there may soon be more bookworms than hookworms in schools in developing countries.

About Ann-Marie Sevcsik

Ann-Marie Sevcsik is a Programme Director at the UBS Optimus Foundation in the field of health and emergency response. She brings over 20 years of experience in biomedical and health research, having spent the past 10 years engaged in research, development and access issues related to bringing relevant tools to improve the health and development of vulnerable populations worldwide. Prior to joining the UBS Optimus Foundation, Ann-Marie worked at the Drugs for Neglected Diseases initiative, which developed the first anti-malarial treatment by a public-private partnership that has now delivered more than 400 million treatments around the world. Educated at Harvard University, the Massachusetts Institute of Technology (MIT) and the University of California, San Francisco, she has worked with a wide range of organisations – including the Nobel Prize-winning Médecins Sans Frontières, the World Health Organisation; multinational pharmaceuticals like GSK Pfizer, Sanofi-Aventis; biotechnology companies like Amgen and Chiron and patient advocacy organisations, with hands-on projects in more than 30 countries around the world.


P – identify the Problem you want to solve;

O – understand the Obstacle to overcoming the problem;

S – define the Solution to overcoming the obstacle.

About the UBS Optimus Foundation

UBS Optimus Foundation is an award-winning, expert grant-making foundation that helps UBS clients employ their wealth to drive positive, sustainable social change for children. It selects programmes that improve children's health, education and protection, and that have the potential to be transformative, scalable and sustainable. And because UBS covers all the Foundation's administrative costs it guarantees that 100% of all donations go to support program partners, including research and development activities that benefit children.

Photos: courtesy of Last Mile Health, Daniel Mauszezahl; Gregory Muhr, Grant Squibb, Human Institute of Parasitic Diseases

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