Article 25: Deworming Dividend

Parasitic worms are one of the world's most common infections, leaving "more than 880 million children" in need of treatment. These parasites burden children with malnutrition, anemia, diarrhea, worsening school performance, and sometimes death.

The solution is simple and cheap. Most burdens are relieved with a simple pill costing less than $1. Treated children are healthier, perform better in school, earn more in life, and lower peer infection rates. Despite deworming being called a "best buy for development," a significant gap in coverage remains. 

At Article 25: Deworming Dividend we are closing this gap by establishing a $1 billion social endowment fund for the treatment and eradication of parasitic worms.$1 billion invested conservatively will generate enough annualized returns to fund the average gaps in coverage for deworming programs, allowing the Article 25: Deworming Dividend to perpetually enable implementation partners to expand deworming services to tens of millions of children every year.

Parasitic worms are one of the world's most common infections, affecting more than 1 billion people globally. While the worms are unbiased to income, age, or gender, infections disproportionately affect the poor and young. The impacts of infection pose serious threats to a child's school attendance and performance, health outcomes, and life-long productivity. Children with worms are less likely to be enrolled in school, have lower attendance rates, perform lower on tests, and severe cases can cause death.

The WHO estimates that "more than 880 million children are in need of treatment." A child with "a moderate intestinal worm infection will have more than 200 worms in their body," enough to fill a three-liter jar. Even after years of progress, just less than 1 in 3 pre-school aged children requiring deworming go untreated.

While there has been terrific growth in international efforts to reduce parasitic worm burdens, continuous fundraising is limiting progress and there are resource barriers that limit full coverage, resulting in billions of dollars in productivity losses every year. GiveWell estimates that there is need for around $100 million/year in additional funding in order to extend coverage to all currently untreated.

Our intervention works alongside the humanitarian community to serve the children, women, and families burdened by parasitic worms.

In numbers:

• "880 million children in need of treatment." (WHO)
• 272.7 million pre-school age children required treatment for soil-transmitted worms (STH) in 101 countries/territories. (2017, WHO)
• 120.3 million school-age children in 52 countries required treatment for worms (schistosomiasis), representing more than half of all people requiring treatment globally.  (2017, WHO) 
• "school-age children tend to harbour the heaviest infections with [intestinal worms] and are the group in the population most likely to suffer from disease." (RSTMH, RSTMH)
• 596+ million school-age children in 101 countries/territories were estimated to require treatment (for STH).  (2017, WHO)
• 688 million women of reproductive age require treatment (for STH). (2017, WHO)
• The coverage of pregnant women with deworming is between 1.4% in Europe and 33% in Africa.(2017, WHO)

Children and families impacted by parasitic worm infections live with a burden inside of them. They can suffer from abdominal pain, diarrhea, nausea, vomiting, micronutrient deficiency, anemia, and persistent fatigue. Being poor, young, or pregnant already exposes many children and expecting women to vulnerabilities, worm infections add a burden that offer them little hope of improving their lives.

Article 25: Deworming Dividend is a $1 billion endowment fund who's returns will fill the void in funding for global deworming efforts. We derive our name and mission from Article 25 of the Universal Declaration of Human Rights. We are taking the tools and resources of Wall Street and applying them to truly invest in humanity.

Our fund seeks a one-time collection of $1 billion dollars as a principal investment. The principal will be strategically invested with considerations towards security, historical performance, partnership opportunities, and ethical conflicts of interest. We see this investment as an enormous opportunity to not just secure returns to fund deworming efforts, but to also support impact investing, and increase leverage opportunities.

Our entire model is built upon gathering and restructuring the brilliance of experts in their respective fields. A strategic sub-committee will guide our investment with the charge to secure the principal, generate a 4-5% average annual return, and avoid ethical conflicts.

Once established the fund will be overseen by a board of advisors with expertise in humanitarian programming, economics, asset management, impact evaluation, as well as sector representation (UN, WHO, etc.), key implementation partners, beneficiary representatives, appropriate pharmaceutical connections, and other relevant skills and perspectives yet unseen. The board will approve long-term grants to implementation partners with the intention of extending coverage, increasing efficiency, and maximizing impact.

Our grant recipients will be our implementation partners. We aim to be able to provide them with longer-term grants that will allow them to extend their vision beyond the next grant cycle. Our grants will not replace current sources of funding, but will supplement and extend coverage and to those yet unreached.

The desired primary results are that the funding gaps for deworming efforts are met regularly, expanding coverage, increasing institutional stability, and supporting the WHO's targets for Neglected Tropical Diseases. We also believe there are strong opportunities for secondary results such as increased power of negotiating with pharmaceutical partners, increased media attention, support for increasing "herd effects" as parasite numbers decrease, increased collaboration through the board, and increased research efforts.

GiveWell estimates that Article 25 contributing $90 million over three years to just their top deworming charities would "treat over 198,000,000 children for intestinal parasites and lead to over 3,500,000 person-years of doubled income." When we averaging out an expected 4-5% rate of return from the endowment, we conservatively expect to extend deworming coverage to tens of millions of affected children annually.

In the last decade the world has made great strides in addressing worm burdens globally. International governing bodies and local governments have increased their prioritization of deworming. Pharmaceutical companieshave increased support and donations to international deworming programs. Researchers have increased data collection and analysis efforts. Organizations have moved towards cost-efficient mass deworming programs. And many rating agencies have identified deworming as a high-return social investment.

Despite all of the progress made, there are still billions of children, women, and families impacted by the burden of parasitic worm infections.

Our innovation is combining existing systems and products into a unique solution to a solvable, high-return social problem. Its elegance is its simplicity. Our use of proven systems (socially conscious investments, impact analysis, deworming programs, and endowments) enables us to push humanitarian impact past a critical mass.

Ultimately, we are creating a new model for creating unceasing impact. Once proven and fully developed, our model could prove a meaningful way for large social solutions to be served with economy supporting investments whose returns are guided by data driven experts with a focus on results-driven social impact.

Our solution relies heavily on technology. While launching, we are excited to identify products and resource partnerships that will support out solution. We will be heavily relying on internet hosted and digitized services to lower costs and to work across borders and timezones. As a digital organization our public interface, fundraising, and reporting will take place entirely on web platforms. Our financial structure will follow the evolution into electronically traded platforms, allowing us to keep costs and fees down. By utilizing digital tools for communication we are able to build a more diverse and remote board of advisors. We are also excited to support the adoption of advanced logistical programs and cell phone based tracking in the sector. Our core function may not be building a new app, but we depend upon the modern setting of technology to create the most good for our beneficiaries. 

Once established, we see many opportunities to leverage technology for improved outcomes and gained efficiency. For instance, machine learning could be used to compare indicators (i.e. - weather patterns, local reporting, pharmaceutical orders, programs ran, and cross-cutting programs) so as to warn for predictive outbreaks. Improved testing could warn us of drug-resistance or fake drug manufacturing.

Article 25: Deworming Dividend was born out of the desire to improve health, education, and opportunity outcomes in those burdened by parasitic worms. What drew us to address this issue specifically was how clearly the solution led to the desired outcomes. The science, tools, and infrastructure has been developed. Funding and coordination are too often the limiting factors.

The opportunity is as follows:

Article 25 will raise $1 billion. This money will produce three desired outcomes; (1) funding a social endowment, (2) garnering media attention to a neglected cause, (3) initiating a unique social investment opportunity. Once funded, the investing process will connect Article 25 with the booming world of social investment and opportunities for leveraging. Once invested, we will bring together a board of diverse skills and perspectives to maximize the impact of grants. This will optimize our impact as well as connecting parties that may not have otherwise connected. We hope this model will catch on with other organizations. Our board will design and approve grants that will fund gaps in deworming programs around the world. Once funded, the investment in deworming stands for itself. The WHO, GiveWell, Innovations for Poverty Action, Copenhagen Consensus, and others have done the research and calculations to measure the impact of deworming and have determined it to be a "best buy for development" that could result in billions in economic growth.

(A limited) Logic model for the effects of community deworming (International Journal of Epidemiology)

Currently Serving: 0
We are currently in the concept development stage.

Serving in One Year: 0
The fund will take at least a year to be established and generate returns. No beneficiaries will be served in the first year. 

Serving in Five Years: 40 - 100 million children per year
Due to the lasting nature of Article 25, we estimate impact averaged over time. Our forecasts assume historically consistent performance in the US stock market. For scale, the S&P 500 has averaged a 10% return since 1926 (8% since going to 500 companies in 1957). Investments in one of the largest and oldest social index funds have more than quadrupled in the last decade. "More than 140 ESG funds have launched globally [in 2018], with overall U.S. assets in the space growing to nearly $12 trillion—more than a quarter of all U.S. assets under management."

We believe that a conservative estimate of a 4-5% annualized return would provide the funding allowing us to serve tens of millions of children annually. These regular returns can have immense impact when treatment can be delivered for just $1 (GiveWell estimates $0.50-$1.00 generally. Evidence Action states that deworming can produce results for an "average cost of less than $0.50 per child per year."). In communications with GiveWell they stated, "We would estimate the impact of providing $90 million to fill the gaps among our top charities over three years to treat over 198,000,000 children for intestinal parasites and lead to over 3,500,000 person-years of doubled income."

Our goal within the next year is to establish Article 25: Deworming Dividend. We see that process as launching the concept here at Solve and inviting the most informed and experienced minds to offer constructive criticism. We desire to gather a board of advisors who bring diverse skills and a collaborative perspective. We are seeking a collection of lead investors to launch the fund. We operate on the idea of standing on the shoulders of giants and taking another step. The right partnerships are key to our success.

We will be building a sub-committee on the board to manage our investment strategy. The investment strategy will seek to protect the initial principal while generating an average annual return of 4-5%. We will also take partnership and leveraging opportunities into consideration as well as ethical considerations.

Once established, advised, and invested, we want to begin making grants to verified implementation partners. We currently plan on using a GiveWell inspired method for granting funds to the most cost-effective, impactful organizations in the field. As this process unfolds we want to utilize the opportunity to partner with research institutions to better understand the impact of such a fund. We also hope to act on opportunities to increase efficiencies within the deworming arena (i.e. - pharmaceutical pricing and ordering, logistics, testing, tracking, etc.). 

We aim to fail fast and learn faster. This could be a powerful model for creating indefinite impact for generations.

While many yet unseen barriers are likely to exist, these are the ones we are currently planning for:

Immediate/Founding:

• Raising $1 billion.
• Developing an effective investment strategy.
• US market disruptions due to the 2020 elections.
• Developing key partnerships within multiple sectors.

Operational:

• Impact measurement and redirection.
• Board recruiting and commitment strategy.
• International collaboration and communication.
• Market losses over time.

Future:

• Unfavorable research findings and public opinion swaying.
• Success making the fund unnecessary.
• Fake drug production.
• Drug resistance developing as a result of farming and mass treatments.
• Cost-effectiveness dropping as a result of limited donations, changing WHO recommendations, or decreased worm burdens.

We build upon the established work of experts, reorganizing existing systems to create social impact. Most barriers will be overcome with the guidance of leaders, experts, and the wisdom of experience.

Founding:

• Raising $1 billion
  • We're connecting with large donors to be "lead investors."
• Effective investment strategy
  • Assign the task with parameters to an expert investment sub-committee.
• 2020 elections
  • We will delay investing until after the election to avoid potential market volatility.
• Key partnerships & board recruiting
  • We've connected with GiveWell and are reaching out to other leaders. We are applying to Solve seeking introductions for key partnerships as well as board recruits.

Opperational:

• Impact measurement
  • We are currently using generalized studies and estimates. We seek a partnership with Impact Matters to evaluate and advise our impact.
• International collaboration
  • We are building a centralized website and tool suite that will be used to facility collaboration and communication across borders. Technology has never been more aligned to overcome this challenge.
• Market losses
  • We are seeking diversified investment proposals to mitigate the risk at the time of investment. After a downturn the board will have limited granting opportunities until the fund fully recovers its principal.

Future:

• Critical research findings/reviews
  • Our operational structure will default to scientific consensus and expert guidance (WHO, GiveWell, GWWC).
• Success
  • We hope for our solution to become unnecessary, triggering a dissolution clause initiated by the board.
• Fake drugs/drug resistance
  • As the WHO monitors and advises the sector, we will support compliant organizations with monitoring in place.

We are currently engaging with a lawyer to legally incorporate. Once incorporated, we intend Article 25 to be one "solution" offered and managed by our umbrella organization, Whetstone Innovations. We are working on the multiple opportunities met by our recipe of applying established financial tools to the non-profit sector, with a focus on calculated impact optimization. 

Currently we are a team of two. Nathan Heath is working full-time on Whetstone Innovations, the umbrella organization for Article 25. Alexandra is a co-founder of Whetstone Innovations who works part-time on this solution. Our solution has also been reviewed and advised by multiple financial professionals with more than a century of experience in leading financial institutions. We are in the process of identifying additional hires to be employed by Whetstone Innovations and to work on Article 25. 

Combined we have more than a decade of experience in the non-profit and humanitarian sectors. Nathan has been studying economic solutions to social problems for the last two years in an effort to bring academic guidance to his humanitarian efforts. Alexandra has nearly two decades as an entrepreneur and has many contacts into US and European financial institutions. Together we have been working to combine their philanthropic connections, academic studies, and humanitarian experience to create result-driven solutions to the world's most solvable problems. 

We have primarily been researching publicly available studies and data while formulating our solution. In May, we reached out to GiveWell to seek their understanding of the sector and to utilize their cost-effectiveness model. We have maintained contact with them to further understand the deworming financial landscape. We have yet to formally partner with any organizations.

Our innovation is reorganizing existing structures to create lasting social impact. As such, our solution reapplies multiple successful models to the task of ending a solvable social burden.

We will launch with a catalyzing social cry to back a solution with perhaps the highest tangible social return. We will bring large donors to the table by creating an attention generating venture in contrast to the typical low interest reoccurring requests. 

Once funded, an investment sub-committee will generate and execute an investment strategy balancing security and returns. This process adds value to our donors through association, draws on the wisdom of experience and expertise, while creating opportunities for strategic partnerships.

Once invested, we will utilize the endowment model used by so many legacy institutions. The investment will bring stability and resources otherwise unavailable. The returns will be used to cover our operating expenses and to provide grants to our implementation partners.

We will adopt a board structure seen in most lasting institutions. Our strategy will be to combine the expertise of individuals from all relevant perspectives.  

Our grants will be given with the aim of supplementing existing funding, providing operational security and coverage expansion to proven programs.

We will actively engage with impact measurement partners to review and improve our systems with the goal of positively impact all who need care.

Our revenue model may be rare within the Solve community, but it is built upon well-established models. Our founding endowment will fund our operations and grants. We will focus on utilizing technology to keep our costs down (electronic financial tools, web-based communication and work-flows, digital data reporting, etc.). We will also piggy-back on the work of partners and sector leaders (WHO, GiveWell, J-PAL, etc.) to minimize our overhead, and extend our coverage. 

Through the guidance of an experienced sub-committee, our investment strategy will seek a balance of security, income generation, ethical considerations, and partnership potential.

We believe that a conservative estimate of a 4-5% annualized return on investment after fees would provide funding or operational expenses and grants allowing us to serve, conservatively, tens of millions of children annually. We are excited to build an investment committee who sees the impact potential our investment will be. In communications about the potential of such and investment, GiveWell stated, "We would estimate the impact of providing $90 million to fill the gaps among our top charities over three years to treat over 198,000,000 children for intestinal parasites and lead to over 3,500,000 person-years of doubled income."

We are applying to Solve with the hope of it being our launch catalyst. Solve's high standards for selected solver teams and dedication to meaningful partnership is exactly what we seek in moving forward. As we develop our solution, we believe that Solve's community can offer the type of feedback and partnership that makes good ideas truly great.

Our solution is built upon the belief of building upon the great work of those before us. We are seeking the support and feedback of Solve's community with the hope of the gained wisdom to take our solution even farther.

Making it through Solve also has the benefit of further validating the concept. While we have begun seeking out feedback from industry leaders, Solve is an opportunity for us to find a validation that many donors seek out.

Governance:

We seek guidance and board membership from the global bodies coordinating efforts to eradicate parasitic worms and NTD's.

• WHO (Neglected Tropical Diseases Department)
• DFID (Specifically Rachel Glennerster)
• Uniting to Combat NTDs coalition
• STH Coalition

Implementation Partners:
These are the humanitarian actors that we seek to fund and build implementation relationships with. All of our implementation partners are recommended by GiveWell, The Life You Can Save, or are UN/WHO Partners.

• Evidence Action: Deworm the World Initiative
• The End Fund
  • We would like to meet with The End Fund to better understand their strategic investment strategy and how they would utilize additional funding to expand their deworming support.
• Children Without Worms (CWW) & Task Force for Global Health
  • We hope to connect & understand how they collaborate with drug manufacturers and where they see potential for improvement. We would also seek membership into the STH coalition.
• The Schistosomiasis Control Initiative (SCI)
• Sightsavers
• Living Goods
  • We are interested in seeing how we can support their deworming product line and model expansion.

Cost-Effectiveness/Impact Analysis:
We would like these entities to assess our impact and advise our grants with a focus on impact maximization and cost-effectiveness.

• GiveWell
• Impact Matters
• J-PAL
• Effective Altruism
• Innovations for Poverty Action
• The London Centre for Neglected Tropical Disease Research (LCNTDR)
• CEGA

Additional Support:

• Academic institutions interested in studying the impacts of the our grants.
• We are currently developing a list of desirable financial advisors to help us structure our investment strategy.

Parasitic worm burdens are hard on anyone. These parasites make it difficult to absorb nutrients, leaving those infected with less energy, mental capacity, and creative opportunities. As an additional difficulty, parasitic worms thrive in low-resource settings where there are often limited opportunities for young women as it is.  Once infected, young girls and women have even fewer options as they are less able to attend school and the medical support  is limited. The scale is massive as well, with "688 million women of reproductive age ... estimated to require [treatment]" globally (STH only)." Despite the scale of the problem and possibly increased exposure as a result of "domestic tasks," there is "no coverage target for this risk group is given in the WHO NTD roadmap." The situation is so severe that the WHO estimates that "the coverage of pregnant women with deworming is between 1.4% in Europe and 33% in Africa."

We are keenly interested in supporting programs that serve and support female children and girls of child-bearing age. As we gather more evidence and the WHO recommends treatment for girls and women of child-bearing age , it is critical to scale up programs that include these vulnerable young women. We have an opportunity to support the implementation of female-focused and inclusive programs as we work with implementation partners to scale their programs.

We would love to use the funding from the Innovation for Women Prize to earmark resources for female-focused programs seeking out underserved women burdened by parasitic worms.