International Day of the African Child: Schistosomiasis and the Challenge to Early Childhood Development

Early childhood development in children facing schistosomiasis in Africa is part of our Company’s Sustainability Goal of “Driving health equity for underserved population.”

It is well established that early childhood development (ECD) lays the foundation for lifelong health, learning, and long-term productivity. Investments in health, nutrition, learning, and nurturing care in the first 1,000 days yield higher education and socioeconomic outcomes with reduced healthcare costs, translating into stronger human capital, national competitiveness and political stability.

Unfortunately, hundreds of millions of children in the world’s poorest regions are disproportionately impacted by factors hampering their development. This is predominantly the case in sub-Saharan African countries where a massive 40 to 50% of children below five years are not reaching their developmental potential.

In Africa, early childhood development status remains critically low due to converging factors: a high burden of multiple infectious diseases that can exacerbate each other and weaken the immune system of young children; climate change leading to widespread food scarcity and malnutrition stunting physical and brain development; and limited economic drivers that restrict investments in quality childcare, early learning programs, safe water and sanitation, and access to essential health services. These combined factors create a cycle where children do not access the basic elements required during the crucial early years, potentially leading to long-term deficits in learning, productivity, and well-being.

Although most attention has been paid on the impact of infectious diseases such as malaria, diarrheal diseases, pneumonia and HIV/AIDS, it is increasingly recognized that disease such as schistosomiasis can significantly affect the development potential of very young children.

Schistosomiasis, one of the 21 Neglected Tropical Diseases that plagues the African continent, impacts over 250 million people. This disease is carried by a water-born parasite that infects people when in contact with freshwater bodies while bathing or conducting their daily chores or professional activities. Indeed, in communities where access to sanitation and clean water is either limited or non-existent, the exposure to unsafe water remains the only option. If the infection is left untreated, the parasites can mature in the urinary or intestinal venous systems and lay eggs which become trapped within organs, or excreted from the body through urine or feces, thus maintaining the life cycle of transmission in humans.

The World Health Organization (WHO) estimates that over 50 million children under five are at risk of schistosomiasis in sub-Saharan Africa. By the age of 1 year, most children will be exposed to schistosomiasis in highly endemic regions, and early signs of the disease can be observed before the age of five years is reached!

The Hidden Toll of Schistosomiasis on Children below 5 years old

• Malnutrition and stunting: Parasites compete for nutrients, cause diarrhea, and trigger inflammation. In young children, repeated infections can lead to malnutrition and stunting, which constrain physical growth.
  
  
• Anemia and fatigue: blood loss and inflammation from schistosome infection can lead to fatigue and malaise.
  
  
• Increased susceptibility to infections: compromised immunity and poor overall health raise vulnerability to other illnesses.
  
  
• Cognitive and motor development: the iron-deficiency anemia and chronic inflammation induced by schistosomiasis and undernutrition during the critical early years can impair memory, attention, and learning, and delay motor milestones.
  
  
• Chronic organ involvement: in heavy/intense infections, schistosomiasis can affect liver, intestine, urinary tract, or bladder function, with long-term health consequences.
  
  
• School unreadiness: When children arrive at preschool or primary school with stunted growth or cognitive impairment, their engagement and performance can suffer, perpetuating cycles of disadvantage.
  
  
• Household and community impact: Parasitic diseases burden families with missed work, increased healthcare costs, and heightened caregiver stress-reducing the resources available for a child’s overall development.

Addressing schistosomiasis at an early age alongside other infectious diseases and nutritional programs is therefore essential to protect nutrition, health, and early developmental potential.

Our Company has been engaged in the fight against Schistosomiasis since 2007.  This has been through its donation of the standard-of-care treatment, in partnership with WHO, to treat primarily school-aged children at risk of the disease in Africa. Moreover, our approach to fight schistosomiasis goes beyond the donation program, and integrates a number of strategic pillars: awareness and behavior change initiatives to deepen disease understanding within communities and local health systems; targeted R&D to address early childhood treatment needs; and innovative access mechanisms aiming at addressing schistosomiasis alongside nutritional programs for children in endemic countries, all supporting the elimination of schistosomiasis across all age group at risk. This effort builds on decades of sustained investment and strong partnerships, including with local African stakeholders.

Healthy growth in the earliest years is not a luxury - it is a necessity for the future. By integrating schistosomiasis control with child’s health programs, we safeguard Africa’s most vulnerable children, enabling them to become healthy, capable adults who contribute to their communities and economies.