Patients and doctors are both aware of worms but still ignore them – so both need focus.

Worm infestation affects 1 in 2 Indians, with treatment limited by understanding, not affordability. So, doctor reach was equally wide–GPs (family physicians), consulting physicians and paediatricians with no limitations on consulting fees/demographics.

In India, prescription drugs can only be promoted to doctors. This communication is governed under the Drugs and Cosmetics Act and a self-controlled industry body – ASCI. Doctor-patient communication is also governed by MCI's ethics policy, which prevents doctor endorsement of brands but allows unbranded information/diagnosis.

Worm infestation is so prevalent in India – 1 in 2 Indians have it – that it is taken for granted or ignored, even though it has serious long-term impact like fatigue, weight-loss, malnutrition and anaemia resulting in poor cognitive function, language and motor skills. This is in spite of long-term government and WHO focus, including a national deworming program.

In India, what better way to visualise the worms encroaching, living in, and damaging the intestine than the ubiquitous slums (housing colonies). More than 68 million people live in slums in India, about 20% of the urban population, so Indians are familiar with slums. For anyone with the right cultural context, the similarities are uncanny – slums set up overnight and stay forever, growing in any available shape and space, just like worms in the intestine.