More than a billion people, mostly in developing nations, still serve as hosts to roundworms. They are a source of diseases that often kill – yet medicines for these diseases have generally been adopted from veterinary use and have not been optimized for humans. This lecture provides an introduction to parasitic diseases of poverty and describes a novel drug discovery process – involving scientists living in the most affected areas – that has been implemented in South Africa and Botswana. The integration of multiple levels of development is a significant challenge – but one with great rewards.