The summary
- Former President Jimmy Carter worked for decades to eliminate Guinea worm disease worldwide.
- While in 1986 there were 3.5 million cases of this painful parasitic infection, preliminary data indicate that this year there were only 11.
- Carter died Sunday at age 100.
Former President Jimmy Carter hoped to survive the Guinea worm, and he came painfully close to achieving that goal.
Carter, who died Sunday at age 100, and his nonprofit, the Carter Center, led a decades-long campaign against the disease, raising funds, tracking cases, helping quell outbreaks and organizing support among world leaders and agencies. of health.
Guinea worm infections are caused by a parasitic worm whose larvae can contaminate water. When people consume contaminated water, the larvae mature inside the body and grow to about 3 feet long. The worms then exit people’s bodies, forming blisters on the skin as they emerge, in an agonizing and painful process that can take weeks.
In 1986, five years after Carter’s presidency ended, 3.5 million cases of the disease were recorded worldwide. As of early December, preliminary data indicate that only 11 cases have been recorded this year, and in just two countries: Chad and South Sudan, according to Adam Weiss, director of the Carter Center’s Guinea Worm Eradication Program.
“We continue to see a reduction in the distribution of the disease from more than 20 countries in the 1980s to just a few so far this year,” Weiss said. “A lot of good progress is being shown.”
In 1986, the World Health Assembly called for the eradication of Guinea worm disease. The Carter Center, a nonprofit organization created by the former president, stepped in to lead the effort, partnering with health departments in partner countries, the World Health Organization and the U.S. Centers for Disease Control and Prevention. Joined.
Carter visited a village in Ghana in 1988 that was suffering from guinea worm infections, and he often spoke of an image that haunted him during that visit: a guinea worm emerging from a woman’s swollen breast.
“It left such a deep mark on him, not because he saw desperation. He felt desperation, but what he saw was that there was an opportunity,” Weiss said. “It was something I couldn’t turn my back on.”
Carter remained focused on the project until his death, telling reporters in 2015 that he wanted “the last Guinea worm to die before me,” according to The Associated Press. He received updates on Guinea worm even after entering hospice care, the AP reported.
Only one human disease, smallpox, has been eradicated through human efforts. Guinea worm disease could become the second, although it could take years and new methods to get the effort across the finish line.
The disease, which is most frequently reported in impoverished rural areas without clean water, remains endemic in several African countries. People can become infected with several worms at once: a man in Nigeria suffered when health workers removed more than 80 worms from his body in 1999.
Unlike smallpox, there is no vaccine or treatment to stop Guinea worm disease. That’s why the Carter Center has worked with African and Asian health agencies to change the way rural villagers live daily lives by offering education about how the disease spreads and how to prevent it, providing water filters to those who need them, and using larvicides to control outbreaks.
By 2000, the disease had been eradicated from Southeast Asia.
“You need an advocate like President Carter to say, ‘This is the Carter Center’s signature health program. We want to get this done,” said Dr. Jordan Tappero, deputy director of neglected tropical diseases at the Gates Foundation, which has funded the Carter Center’s work.
The World Health Organization’s goal is to eradicate Guinea worm disease by 2030. For that to happen, global cases must remain at zero for three consecutive years.
This year’s preliminary total of 11 cases represents a record low, but Tappero said more work remains and new methods will likely be required to achieve eradication.
Complicating efforts are cases of Guinea worm disease detected in domestic animals. Guinea worm disease was first detected in dogs in 2012, forcing a change in strategy.
“Infection in dogs and cats in these latter countries makes it more difficult to get there by 2030,” Tappero said. “You can’t teach a dog to say it’s safe to drink from this pond and not that pond.”
Tappero said researchers are developing tools to immediately detect signs of the disease in water samples, working on diagnostic tests that could identify cases months before the parasite emerges and conducting trials of a drug called flubendazole for use in infected dogs.
In 2022, the Carter Center held a summit for some of the last countries to fight the disease. Angola, Cameroon, Chad, the Democratic Republic of the Congo, Ethiopia, Mali, South Sudan and Sudan agreed to accelerate their efforts to eradicate Guinea worm.
“That kind of political will is very important: having that kind of high-level commitment along with the village level. People just want to do this,” Weiss said. The path Carter blazed, he added, makes it “pretty easy now.”
