Near Eradication Of The Neglected Tropical Disease Guinea Worm Is One Of President Jimmy Carter’s Legacies

Former President Jimmy Carter leaves behind many legacies, including brokering the Camp David accords which brought peace and diplomatic relations between Egypt and Israel, making human rights considerations integral to U.S. foreign policy, and near eradication of the debilitating Guinea worm disease.

In 1986, Guinea worm affected 3.5 million people annually, mostly in low-income nations in tropical areas. In 2022, thanks largely to decades of work by the Carter Center, Guinea worm disease reached an all-time low in incidence: Only 13 human cases were reported.

President Carter viewed development of the poorest nations as not only a moral concern, but also imperative to achieving world peace. He understood perhaps better than any other U.S. President that economic development in developing nations depends on establishing the conditions for a healthier society. Carter and his wife Rosalynn founded the Carter Center in partnership with Emory University on the principle of a fundamental commitment to human rights and the alleviation of human suffering from diseases such as Guinea worm.

Guinea worm disease (dracunculiasis) is usually contracted when people consume water contaminated with small crustaceans that eat Guinea worm larvae. The larvae develop into parasites inside the human host. After about 12 months, a meter-long pregnant female worm emerges through a painful blister in an infected human, often somewhere on the person’s legs or feet. A sufferer may find temporary relief by dipping the affected limb in water. However, contact with water stimulates the worm to release its larvae and start the cycle again. Guinea worm disease incapacitates people for weeks or months, reducing individuals’ ability to care for themselves, work, grow food for their families, or attend school.

Guinea worm disease has no cure or vaccine. Essentially, the entire eradication effort is built on systematic behavioral change, in addition to access to safe water supplies, better detection of human and animal cases, sterilizing and bandaging of wounds, deterring infected people and animals from wading in water, and using larvicide to kill the worms.

Only one human disease has ever been eradicated. It was smallpox, and in 1980 it was officially considered eradicated. For a disease to be declared eradicated, every country in the world must be certified free of human and animal infection, even in countries where transmission is not known to have taken place. To date, the World Health Organization has attested that 200 countries are free of Guinea worm; only six have not yet been certified.

Neglected tropical diseases

For nearly four decades, the Carter Center has established itself as a world leader in tackling the scourge of neglected tropical diseases (NTDs), including Guinea worm.

NTDs are a group of preventable and often treatable parasitic and bacterial illnesses that impose devastating health, social, and economic burdens on more than 1.7 billion of the world’s most vulnerable people, in developing regions of Africa, Asia, and the Americas. NTDs cause disability and disfigurement, and some can be fatal. They create vicious cycles of poverty, costing developing nations billions of dollars in healthcare resources and lost productivity.

The diseases include, among others, onchocerciasis (river blindness), African trypanosomiasis, leishmaniasis, cholera, Chagas disease, Dengue fever, and Guinea worm. Diseases are said to be neglected if they are overlooked and therefore underfunded by drug developers, owing to a lack of commercial prospects.

Peter Hotez and colleagues coined the term “neglected tropical disease” more than 20 years ago. Hotez is Professor and Dean of the National School of Tropical Medicine at Baylor College of Medicine. He is one of the world’s preeminent authorities on the topic of NTDs, having researched and written extensively on numerous NTDs. He’s called NTDs “the most important diseases you’ve never heard of.”

In addition to combatting Guinea worm, the Carter Center has funded numerous global public health programs targeting NTDs in over 30 countries, including lymphatic filariasis, schistosomiasis, trachoma, soil transmitted helminths, and river blindness (onchocerciasis).

Almost 30 years ago, the Carter Center began work towards eliminating river blindness. River blindness (onchocerciasis) is a parasitic infection that can cause intense itching, skin discoloration, rashes, and eye disease that often leads to permanent blindness. The parasite is spread by the bites of infected black flies which breed in rivers. Stamping out river blindness requires both health education and mass drug administration of the therapeutic Mectizan (ivermectin), donated by Merck.

Together with Merck, the Carter Center has assisted in the distribution of more than 500 million treatments of Mectizan in Africa and Latin America. Its program has successfully eliminated river blindness in Colombia, Ecuador, Guatemala, and Mexico.

Since 1986, the Carter Center has been a pioneer in NTD prevention, control, and elimination. Not only have the Center’s efforts saved lives, they’ve also reduced or banished altogether the burden of NTDs for tens of millions of people in developing nations. And because of President Carter’s philanthropic deeds the world has come incredibly close to wiping out Guinea worm.