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Global Health Thought Leadership

Guinea Worm Shows a Historic Decline Despite Pandemic and Inequity

Young goat herders in South Sudan drink water through personal pipe filters to avoid ingesting the parasite that causes Guinea worm disease. The Carter Center/Louise Gubb

By Dr. Kashef Ijaz, Vice President-Health, The Carter Center And Adam Weiss, Director, Carter Center Guinea Worm Eradication Program

Despite the enormous challenges posed by the COVID-19 pandemic, The Carter Center and its partner countries drew closer than ever in 2021 to eradicating Guinea worm disease. The work is still far from over, but the recent progress against it has been remarkable.

The ghastly tropical disease that once afflicted an estimated 3.5 million people every year struck a historically low 14* people in 2021, a 48% decline from 2020 and a 74% drop from 2019’s total. Chad had the most cases, just seven, while South Sudan recorded four; Ethiopia had one case, and Mali had two. Animal infections — whose elimination is essential to eradication — also were cut nearly in half. 

These gains were made possible, first, by communities’ commitment and diligent implementation of interventions demonstrated and monitored by Carter Center-trained health workers and volunteers. Along the Chari River in Chad, villagers buried or burned fish entrails rather than feeding them to their dogs, eliminating a likely source of canine infections. There and elsewhere, families and individuals faithfully ran all their drinking and cooking water through fine filters, which protected them from ingesting the tiny water fleas that harbor the larvae that grow into meter-long worms inside the body. Water sources were treated with larvicide, people dutifully reported suspected cases, investigations were conducted, and cash rewards were paid out — all despite the pandemic. 

Carter Center scientists, technical assistants, and other personnel were able to do their research and field work safely by carefully following strict COVID-19 protocols — getting vaccinated, wearing masks, maintaining social distance, frequently washing hands, and isolating when appropriate. Despite the ubiquity of the delta and omicron variants, the Guinea worm eradication campaign was never disrupted, as demonstrated by the number of public health surveillance reports, which remained at par with the previous years. 

This is significant, because the parasite never rests. It lurks in stagnant water sources, an ever-present threat to some of the world’s poorest and most vulnerable people, but not to those in more developed places, where safe water is a given. January 30 was the third annual World Neglected Tropical Diseases Day, focused on addressing the inequities that characterize NTDs, including Guinea worm. The Guinea Worm Eradication Program is working hard to rectify one of those inequities — and getting closer to the goal all the time. One day, we hope soon, this disease of poverty will be no more.   

*All case numbers are provisional until certified, typically in March.


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