FORMER PRESIDENT CARTER ON ERADICATING GUINEA WORM DISEASE: EXCLUSIVE INTERVIEW by MARISHA WOJCIECHOWSKA-SHIBUYA: 19/12/2008 (MaximsNews Network)

UNITED NATIONS - / MaximsNews Network / 19 December 2008 --The world is on the eve of eradicating Guinea worm disease (dracunculiasis), an extraordinarily debilitating disease which has endured in the waters of poor nations where scores of people suffer the excruciating pain of worms up to 1-meter-long slowly emerging from blisters in their skin, commonly on their legs and other extremities. 

Contracted from stagnant, contaminated waters in developing nations, the disease is prevented by filtering the water prior to consumption or by using a mild larvicide that is safe for humans. 

From approximately 3.5 million cases in 1986 in 20 countries in Africa and Asia, fewer than 5,000 cases were reported in 2008 in six countries of Africa. This will be the first disease to be eradicated since smallpox and the first parasitic disease to be eradicated. 

Moreover, Guinea worm disease is not tackled through some vaccine necessitating fantastic research efforts, but through behavioral change promoted with health education and low-technology measures. 

The significance of this accomplishment is beyond measure, since not only will a cause of excruciating suffering vanish from the face of the Earth, but also this success provides much-needed evidence that water-related diseases can be tackled and overcome, with the right mix of commitment, human ingenuity, partnerships and resources. The eradication of Guinea worm disease will also have an important impact on agricultural productivity and school attendance in endemic areas. 

Since 1986, The Carter Center has led the international coalition for the eradication of Guinea worm disease, with former President Jimmy Carter (39^th President of the United States) and former First Lady Rosalynn Carter personally committed to see this through.

Marisha Wojciechowska-Shibuya: As we are on the verge of seeing Guinea worm disease eradicated from Earth, and knowing that it is being accomplished out of sheer human will, it seems crucial to dissect the path that has led to this. What did it take to get here?

President Carter: For more than two decades The Carter Center has spear-headed the international campaign to eradicate Guinea worm, which includes dozens of partners such as the World Health Organization, UNICEF, the U.S. Centers for Disease Control and Prevention, the private sector, the nongovernmental sector, and the governments of endemic countries. The campaign has invested an estimated US$225 million in endemic African communities to end this debilitating parasitic infection. Financial and international support have been critical; however, the successful eradication of Guinea worm will be achieved mainly through the hard work and dedication of the endemic communities themselves. Despite enduring some of the most extreme poverty and isolation in the world, people in these communities are transforming their lives forever through simple tools like health education. 

M.W.-S.: When do you expect Guinea worm disease to be eradicated?

President Carter: During the 2004 World Health Assembly, the ministries of health from endemic countries set a target date calling for Guinea worm eradication in Sudan by 2009, but noted that all other countries were expected to stop disease transmission well before then. In 2008, we have six remaining endemic countries— Sudan, Ghana, Mali, Ethiopia, Niger, and Nigeria —but the vast majority of cases are concentrated in Sudan, Ghana, and Mali. All endemic countries have made great progress in the past two years. Fewer than 5,000 cases have been reported in 2008, and we believe Nigeria and Niger already may have reported their last cases. As we near the end of Guinea worm disease, Sudan is of particular interest to global eradication efforts because certain endemic areas only have been accessible to health workers since the peace accord was signed in 2005.

M.W.-S.: Can the Guinea worm eradication success be replicated for other diseases?  If so, what are the main ingredients to successfully tackling other such ills (from a social point of view, not the technical)?

President Carter: One of the most important lessons we have learned so far from this campaign has been the potential power of health education. Before, it was thought you only could have an effective eradication campaign by using a vaccine, as with smallpox, and later polio. Guinea worm eradication relies primarily on health education.

We've learned about the power of village volunteers, particularly women, to effect real change in their communities. For example, in Ghana, more than 6,000 women Red Cross volunteers are serving as the eyes and ears of endemic communities by reporting cases and helping to conduct health education and disease prevention.  

M.W.-S.: What role does political leadership and public policy play in a success story such as the Guinea worm one?

President Carter: Political leadership in the fight against Guinea worm disease is absolutely critical. When we started the campaign, I was fortunate that my position as a former U.S. president gave me access to the leaders of endemic nations. We were able to convince leaders and decision makers that the eradication of Guinea worm disease would be an important investment in their nation’s public health.

The Guinea worm eradication efforts also have benefited from African leaders who have adopted the cause of Guinea worm disease and committed their time and influence to stopping Guinea worm in their homelands and regions—people like former Nigeria Head of State General Yakubu Gowon and Mali President Amadou Touré.

M.W.-S.: What can be done to bring us to the end of transmission of Guinea worm disease?

President Carter: The last cases of Guinea worm will be the most difficult and expensive to eliminate. Although victims become few and far between, entire countries still must be monitored closely to prevent outbreaks and setbacks. And because Guinea worm has a one-year incubation period, the cost of maintaining surveillance is high. Now more than ever, it is vital that endemic nations remain dedicated to their goal of elimination, and we will be there to support them in their efforts.

To help finish the job, the Guinea worm eradication campaign recently received renewed funding from the United Kingdom Department for International Development and a matching grant from the Bill & Melinda Gates Foundation. The matching grant allows anyone (from an individual donor to a government) to contribute to Guinea worm eradication and have their donation effectively doubled. We hope that people will see this as an opportunity to support endemic communities and be a part of history.

- by Marisha Wojciechowska-Shibuya is MaximsNewsWATER Senior International Editor.

Labels: United Nations, U.N., MaximsNews, MaximsNews WATER, MaximsNewsWATER, water, President Jimmy Carter, The Carter Center, Guinea worm disease, water-related disease, unsafe water, drinking water, Africa, eradication, Gates Foundation, DFID, WHO, UNICEF, CDC, health education, Marisha Wojciechowska-Shibuya, international development, environment, water news, water sustainability, water resource, water management, global water crisis, sustainable development 

 

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