Contact: Emily Staub, The Carter Center, Emily.Staub@emory.edu, +1-404-420-5126
NEW YORK…The Carter Center announced today that 126 Guinea worm cases were reported worldwide in 2014. These provisional numbers, reported by ministries of health in the remaining four endemic nations and compiled by the Center, show that cases of the debilitating disease were reduced by 15 percent in 2014 compared to 148 cases in 2013. When the Center began leading the first international campaign to eradicate a parasitic disease in 1986, there were an estimated 3.5 million Guinea worm cases occurring annually in Africa and Asia.
"The number of cases of Guinea worm disease continued decreasing in 2014, bringing Guinea worm eradication closer to the finish line," said former U.S. President Jimmy Carter, whose Carter Center leads the international campaign to eradicate this waterborne disease. "We believe eradication of Guinea worm disease is very possible in the next few years, but success will require the strong commitment and focus of the four remaining endemic countries and the many international partners in this public health initiative."
President Carter reported the latest Guinea worm numbers during a New York press conference to open Countdown to Zero: Defeating Disease, a new exhibition on disease eradication at the American Museum of Natural History created in collaboration with The Carter Center (see editor's note).
In 1991, there were 23,735 villages with endemic transmission of Guinea worm disease in 21 countries in Africa and Asia. As of the end of 2014, there were only 30 endemic villages in four countries — all in Africa.
South Sudan, the world's youngest nation, reported 70 cases, or 56 percent of the worldwide case total in 2014. Most of those cases were in Eastern Equatoria state. The remaining indigenous cases in 2014 were reported in isolated areas of Chad (13), Mali (40), and Ethiopia (3).
Considered a neglected tropical disease, Guinea worm disease (dracunculiasis) is contracted when people consume water contaminated with Guinea worm larvae. After a year, a meter-long worm slowly emerges from the body through a painful blister in the skin. In the absence of a vaccine or medical treatment, the ancient disease is being wiped out mainly through community-based interventions to educate and change behavior, such as teaching people to filter all drinking water and preventing contamination by keeping anyone with an emerging worm from entering water sources.
The Carter Center, together with ministries of health, local communities, and other partners, has reduced cases by more than 99.99 percent since 1986. The Center estimates that the eradication campaign has averted more than 80 million cases among the world's poorest and most neglected people. Guinea worm disease is positioned to be the second human disease, after smallpox, to be eradicated. It will be the first parasitic disease to be eradicated and the first disease to be eradicated without the use of a vaccine or medicine.
Remaining Guinea Worm Countries
"Recognizing that the final cases of any eradication campaign are the most challenging and most expensive to eliminate, the potential for disease eradication to permanently improve quality of life worldwide is tremendous," said eradication expert Dr. Donald Hopkins, Carter Center vice president for health programs.
The South Sudan Guinea Worm Eradication Program reported 70 cases January-December 2014 compared to 113 cases for the same period in 2013, a reduction of 38 percent. This was a remarkable success in light of political and ethnic hostilities that broke out in December 2013 and spilled over into early 2014. Even given circumstances of unrest and an isolated outbreak (accounting for the majority of South Sudan's 2014 cases), the program continued to function at a high level by reducing and containing cases.
"We've seen similar small outbreaks like this just before the end of transmission in other countries, such as Ghana, Nigeria, and Pakistan, and each of these countries have since successfully wiped out Guinea worm disease," said Dr. Hopkins.
Since 2006, the overall number of Guinea worm cases in South Sudan has been reduced by 99 percent. While this number represents great relative success, continued efforts towards improved peace and stability will be vital in maintaining the levels of surveillance and supervision necessary to reach the ultimate goal of eradication.
The Gambella region of Ethiopia remains as the nation's only Guinea worm-endemic area. In 2014, the federal ministry revamped the national Guinea Worm Eradication Program and expanded the network of villages under active surveillance (62 to 173). With only 3 reported cases in 2014, Ethiopia is positioned to stop transmission by the end of 2015.
In Chad, the program expanded health education and continued to investigate the unusual epidemiology of its Guinea worm cases in 2014, and the government is preparing additional control measures to address remaining transmission.
In Mali, insecurity that began in April 2012 continues to delay interruption of Guinea worm disease transmission because the national program has not been able to operate fully and consistently in all of its Guinea worm-endemic regions. In 2014, the program was partially operational in three regions and only slightly operational in one region due to insecurity. However, the program expanded the number of villages under active surveillance (85 to 391).
Steps to Eradication
The Carter Center leads the international Guinea worm eradication campaign and works in close partnership with national programs, the World Health Organization (WHO), U.S. Centers for Disease Control and Prevention (CDC), UNICEF, and many other partners. The Carter Center provides technical and financial assistance to national Guinea worm eradication programs to interrupt transmission of the disease. When transmission is interrupted, the Center provides continued assistance in developing or strengthening surveillance in Guinea worm-free areas and preparing nations for official certification. CDC provides technical assistance and verifies that worms from these final patients are truly Guinea worms. The presence of Guinea worm disease in a geographic area indicates abject poverty, including the absence of safe drinking water; UNICEF mainly assists countries by helping to provide safe sources of drinking water to priority areas identified by the national Guinea worm eradication programs. The WHO is responsible for certifying countries as Guinea worm-free, and is the only organization that can officially certify the eradication of a disease.
For a disease to be eradicated, every country must be certified, even if transmission has never taken place there.
Many generous foundations, corporations, governments, and individuals have made the Carter Center's work to eradicate Guinea worm disease possible, including major support from the Bill & Melinda Gates Foundation; the United Kingdom's Department for International Development (DFID); Children's Investment Fund Foundation (CIFF) - United Kingdom; and His Highness General Sheikh Mohamed bin Zayed Al Nahyan, Crown Prince of Abu Dhabi, in the name of His Highness Sheikh Khalifa bin Zayed, President of the United Arab Emirates (UAE). The DuPont Corporation and Precision Fabrics Group donated nylon filter cloth early in the campaign; Vestergaard donated pipe and household cloth filters in recent years. ABATE® larvicide (temephos) has been donated for many years by BASF. Key implementing partners include the ministries of health in endemic countries, The Carter Center, WHO, CDC, and UNICEF.
Editor's Note: Countdown to Zero: Defeating Disease, a new exhibition about scientific and social innovations that are ridding the world of ancient afflictions, will open at the American Museum of Natural History in New York City on Jan. 13, 2015. The exhibition, created by the Museum in collaboration with The Carter Center, focuses on several global efforts that have been able to contain, eliminate, or eradicate disease; chief among the featured diseases is the 30-year campaign to wipe out Guinea worm. Countdown to Zero is proudly supported by Clarke Public Health Mosquito Control, Conrad N. Hilton Foundation, Lions Clubs International Foundation, Mectizan Donation Program, and Vestergaard.
"Waging Peace. Fighting Disease. Building Hope."
A not-for-profit, nongovernmental organization, The Carter Center has helped to improve life for people in over 80 countries by resolving conflicts; advancing democracy, human rights, and economic opportunity; preventing diseases; and improving mental health care. The Carter Center was founded in 1982 by former U.S. President Jimmy Carter and former First Lady Rosalynn Carter, in partnership with Emory University, to advance peace and health worldwide.