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Guinea Worm Disease
“[I want the] last guinea worm to die before I do.” Jimmy Carter may soon get his wish. The former President of the United States has spent the last 30+ years on a number of humanitarian missions through his namesake nonprofit—The Carter Center—but people may undoubtedly see one particular mission as ranking among its magna opera. That mission is to eradicate Guinea worm disease (GWD), and frankly, those worms are unpleasant at best.

What is Guinea Worm Disease?

GWD is a parasitic infection in which extremely small worms enter the human body through contaminated water, leading to crippling, painful blisters about a year later when the matured female worm emerges. It has been infecting people since ancient times, and in the mid-1980s, an estimated 3.5 million cases existed across at least 20 countries, including 17 in Africa. In 2019, however, there were only 54 cases in humans.

Success in Reducing GWD

This is thanks largely to the efforts of The Carter Center, in partnership with the World Health Organization (WHO) and UNICEF. This partnership has been leading the charge against the disease both in introducing preventative measures in hotspots on the ground in Africa and by raising awareness in the developed world since 1986. Since no vaccine or other modern treatment exists for Guinea worm disease, The Carter Center’s strategies most often include working with health ministries and community-based volunteer groups in order to stop the spread of GWD and bring attention to it via health education.

The attention is important because of the rapid ability of the disease to spread. One missed case can lead to 80+ new infections over one year and delay a country’s ability to control the disease for just as long. This is partly why the WHO has strict criteria when assessing the disease in a given area.

When Can One Consider a Country Free of GWD?

A country must have zero new cases for at least three years for it to receive a declaration of being free of GWD. Despite the rigorous criteria, some countries continue to encounter problems confronting the disease. Chad, for example, has reported almost 2,000 infections in dogs in 2019—a testament to the disease’s stealth and endurance over the years.

In fact, “years” may be an understatement—GWD has emerged in Medieval Middle Eastern and Ancient Egyptian texts under a variety of labels, with some Egyptian mummies even showing evidence of the worm’s presence in their remains. The Old Testament even refers to it as a ‘fiery serpent’ (citing the on-fire feeling when the creature emerges through the skin).

The Correlation Between GWD and Sanitation

In more recent years, the disease received highlight in the early ‘80s as an international threat to clean water—which is where the fight to eliminate the disease originated. Even today, GWD exists primarily in countries—notably Chad and Ethiopia—that consistently rank among the poorest in the world (and are thus most lacking in access to clean water).

The Carter Center has sought to combat this shortfall as well, specifically by introducing a straw-like pipe filter that allows people in affected countries to drink from any water source without fear of contamination.

The eradication of the disease would mean the end of widespread, debilitating illness across several predominantly African nations. Although the fight has gone on for decades, the organizations working to eliminate it now say that the end is in sight. Even Jimmy Carter made his wish—that GWD would go before him—as he was battling cancer a few years ago.

Now, the eradication of all diseases of this sort will be the target of the U.S.’s End Neglected Tropical Diseases Act, which entered into law earlier in 2020. The goal of the act is to facilitate and coordinate an effective, research-based international effort to end neglected tropical diseases, such as GWD, with special emphasis on impoverished nations.

If the world meets international goals, GWD would become the second human disease (behind smallpox) and the first parasitic disease to experience eradication. It would also be the first disease to disappear without the use of a vaccine or medicine.

– Bardia Memar
Photo: Flickr