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 created by the American Museum of Natural History 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.

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