Guinea worm disease is on track to be the second disease eradicated from the world, but there is still work left to be done.

Guinea worm disease, also known as dracunculiasis, is an infection caused by the parasite Dracunculus medinensis. Larvae of the parasite are found in water sources in sub-Saharan Africa, and they can contaminate drinking water. Once consumed, the parasite stays inside the infected individual for up to a year as it grows into a worm until it removes itself from the human host, leaving through the skin. 

When the worm emerges from the human, it causes a painful skin blister, possibly resulting in a fever or secondary infection. There have been cases of people becoming crippled by a Guinea worm infection. The worm needs to be pulled out from the human body, several centimeters per day, by winding it around some gauze or a small stick. 

In 1986, the Carter Center, the foundation of former president Jimmy Carter, began to lead the global campaign to eradicate Guinea worm disease. When the campaign started, there were 3.5 million cases of the disease in that one year. In 2021, there were only 15 reported human cases worldwide. This dramatic reduction of cases was the result of several carefully planned interventions.

The program to eradicate Guinea worm disease is community-based and relies on extensive villager volunteers. This approach respects the dignity of the people affected and builds trust between the community members and health professionals. The Carter Center aims to work with ministries of health to provide comprehensive health education and maintain political will.

Surveillance and supervision is instrumental in containing the spread of the disease. In the Gambella region of Ethiopia, village volunteers try to ascertain possible cases among their peers every week. When a suspected case is found, an investigation occurs. A lab test is needed to confirm a case of Guinea worm disease. The infected person’s demographics and symptoms are also tracked, as is information about the water sources that the person used. There are also community meetings to inform them of those infected. This is why gaining the trust of communities is so important. Community participation, especially in light of the stigma associated with the disease, is vital in containing the disease, and it all depends on trust.

As Guinea worm disease is waterborne and is contracted by drinking water contaminated with the larvae, interventions that involve treating water before it is drunk is essential. The Carter Center has distributed pipe filters to affected populations and taught them how to use them to prevent the new cases of the disease. In some places, the pesticide abate is applied to water sources to kill the larvae that cause Guinea worm disease. These interventions have drastically reduced the prevalence of Guinea worm disease, but the fight is not over yet.

While great progress has been made in eliminating Guinea worm disease in much of the world, some challenges have arisen. Civil unrest and political instability in some places where Guinea worm disease is prevalent have prevented efforts to combat the disease. Ethiopia, which had some of the highest rates of the disease, is mired in a civil war, making it hard to reach everyone affected by Guinea worm disease. Recently, cases of Guinea worm disease have also started to appear in animals. Today, most cases of Guinea worm disease occur in other animals, not humans. Complete eradication of Guinea worm disease cannot be completed until the world is free of the disease in both humans and animals.

To Get Involved

While the Carter Center is the leader in the drive to eradicate Guinea worm disease, there are also other partners and stakeholders in the campaign who can be supported through donations and volunteering. Among them include the ministries of health of affected countries, UNICEF, WHO, Ethiopian Public Health Institute and the UNHCR.

Bryan is currently a History and Global Affairs major at the University of Notre Dame. He aims to apply the notion of Integral Human Development as a framework for analyzing global issues. He enjoys hiking and visiting national parks.