
Former President Jimmy Carter, who passed away on December 29 at his home in Plains, Georgia, at the age of 100, leaves behind an extraordinary legacy in public health. Best known as the 39th president of the United States, Carter’s efforts through the Carter Center significantly improved the lives of millions by targeting the eradication of Guinea worm disease, a debilitating parasitic infection.
The Beginning of a Mission
Carter’s first encounter with Guinea worm disease was during a 1980s visit to villages in Ghana. Witnessing the agonizing suffering caused by the disease, Carter was deeply moved. “Once you’ve seen a small child with a two- or three-foot-long live Guinea worm protruding from her body, right through her skin, you never forget it,” he later wrote. At that time, an estimated 3.5 million people globally were afflicted annually.
In 1986, the Carter Center, founded by Jimmy and Rosalynn Carter, embarked on a mission to eradicate Guinea worm disease. Partnering with the World Health Organization (WHO), national health ministries, and NGOs, the center adopted a comprehensive approach to prevention and intervention.
How Guinea Worm Disease Spreads
The disease, caused by consuming stagnant water containing infected copepods (water fleas), leads to the development of adult worms that migrate under the skin. These worms eventually emerge, causing intense pain. Historically, treatment involved slowly extracting the worm by winding it around a stick. However, prevention became the cornerstone of eradication efforts.
Key Interventions
The Carter Center implemented simple yet effective strategies:
- Clean Drinking Water: Communities were provided with fine-mesh filters and straw filters to remove water fleas from drinking water.
- Water Source Protection: Wells were fortified to prevent contamination, and stagnant water was treated with larvicides.
- Surveillance and Education: Local volunteers tracked suspected cases and educated villagers on prevention.
In 1995, Carter brokered a “Guinea worm ceasefire” during Sudan’s civil war, allowing health workers to deliver supplies and interventions to affected regions.
Progress and Challenges
By 2022, Guinea worm disease cases had plummeted to just 13 globally, primarily in Chad, Ethiopia, South Sudan, and the Central African Republic. If eradicated, it would be only the second human disease, after smallpox, to be eradicated.
However, new challenges emerged as Guinea worms were found infecting animals such as dogs, cats, and baboons. The Carter Center adapted its efforts by encouraging villagers to report and tether infected animals and avoid consuming undercooked fish.
Jimmy Carter’s personal involvement, from meeting world leaders to advocating for resources, was instrumental in the program’s success. His commitment to eliminating Guinea worm disease underscored his broader mission to address poverty and inequity through health initiatives.