Global Health Policy
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March 26, 2006
The Defeat of Guinea Worm
Posted by Owen Barder at 08:04 PM
The New York Times today describes the progress being made in the defeat of Guinea worm.
Now, thanks to a relentless 20-year campaign led by former President Jimmy Carter, Guinea worm is poised to become the first disease since smallpox to be pushed into oblivion. Fewer than 12,000 cases were found last year, down from 3 million in 1986.Mr. Carter persuaded world leaders, philanthropists and companies to care about an obscure and revolting disease and help him fight it. His foundation mobilized volunteers in tens of thousands of villages to treat the drinking water the worms live in.
The story is told in more detail in Millions Saved by my colleague Ruth Levine. The study finds that eradication efforts have led to a 99 percent drop in guinea work prevalence. The total cost of the program has been less than $100 million - an estimated cost per case of $5- $8. The economic rate of return based on agricultural productivity alone has been estimated at 29 percent.
We do not have a vaccine against guinea worm, and yet we are close to complete eradication of the disease. The success demonstrates that is is possible affordably and sustainably to control (and largely eliminate) a disease through a program to promote substantial changes in behavior.
The fight against guinea worm represents one of the most successful international collaborations, whose success hinged on the steady, long term commitment of donors, national governments, and the public health community, combined with the steadfast political leadership of President Carter of the US, General Toumani Toure of Mali, and General Yakubu Gowon of Nigeria.
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Comments
I worked as a Carter Center technical advisor the Guinea Worm Eradication Program in South Sudan in 2005. The success of the global eradication campaign has been impressive, but in many ways the greatest challenge still lies ahead.
For an international campaign that was set to be completed some 10 years ago, the risks of donor fatigue and loss of political support remain high. As President Carter notes in this article, the cost of eliminating the final cases of Guinea worm disease is high, compared to the cost per case when the disease was more prevalent.
In Millions Saved, Ruth Levine articulates the Elements of Success, one of which is political leadership. I hope President Carter and the Carter Center can garner enough political and financial support to keep the campaign moving full steam ahead. It’s time to finish off this ancient, painful, and economically destructive parasite.
Posted by: Conor Hartman at March 28, 2006 01:02 PM