Tropical Medicine Programs

of the

Carter Center


Guinea Worm Eradication Program


Guinea worm disease is set to become only the second disease to be wiped off the face of the earth. The "fiery serpent," as it is commonly called throughout the world, has been around for centuries. It's even been found in 3,000-year-old Egyptian mummies. The numbers afflicted by this debilitating disease have been reduced worldwide by 98 percent, from 3.2 million cases in 1986 to less than 100,000 in 2001. Guinea worm will be the second disease to be eliminated from the world (after smallpox) and the first disease to be overcome without "magic-bullet" vaccines and medications.

The Carter Center began its fight against Guinea worm in Pakistan and Ghana in 1987. Today, the Center leads the effort worldwide. Much of the Center's work is concentrated in countries with the heaviest burden of disease: Sudan, Nigeria, and Ghana, where 91 percent of the 60,000 cases remaining are located.

Guinea worm is a painful and debilitating disease whose effects reach beyond a single victim, crippling agricultural production and school attendance, for example. A child suffers and is unable to attend school. Or his parent suffers, unable to harvest crops or attend to younger children. The village suffers a food shortfall when its people are unable to work. During one year in the mid-1980s in southeastern Nigeria, rice farmers lost $20 million (U.S.) due to outbreaks of Guinea worm.

Guinea worm is contracted when stagnant water, contaminated with microscopic fleas carrying infective larvae, is consumed. Inside a human's abdomen, the larvae mature and grow, some as long as three feet. After a year, the worm slowly emerges through an agonizingly painful blister in the skin.

Some worms can take up to two months to be completely expunged. The burning sensation caused by the emerging worm leads many victims to immerse their limbs in water, seeking relief, but the cycle of infection only begins again as the worm releases more larvae into the water.

Preventing Guinea worm seems simple: don't enter the water with an
emerging Guinea worm and don't drink unfiltered water
. But the challenge lays in educating villagers to always filter their water and ensuring they have the necessary filters to do so. Teaching these practices can come in conflict with traditional beliefs; for example, some villagers believe Guinea worm is the result of sorcery. Carter Center staff help train local health workers to use educational materials to explain the cause of Guinea worm and to treat those who are infected. They also treat stagnant ponds with monthly larvacide treatments.

How many supplies are needed to treat Guinea worm in 5,000 villages?

6,000 forceps
6,000 scissors
30,000 tablets of painkiller
6,000 plastic bags
6,000 gauze pads

The Carter Center helps to provide the essential ingredients for a successful eradication campaign--political will, financial support, and technical expertise. Our partners in the fight against Guinea worm help make our work possible. The government of Japan provides funding, water wells and vehicles, while the Japan Overseas Cooperation Volunteers provide hands-on support. Major assistance is also being provided by the U.S. Peace Corps volunteers. There are also numerous ongoing corporate and private donors. E.I. du Pont de Nemours & Company and Precision Fabrics Group have given filter cloth valued at more than $14 million; BASF has provided the larvicide Abate, valued at more than $2 million; Johnson & Johnson has donated enough medical supplies-like Tylenol®, forceps and gauze-to treat more than 3,000 villages; Hydro Polymers has provided 9 million pipes to provide personal water filters; and the Gates Foundation has given generous funding.



River Blindness Program