According to an announcement last month, an old foe may be on the way to total defeat. Public-health specialists say that the parasite Dracunculus medinensis, or Guinea worm, has very nearly been eliminated, and is on the road to complete eradication. The parasite is transmitted in drinking water, and causes pain, fever, and nausea, and in the long term, sores on the skin—in which it is often visible—and arthritis and paralysis if treatment is not administered. The only treatment for guinea worm disease is drawing the three-foot-long worms to the surface of the skin and then pulling them out of the body.
In 1986, when the current eradication push began, there were 3.48 million cases primarily in 20 African countries. In 2013, there were just 148 cases in only four countries, a tremendous advance in less than 30 years. Three-quarters of those cases were in newly independent South Sudan, where the Carter Center, a non-governmental organization founded by former United States president Jimmy Carter to improve health in the Third World, has been focusing its efforts to defeat D. medinensis once and for all. In 2008, the Carter Center announced the forthcoming end of Guinea worm; that year, there were 4,647 cases, more than 30 times as many as currently.
Guinea worm eradication presents unique challenges. There is no vaccine, and no treatment other than complete removal. On the other hand, the parasite almost never returns to an area in which there are no infected humans. That means that while the painful removal process must be done for each infected person, one this is accomplished, the worm is definitively gone. The most recent national success story is Ghana, which has not had a reported case since 2010 and is in line to be certified by international agencies as Guinea worm-free.
In 2014, thus far, only two countries—South Sudan and Chad—have reported any cases at all of Guinea worm infestation. Most of the effort now is political. South Sudan has had internal conflicts since before independence, and Chad has be in the midst of civil war for over a decade. These conditions make it difficult for people to carry out humanitarian work, or to develop the infrastructure necessary to sustain that work.