Former President Jimmy Carter leaves behind many legacies, including the negotiation of the Camp David Accords that brought peace and diplomatic relations between Egypt and Israel, the integration of human rights considerations into American foreign policy and the virtual eradication of the wasting disease Guinea worm.
In 1986, Guinea worm affected 3.5 million people a year, mainly in low-income countries in the tropics. In 2022, thanks in large part to decades of Carter Center work, Guinea worm disease reached an all-time high in incidence: only 13 human cases were reported.
President Carter viewed the development of the poorest nations not only as a moral concern, but also as an imperative for achieving world peace. He understood perhaps better than any other American president that economic development in developing countries depends on establishing the conditions for a healthier society. Carter and his wife Rosalynn founded The Carter Center in partnership with Emory University on the principle of a fundamental commitment to human rights and the alleviation of human suffering caused by diseases such as Guinea worm.
Guinea worm disease (dracunculiasis) is usually contracted when people consume water contaminated with small crustaceans that eat guinea worm larvae. The larvae turn into parasites inside the human host. After about 12 months, a meter-long pregnant female worm emerges through a painful blister in an infected human, often somewhere on the person’s legs or feet. A victim may find temporary relief by soaking the affected limb in water. However, contact with water stimulates the worm to release its larvae and start the cycle over again. Guinea worm disease disables people for weeks or months, reducing their ability to care for themselves, work, grow food for their families, or attend school.
Guinea worm disease has no cure or vaccine. Essentially, the entire eradication effort relies on systematic behavior change, in addition to access to clean water supplies, better detection of human and animal cases, sterilization and dressing wounds, deterring infected people and animals from wading in water, and using larvicides to kill worms.
Only one human disease has been eradicated. It was smallpox, and in 1980 it was officially considered eradicated. For a disease to be declared eradicated, every country in the world must be certified free of human and animal infection, even in countries where transmission is not known. To date, the World Health Organization has certified 200 countries as Guinea worm free; only six have not yet been certified.
Neglected tropical diseases
For nearly four decades, The Carter Center has established itself as a world leader in the fight against the scourge of neglected tropical diseases (NTDs), including Guinea worm.
NTDs are a group of preventable and often treatable parasitic and bacterial diseases that impose devastating health, social and economic burdens on more than 1.7 billion of the world’s most vulnerable people, in developing regions of Africa, Asia and the Americas. NTDs cause disabilities and disfigurements, and some can be fatal. They create vicious cycles of poverty, costing developing countries billions of dollars in health care resources and lost productivity.
Diseases include, among others, onchocerciasis (river blindness), African trypanosomiasis, leishmaniasis, cholera, Chagas disease, dengue and Guinea worm. Diseases are said to be neglected if they are ignored and therefore underfunded by drug developers for lack of commercial prospects.
Peter Hotez and his colleagues coined the term “neglected tropical disease” more than 20 years ago. Hotez is a professor and dean of the National School of Tropical Medicine at Baylor College of Medicine. He is one of the world’s leading authorities on the subject of NTDs, having researched and written extensively on many NTDs. He called NTDs “the most important diseases you’ve never heard of”.
In addition to Guinea worm control, The Carter Center has funded numerous global public health programs targeting NTDs in more than 30 countries, including lymphatic filariasis, schistosomiasis, trachoma, soil-transmitted helminths, and blindness. rivers (onchocerciasis).
Nearly 30 years ago, The Carter Center began working to eliminate river blindness. River blindness (onchocerciasis) is a parasitic infection that can cause intense itching, skin discoloration, rashes, and eye disease that often leads to permanent blindness. The parasite is spread through the bites of infected black flies that breed in rivers. Eradicating river blindness requires both health education and mass drug administration based on therapeutic Mectizan (ivermectin), donated by Merck.
Together with Merck, The Carter Center has helped distribute more than 500 million courses of Mectizan in Africa and Latin America. His program has successfully eliminated river blindness in Colombia, Ecuador, Guatemala and Mexico.
Since 1986, The Carter Center has been a pioneer in the prevention, control, and elimination of NTDs. Not only have the Center’s efforts saved lives, they have also reduced or completely eliminated the burden of NTDs for tens of millions of people in developing countries. And thanks to the philanthropic actions of President Carter, the world has come very close to eliminating Guinea worm.