Jimmy Carter, who has died at the age of 100, helped save millions from the debilitating Guinea worm.

Jimmy Carter, who died at age 100, saved millions from Guinea worm

Written by Charles Schmidt Edited by Tanya Lewis

Former President Jimmy Carter first encountered people suffering from Guinea worm disease while visiting a village in Ghana in the late 1980s. This tropical disease involves infection by a parasite that eventually emerges from the human skin. The 39th President of the United States was shocked by the plight of people infected with the parasite. “Once you see a small child with a live Guinea worm two or three feet long sticking out of his body through the skin, you’ll never forget it…” he later said. I wrote. “In just a few minutes, [former first lady] Rosalyn and I saw over 100 victims, including people who had bugs coming out of their ankles, knees, groin, legs, arms, and other body parts. ”

Mr. Carter passed away on Sunday, December 29th in Plains, Georgia. enter hospice care His efforts to eradicate this terrible disease have improved the lives and well-being of many of the world’s poorest people. The number of Guinea worm occurrences was average. 3.5 million annually When Carter first toured Ghana, he was attracting attention around the world. But mainly thanks to their efforts, Carter Centera nongovernmental organization (NGO) founded by former president and former first lady Rosalynn Carter, who passed away in November 2023, has nearly eradicated the disease. monitoring data Sharon Roy and Vitaliano Cama, scientists at the U.S. Centers for Disease Control and Prevention who collaborate with the Carter Center, estimate that the number of global infections in 2022 will be just 13, spread across Chad, Ethiopia, South Sudan and the Central African Republic. They say it’s a person. If the number of infected people decreases to zero, Guinea worm will be the only one infected. Second disease in human history It should be eradicated (after smallpox). These efforts are thanks to Carter’s “bold vision, leadership, and ability to generate the political will to help eradicate Guinea worm in affected countries,” Cama said.

The Carter Center began eradicating Guinea worm in 1986, five years after Carter left office, shortly after the World Health Organization (WHO) made it a target for global eradication. The disease is spread by drinking stagnant water infested with tiny fleas called copepods, which contain Guinea worm larvae. Fleas die in the human intestine, but Guinea worms survive unaffected by stomach acid and begin mating. Over the course of a year, the pregnant female worm develops into an adult worm and migrates toward the host’s skin. A blister quickly forms, and when it ruptures, the bugs begin to crawl out of the body. To relieve the burning pain caused by this, infected people often soak the affected area in water. In some cases, they may be immersed in the same pond or lake where others are drinking water. Once submerged, the worms respond by releasing eggs, and the hatched larvae are eaten by copepods and a new parasitic life cycle begins.

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There is no vaccine or treatment for Guinea worm disease, and people cannot develop immunity to it. The traditional strategy for removing emerging bugs was to wrap them around a stick and pull them a few inches a day. It is important not to pull the worm out too quickly, as the debris inside its body can cause a secondary infection if it breaks apart. However, the best defense is prevention.

To move toward eradication, the Carter Center organized NGOs, national health ministries, and donors around one overarching goal: providing clean drinking water to affected villages. Several simple interventions have proven to be highly effective. Village-based volunteers and supervising medical staff have built protective walls around wells and other water sources to prevent people from entering and spreading new infections. The Carter Center supplied villages with fine cloth to strain fleas from drinking water and personal filter straws. The stagnant water was treated with an insecticide called Temephos (which the WHO considers acceptable for use in drinking water), and rumored infections were tracked and investigated.

Over time, more and more countries joined this effort. Meanwhile, former President Carter “meeted privately with leaders of countries where the Guinea worm is endemic,” said Kashef Ijaz, deputy director of health programs at the Carter Center. In 1995, Carter completed a four-month “Guinea worm ceasefireDuring the Sudanese civil war. The cessation of fighting has allowed health workers to distribute 200,000 cloth filters to impoverished areas, along with vaccines and treatments for other diseases such as river blindness, measles and polio.

“Guinea worm eradication programs may be the only point of contact between local populations and any kind of public health system,” says Jordan Schermerhorn, a global health expert based in Austin, Texas. Schermerhorn spent more than a year in 2016 and 2017 as a technical advisor for the Carter Center in southern Chad, where he often travels by motorcycle to remote areas where people live in mud huts on barren land. . She and her colleagues visited each village in their jurisdiction about once a week to check for new cases and educate people on how to protect themselves from infection.

By this point, the eradication program had been a huge success. In 2016, only 25 human cases were recorded worldwide. But the program also faces new challenges. Scientists once thought that Guinea worm only infected humans, but now they are discovering it in other species as well. . the insects First discovered in dogs, then cats and baboons. More recent evidence suggests that frogs and fish may also carry the bug, but it is not clear whether these animals transmit the bug. In response, Carter Center staff urged villagers to report and tether infected dogs and to avoid eating undercooked fish. They hypothesize that these are the routes by which most people and animals are infected today.

Matthew Boyce, assistant professor of health policy and management at Texas A&M University, said it’s unclear whether Guinea worm is expanding its range or whether its findings in other animals simply reflect expanded disease surveillance. He says it’s unclear. “This may be a classic case of ‘the more you look, the more you find,'” he says. There is still no conclusive evidence that these animals can transmit the disease in the absence of a human host, which may make it difficult to completely eradicate them. Despite this, WHO has extended the target date for Guinea worm disease eradication from 2020 to 2030. Carter said at a 2015 press conference that he hoped the last of the Guinea worms would die before he died. Although that did not happen, Ijaz believes eradication remains an achievable goal. “The last mile is the hardest,” he says. “We must remain dedicated and more focused than ever.”