New push on Guinea worm disease

Former US President Jimmy Carter and his wife, Rosalynn, are scheduled to attend an international conference on the eradication of Guinea worm disease in the Sudanese capital, Khartoum, in early March, to push anew for a combined effort to make the disease the second to be eradicated worldwide, after smallpox. Sudan has the single highest health burden from Guinea worm disease in the world and poses "the final great challenge to Guinea worm eradication", according to the Carter Center, jointly founded by Jimmy and Rosalynn Carter in 1981 in an effort to address the root causes of suffering, spread democratic governance, and resolve and prevent conflict. "The Sudan civil war is now the single largest obstacle to achieving eradication" of Guinea worm disease, the Carter Center reported on Monday. The organisation is co-sponsoring the 4-7 March meeting in Khartoum, which will bring together leaders of the Guinea worm eradication effort in Africa, with the government of Sudan, the World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF). The Guinea worm is a parasite that gives rise, through contaminated water, to a disease - sometimes known as dracunculiasis or "the fiery serpent" - which causes intense pain, leaving its victims unable to work, attend school, care for children or harvest crops. Sudan reported more than 54,000 cases in 2000, representing almost three-quarters of all reported cases in the world, after worldwide incidence had been reduced from 3.2 million cases in 1986 to fewer than 75,000 in 2000, according to the Carter Center. The areas with the highest recorded incidences were Western and Southern Kordofan in west and south-central Sudan, and southern Blue Nile, White Nile and Sinnar in east-central Sudan. Last year, there were an estimated 49,000-plus reported cases in almost 4,000 Sudanese villages, though the continuing civil war prevented health workers from getting complete reports on the incidence of the disease or educating people on how to prevent it, the Center reported. Twelve other African countries reported an estimated total of 14,000 cases in 2001. Through the Sudan Guinea Worm Pipe Filter Project, the Carter Center and partner agencies last year began a campaign to distribute nine million water pipe filters in Sudan - one for every man, women and child at risk. Systematic filtering of drinking water derived from shallow unprotected wells, from surface water, well heads or pumps is all that is needed to filter out the minute crustacean cyclops which continue the cycle of disease, according to the WHO. "Through an international coalition, 98 percent of all Guinea worm [Disease] cases have been eliminated, but serious challenges remain," according to Jimmy Carter. "We need financial support, political will and diplomatic backing so that affected countries can finish the job as quickly as possible." Using low-technology methods and knowledge gained for eradication efforts, the poorest of the poor in Sudan and elsewhere now have the tools to help themselves and achieve results, said Dr Ernesto Ruiz-Tiben of the Center's Global 2000 Guinea worm eradication programme. However, peace and stability were also "essential to the eradication effort", he added. Sudanese Foreign Minister Mustafa Uthman Isma'il told a press briefing in the Kenyan capital, Nairobi, earlier this month that progress had been made between the government and the US peace envoy, John Danforth, on establishing zones and times of tranquillity to allow for mass immunisations and the eradication of other diseases, including Guinea worm disease. The United States Agency for International Development (USAID) had reported in its situation report on Sudan in January that US proposals related to tranquillity periods to facilitate the eradication of Guinea worm disease had not yet been approved by Khartoum. Carter is to speak at the opening ceremony of the 4-7 March meeting in Khartoum, while Sudanese President Umar Hasan al-Bashir is scheduled to preside over the opening ceremony. In addition to the Guinea worm disease campaign, the Carter Center is involved in efforts to tackle river blindness (onchocerciasis), the world's leading cause of infectious blindness, spread by the black-fly vector in fertile riverside areas; and trachoma, caused by the bacterium Chlamydia trachomatis, where repeated infections (easily spread from person to person or by flies that are attracted to faces and runny noses) can cause scarring that leads to blindness. Of some 120 million people worldwide who are at risk of river blindness, 96 percent are in Africa, according to the WHO. Meanwhile, some 540 million people are at risk of contracting trachoma if the disease is not controlled, and the disease is prevalent in remote areas of poverty, overcrowding and poor hygiene, particularly where clean water and health care are scarce - as they are in many parts of Sudan, and Africa generally. On the diplomatic front, the Center has been involved with the governments of Sudan and Uganda on the implementation of the 1999 Nairobi Agreement, which it helped to broker, and which has already helped improve relations between the two countries by addressing issues of mutual concern and arranging for the common exchange of envoys. Harking back to Guinea worm disease, its eradication would "set a precedent for wiping out other preventable diseases, such as polio, measles, river blindness and lymphatic filariasis," according to Dr Donald Hopkins of the Carter Center.