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Amal, 17, pushes a wheelbarrow with a jerry can of untreated water from a tap on the outskirts of Juba, South Sudan, on March 17, 2017. "I don't have to walk to the river any more, which means I have more time to study, but the water is still dirty, and I worry about my younger siblings getting sick when they drink it," says Amal, who fetches water every day.
Photo by Phil Hatcher-Moore/UNICEF
Health

The UN's Deadline to Eradicate Guinea Worm Was Just Pushed Back by a Decade


Why Global Citizens Should Care
Global Goal 3 has set a target of combating water-bourne and other communicable diseases by 2030. The elimination of Guinea worm will be an indicator of improved health outcomes, particularly as this disease impacts people living in poverty who do not have access to clean water. You can join us in taking action on this issue and more here.

The World Health Organization has pushed its deadline back for eradicating Guinea worm by a decade, from 2020 to 2030. 

“We are being realistic and down to earth,” Dieudonné Sankara, who heads the World Health Organization’s (WHO) eradication effort, told Nature.

The eradication deadline has been pushed back several times, from 1991 initially, to 2009, then to 2015, and finally 2020, before the most recent 2030 goal. 

An editorial published by the independent medical journal The Lancet earlier this year wrote about the moving target, suggesting the 2020 deadline may not be realistic given the new cases of the disease. 

“The added challenges and complexities now facing the [disease eradication] program suggest that this aim is, at best, many years away. At worst, it is simply a pipe dream.”

If eradicated, Guinea worm would become the second human disease in history to be eradicated, after smallpox. 

Guinea worm disease (dracunculiasis) is a parasitic infection that is contracted when people consume water from sources contaminated with Guinea worm larvae, according to UNICEF. The Guinea worm larvae mate and female worms mature and grow inside a person’s abdomen. After about a year, the female worm grows to about three feet long and emerges from the body through painful lesions — an excruciating process which can take weeks. In addition, the skin lesions often develop secondary bacterial infections.

In order to relieve themselves from the burning sensation, people infected with the parasite sometimes immerse themselves in water, which then infects the water source, and increases the likelihood of infection for others who use the same water source. In low-income countries, where bodies of water are used for bathing, washing clothes, and even drinking, there are increased risks of infection. 

The disease is incredibly painful and incapacitates people for extended periods of time. There is no vaccine to protect oneself against it nor any medication to treat it. 


According to the Carter Center, which has led the initiative to eradicate Guinea worm, the infection rate is down by 99.99%. In the 1980s, over 3.5 million people annually would contract the disease, mostly in Africa and Asia. It has been eliminated in 17 countries. In 2018, there were only 28 cases of Guinea worm — all in Africa (Angola, Chad, Ethiopia, Mali, and South Sudan).

Even still, the challenge to eradicate it completely persists, mostly because in recent years, Guinea worm has been found in animals. In 2018, there were 1,040 dogs and 25 cats infected with the disease in Chad in addition to animal cases found in South Sudan, Ethiopia, and Mali. 

The WHO has in part pushed the elimination goal back by a decade because of these cases. Joel Breman, an infectious disease researcher and the president of the American Society of Tropical Medicine and Hygiene, told NPR: "We redefined eradication as elimination of transmission in animals as well as in humans. We're not exactly sure when the last dog or other animal will give up their worms. So that means there will be this delay."

Breman said scientists are looking to better understand how the disease spreads between people and animals. He also said eradication may happen before the new 2030 goal. 

"What we're doing here is under promising and hoping we can overachieve," he said.

For a disease to be declared eradicated, every country in the world must be certified free of human and animal infection by the WHO. According to the Carter Center, 199 countries have been certified and seven have not.

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