Dracunculiasis Eradication: The Final Inch

Abstract

This report summarizes the status of the Dracunculiasis Eradication Program as of early 2005. Nine of the 20 countries that were endemic for this disease when the program began have already interrupted transmission, Asia is free of Guinea worm, and five of the remaining disease-endemic countries reported less than 50 cases each in 2004. Ghana and Sudan each reported 45% of the 16,026 cases in 2004. Except for Sudan, whose reports are delayed, cases in the remaining disease-endemic countries were reduced by 61% during the first quarter of 2005 compared with the same period of 2004. With accelerating momentum towards zero cases in all countries, the recent settlement of Sudan's north-south civil war, and a new challenge grant from the Bill & Melinda Gates Foundation, the way now seems clear to finish eradicating dracunculiasis by 2009 in Sudan and earlier elsewhere. "The rule of the final inch... The work has been almost completed, the goal almost attained... In that moment of fatigue and self-satisfaction it is especially tempting to leave the work without having attained the apex of quality... In fact, the rule of the Final Inch consists in this: not to shirk this crucial work. Not to postpone it... And not to mind the time spent on it, knowing that one's purpose lies... in the attainment of perfection."--Alexander Solzhenitzyn, The First Circle.

Use of surveillance in disease eradication efforts: PART 2: Lessons learned in Guinea worm disease (dracunculiasis) eradication

“…Despite this conflict, there was a 95% reduction in reported cases of Guinea worm disease (GWD) in the 10 Southern states, from 118 587 in 1996 to 5585 in 2005 (Figure 3.2.1). Despite this dramatic decline in cases, as of 2006, Southern Sudan had over 45% of the world's GWD cases [1]. Therefore, the newly formed Ministry of Health (MOH) established the Southern Sudan Guinea Worm Eradication Program (SSGWEP) with the goal of interrupting transmission by 2009 [2].…”

Dracunculiasis: Is the Medical Staff a Symbol of the Past?

“…Elsewhere it has remained primarily unchecked [2]. Apart for a few remote villages in the Rajastan desert of India and in Yemen, the Guinea worm is now found only in sub-Saharan Africa above the equator.…”

“…It is slowly being eliminated and has disappeared or been considerably reduced in many nations [2]. One estimate [2] suggests that it will be eradicated by 2009, assuming it is possible to follow the current schedule of work to remove it. Much of the eradication is through the efforts of Bill Gates and former US President Jimmy Carter, who have set-up a worldwide programme for this purpose.…”

“…Working to eliminate the symbol of the medical staff, one could say. The Carter Center for Health Programs, with funding from the Bill and Melinda Gates Foundation, has made great advances in eradication of this disease in underdeveloped nations [2,3].…”

“…Apart for a few remote villages in the Rajastan desert of India and in Yemen, the Guinea worm is now found only in sub-Saharan Africa above the equator. Currently there are programmes being undertaken to eliminate the Guinea worm, along with another major world diseasepolio [2].…”