How Jimmy Carter Saved Millions of Lives

Jimmy Carter celebrated his 96th birthday on October 1, 2020. This article celebrates one of Carter’s greatest achievements — one that was made after he left politics and does not get the attention it deserves.

In 1986, Carter declared war on a disease called dracunculiasis, which is caused by an insidious parasite known as the Guinea worm. The Guinea worm once threatened millions of people, especially children, in twenty-one countries in Africa and Asia.

People become infected when they drink water contaminated with water fleas (copepods) carrying Guinea worm larvae in their bellies. The person’s stomach acid digests the body of the fleas, releasing the worm larvae. The unfortunate victim will soon experience a living nightmare, the likes of which is usually found in the pages of a Stephen King novel.

Once in the gut, the Guinea worm larvae drill through the intestinal wall, and are now free to mate and roam around the body. After maturing for about a year, the adult Guinea worm is ready to make a dramatic exit. It does so by migrating to the surface of the skin, usually making its appearance in a lesion on the leg or foot.

The good news is — as horrible as it sounds — dracunculiasis is not lethal. The bad news is that the worm cannot be yanked out like a slippery spaghetti noodle. It must be painstakingly extracted bit by bit over a long period of time, being wound around gauze or a stick. Complete extraction of the Guinea worm can take weeks.

Photo: The Carter Center/L. Gubb

If that weren’t bad enough, the worm also causes a distressing burning sensation at the exit site. This makes the unfortunate victim want to soak the infected limb in the village’s water supply. When the worm contacts the water, it releases its larvae, which go on to infect copepods and perpetuate the worm’s life cycle.

The problem in many of the afflicted areas is that the drinking water often comes from the same source that serves as a bath, laundry, and toilet. For the Guinea worm, this makes for an extremely successful mode of transmission — more than 3.5 million people a year were getting infected in the mid-1980s. In addition to the pain and suffering, the Guinea worm causes significant economical losses in these already impoverished nations.

Photo: The Carter Center/L. Gubb

Despite the large number of people affected, the Guinea worm disease remained neglected for a very long time. As it is restricted to largely impoverished nations, there are few fiscal resources to mount research aimed at developing drugs for treatment or prevention. But Carter and his colleagues figured that if they could stop transmission, they could stop this worm.

With remarkable efficiency and just a few hundred million dollars (far less than the economic damage the worm causes), Carter’s organization was able to educate would-be victims about the worm and how it is spread. Through simple hygienic measures that many take for granted, such as filtering the drinking water, treating water with insecticides that kill copepods, and reporting infections, Carter and his organization achieved one of the greatest global health victories of our time. In 2018, only 28 cases of Guinea Worm disease were reported.

Photo: The Carter Center/L. Gubb

In 1980, smallpox became the first disease to be eradicated by humanity. Thanks to Carter’s efforts, Guinea worm disease is poised to become the second. Carter would also make history as being instrumental in eliminating the first disease without the use of a vaccine or drug — compassion and education make all the difference in the world.

Bill Sullivan is the author of “Pleased to Meet Me: Genes, Germs, and the Curious Forces That Make Us Who We Are” (National Geographic Books).

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