Chicago — Guinea worm disease and river blindness are among 17 tropical diseases the World Health Organization considers neglected. Thanks to the efforts of the Atlanta-based Carter Center - founded by former president Jimmy Carter and his wife Rosalynn - focused treatment and prevention are leading to the elimination of one, and the extinction of another.
When Carter and the Carter Center staff started working to eradicate Guinea Worm disease in 1986, it was found in 21 countries in Africa and Asia.
"We had three-and-a-half million cases of guinea worm, and village by village we have done away with it. Last year, we only had 146 cases in the whole world," he said.
Most of the remaining infections by the parasitic worm are found in South Sudan, where Carter said, despite the recent unrest, the Carter Center continues working to prevent transmission of the disease by monitoring and filtering water sources.
"At this moment we have about 212 people on our payroll, almost all of whom have been trained locally, and about 8,000 women who volunteer their services," he said.
Eliminating river blindness
Elsewhere in Africa, the Carter Center has shifted its focus from controlling river blindness - another parasitic infection - to eliminating it.
While river blindness can't be eradicated like Guinea worm, the Carter Center discovered that by modifying the dosage of the antibiotic ivermectin, the disease could be eliminated in the human body.
"If we gave two to four pills a year, then the adult worms that created the microfilaria would be eliminated. We found that out in Latin America, in six countries, we could completely do away with river blindness permanently. Now we've tried that in Africa and found it to be successful again," said Carter.
The World Health Organization reports about 18 million people worldwide suffer from river blindness, 99 percent of them in Africa.
"It can be so itchy that these patients can itch their skin so much that part of their skin goes white. And then there's a huge stigma still in some parts of Africa associating some parts of skin going white with leprosy," said Dr. Aisha Sethi, an assistant professor of infectious diseases at the University of Chicago Medical Center. She said river blindness, which is the second leading cause of preventable blindness by infection, hurts both people and the economy.
"You see the more people that are poor, and are sick, you are losing the working capacity of that country. You are losing money that families are making towards treatment of that person," she said.
Sethi is originally from Pakistan, one of the first countries where the Carter Center eradicated Guinea Worm. As she works on a field manual about neglected tropical diseases she hopes to publish in a few years, one uncertainty about the book is how to represent Guinea Worm.
"I don't know if we'll have guinea worm in there other than as a historic perspective. Maybe by the time the book comes out we might be down to zero cases," she said.
Zero cases is the goal of the Carter Center and an achievement that former president Carter, who turns 90 in October, is confident he will witness in his lifetime.