Although the Zika virus continues to make headlines, and reports of Ebola surface in West Africa from time to time (Liberia was declared Ebola-free for the fourth time yesterday), medical progress nobly soldiers on, quietly advancing in research laboratories and health clinics the world over.
One story of medical progress recently caught the attention of the world press: guinea worm may soon be eradicated. Yes, a parasite that has afflicted humans since the days of the pharaohs could itself be history in a matter of years—and few in the West have ever heard of it, let alone cheered on its eradication.
This is the way disease ends. Not with a bang but a whimper.
From more than 3 million cases of Guinea worm disease a year in the 1980s, the world tally in 2016 stands at just two confirmed cases.
Both are in Chad and are believed to have been contained before they had a chance to spread. (There are also two suspected cases, one in Chad and one in Ethiopia.)
If Guinea worm is pushed into extinction, then Guinea worm disease would be just the second human disease to be eradicated after smallpox.
It’s worth noting that while guinea worm is not fatal, it does cause a great deal of suffering. Over the course of a year, the worm grows up to three feet long in its human host, then tries to exit the body via the feet or the legs. If a health worker is nearby, the patient might be lucky enough to have the worm excised with a knife or coiled around a stick. But usually the tunneling worm creates a burning sensation so severe that it drives the person suffering to seek relief by plunging the afflicted leg in cooling water—which in turn allows the worm to unleash thousands of eggs in the water supply, leaving a new generation of guinea worms to find unwitting hosts.
Behavioral changes have been breaking this vicious cycle. In Ghana, guinea worm-free since 2010, some communities posted guards at water sources to ward off would-be leg-plungers. In South Sudan, the Carter Center has been distributing drinking straws to screen guinea worm eggs from water.
The success of these efforts points to an important observation about our times: medical progress is proceeding so quickly that focused, culture-specific, multi-year efforts can achieve staggering gains. HIV/AIDS, thanks in great part to President Bush’s PEPFAR initiative, is in retreat. Polio has been banished to all but a few remote villages in Afghanistan and Pakistan. And now we await the news that guinea worm will be eradicated—and with it a great deal of human suffering.
Governments have a role to play in accelerating and scaling medical progress, of course, but what is most remarkable about this story is the outsize feats of individuals and private organizations. Jimmy Carter has pursued the problem of guinea worm for three decades now, bringing to bear the same stubbornness that has not served him well in other circumstances—but it has been indispensable here. Carter evokes an evangelist’s manner in the fight against guinea worm, hitting everything from PBS to the late-night comedy shows to preach the good news about the parasite’s declining fortunes.
Likewise, The Bill and Melinda Gates Foundation has devoted millions to combating neglected tropical diseases, employing a quantitative approach that constantly evaluates what’s working and what isn’t. We shouldn’t expect former presidents and wonky philanthropists to solve all of the world’s problems, but we should applaud them, because sometimes they manage to succeed, and we’re all better off as a result.