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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
Received May 5, 2005. Accepted for publication May 13, 2005.
Acknowledgments: We gratefully acknowledge the assistance of Renn McClintic-Doyle and Shandal Sullivan in preparing this manuscript. We also acknowledge the contributions of the national coordinators, village-based volunteers, other health workers in the disease-endemic countries, and other staff of The Carter Center and the WHO Collaborating Center for Research, Training, and Eradication of Dracunculiasis at CDC, without whose efforts these achievements would not have been possible. We publish this paper in memory of Dr. Robert L. Kaiser.
Financial support: In 2005, The Carter Center’s work to eradicate guinea worm is made possible by financial and in-kind contributions from the Bill & Melinda Gates Foundation, the Conrad N. Hilton Foundation, the Canadian International Development Agency, the AG Leventis Foundation, the United States Agency for International Development, CDC, the Organization of the Petroleum Exporting Countries Fund, the Salus Mundi Foundation, Vestergaard Frandsen, BASF Corporation, Mr. and Mrs. Michael D. Ranne, C. M. Gayle, Jr., Dr. W. A. Baldwin, and the governments of Japan, Kuwait, Norway, Oman, and Saudi Arabia.
* Address correspondence to Donald R. Hopkins, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307. E-mail: sdsulli{at}emory.edu
Authors’ addresses: Donald R. Hopkins, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Telephone: 404-420-3837, Fax: 404-874-5515, E-mail: sdsulli{at}emory.edu. Ernesto Ruiz-Tiben, Guinea Worm Eradication Program, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Telephone: 770-488-4509, Fax: 770-488-4532, E-mail: exr1{at}cdc.gov. Philip Downs, Guinea Worm Eradication Program, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Telephone: 770-488-4507, Fax: 770-488-4532, E-mail: pid9{at}cdc.gov. P. Craig Withers, Jr., Program Support Health Programs, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307, Telephone: 404-420-3851, Fax: 404-874-5515, E-mail: cwither{at}emory.edu. James H. Maguire, University of Maryland School of Medicine, 660 West Redwood Street, Howard Hall, Suite 100, Room 102B, Baltimore, MD 21201, Telephone: 410-706-0206, Fax: 410-706-8013, E-mail: jmaguire{at}epi.umaryland.edu
Reprint requests: Donald R. Hopkins, The Carter Center, 453 Freedom Parkway, Atlanta, GA 30307.
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