Guinea worm disease may soon become the second human disease to be eradicated, following smallpox. The stunning decline in annual human cases of this painful parasitic infection—from 3.5 million in 1986 to 10 in 2025—is the result of an eradication campaign led by former U.S. President Jimmy Carter, his team at The Carter Center, and their partners around the globe. With no treatment, vaccine, or diagnostic to fight the disease, some believed it would be impossible to eradicate. But campaigners succeeded through boots-on-the-ground public health work in countries including Ethiopia, Ghana, and South Sudan, tracking down cases and empowering communities to stop the spread.
The Carter Center screened a documentary about the campaign, The President and the Dragon, at Harvard T.H. Chan School of Public Health on March 3. Featured in the documentary are “Guinea worm warriors” including Harvard Chan School alumnus Donald Hopkins, along with people who have been afflicted by the disease. The event, which was hosted by the Harvard Chan School Studio, also included a panel discussion with the Carter Center’s Sarah Yerian and Emily Staub, and Rochelle Walensky, former director of the Centers for Disease Control and Prevention, and a Carter Center board member.
Stopping a dragon with a straw
Guinea worm disease, or dracunculiasis (little dragon), is contracted by consuming stagnant water contaminated with the parasite’s larvae. Over the course of a one-year incubation period, the Guinea worm grows up to three feet long, before slowly emerging through a painful blister. If sufferers attempt to relieve the burning sensation they feel by submerging themselves in water, the worm releases more larvae, continuing the cycle. Encouraging people to change their behavior has been key to the eradication campaign. Attendees at the event received filter straws, which are passed out in remote communities and conflict zones to enable people to drink water safely.
Sarah Yerian, Rochelle Walensky, and Emily Staub. Kent Dayton / Harvard Chan School
“Public health often goes unseen,” Jorge Chavarro, dean of academic affairs and professor of epidemiology and nutrition, said in opening remarks at the event. Success in public health is measured by epidemics and disasters prevented, he said. But the Guinea worm eradication effort is “an extraordinary example of public health success that is visibly changing people’s lives.”
Yerian said that she hopes the film will help the campaign make the final push towards full eradication. “Ten cases is not zero,” she said. “It means that there is still an opportunity for the parasite to continue its life cycle and for the number of cases to go up every year.”
Walensky said that while there needs to be political will to finish the job, that doesn’t just come from politicians. It also comes from regular people like the Guinea worm warriors still out in the field and the children Walensky met who demonstrated how to use filter straws, she said.
Now that there are so few human cases, current research is focusing on how to eliminate Guinea worm disease in animals. Yerian noted that infections in stray dogs in Chad—which has had the highest number of animal cases—have gone down considerably in recent years.
Staub, who worked on the documentary, said that it reflected the Carter Center’s willingness to take on seemingly impossible goals. Yerian highlighted the “daily acts of courage” shown in the film, such as health workers who are willing to walk for hours through difficult terrain to try to track down and document every reported case of Guinea worm disease.
Walensky said that the work of the eradication campaign can be a source of inspiration at a difficult time for public health. “By mobilizing incredible communities and people [we can] do all the things people said couldn’t happen.”
About The Author
Amy Roeder
Senior Editor, Harvard Chan Magazine; Senior Writer in the Office of Communications
