Dracunculiasis (Guinea-worm) eradication

WHO exhorts dracunculiasis-endemic countries to achieve interruption of transmission by 2015

Biggest challenge: insecurity and access to endemic areas
21 May 2014 | Geneva
Steadfast resolve: preparing to write off guinea-worm disease

The atmosphere was that of optimism. A sense of jubilation pervaded the rather official setting of Room XXII at the Palais des Nations in Geneva.

I’ve never seen an informal dracunculiasis meeting which is so packed,” said Dr Alhousseini Maiga, Regional Advisor for dracunculiasis eradication in Africa and focal point for neglected tropical diseases in West Africa, who retires from WHO this year after 25 years.

The poster outside the meeting room set the tone.

It portrays a child seemingly anticipating the demise of guinea-worm disease. The poster’s message – “Zero transmission in 2015” – echoes the target of WHO’s NTD roadmap to rid the world of this disease. The slogan sums up the setting: “Historic Opportunity, New Challenges, Steadfast resolve”.

This year’s informal meeting had something special: the presence of WHO’s Regional Director for Africa, Dr Luís Gomes Sambo, and WHO’s Director-General, Dr Margaret Chan.

Their message: ministers of health of the 4 remaining endemic countries should actively support their teams by personally advocating for the eradication programme and strengthen the resolve to defeat the disease.

The packed room listened to Ministers of Health and delegations about the progress achieved and the challenges ahead. The Ethiopian Minister of Health and the State Minister of Health for Eastern Equatoria in South Sudan spoke of their personal commitment and have personally visited endemic areas in their respective countries.

Countries recently certified free of transmission that share a border with those where transmission is still ongoing spoke of how surveillance is being maintained to prevent any reintroduction of infection.

Some of the countries where transmission is still occurring, like South Sudan spoke of a historic drop in the number of cases, the need to provide safe drinking-water to rural populations and the importance of better roads to enable health teams to access endemic areas.

Mali reiterated its commitment to interrupting transmission; Chad promised to do everything to implement case-containment measures; Ethiopia pledged thorough monitoring and surveillance, after reporting zero cases for the past 6 months; while Pakistan, which eradicated dracunculiasis in 1993, shared how its programme became one of the first countries certified free of the disease.

With 148 cases reported to WHO in 2013 and 11 from January to April this year, one could feel the anticipation of hearing the announcement of “interruption of transmission” of this age-old affliction.

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