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Eradication Program

Global Eradication Campaign

Criteria for Eradication

WHA targeted GWD for eradication because it met specific criteria:

  • It is biologically and technically possible to eradicate this disease[2, 5, 6, 7].
    • There is no chance for the disease to return after the last human case occurs.
    • GWD is easily diagnosed because of its signs and symptoms. Few diseases can be confused with GWD and the public in affected communities know and recognizes the worm.
    • In each affected country the worms emerge from the skin during certain predicable times of the year.
    • GWD was previously eliminated from parts of the Former Soviet Union during the 1920s and from endemic areas of Iran in the 1970s.
  • The benefits of eradication outweighed the costs[2, 5, 6, 8].
    • The World Bank assessed the socio-economic impact of GWD in 1997. It concluded that the costs for GWD eradication and morbidity reduction would be significantly less than the continued costs of the disease.
    • Other direct benefits of eradication would include:
      • The development of a group of trained health workers who could provide both GWD management and other basic health services
      • Improvements in water supplies
        • Water no longer contaminated with Guinea worm
        • Enhanced advocacy for new safe water sources
    • The global community would indirectly benefit from the enhanced culture of disease prevention and social equity afforded by this disease eradication program. Countries and organizations supporting GWD eradication would be helping to reduce the suffering of some of the world’s most underprivileged people.

Criteria for Certification of GWD Eradication

  • Adequate active surveillance systems have confirmed the absence of GWD for 3 or more years.
  • A rumor log of suspected cases has been maintained for a 3-year period detailing:
    • The particulars of each case
    • The origin of each case
    • The final diagnosis of each case (i.e., a true case of GWD or some other condition?).
  • All confirmed cases imported from endemic countries have been traced to their origins and have been fully contained.

Moving Forward with GWD Eradication

Extracting a Guinea worm from the ankle by wrapping it around a stick. Photo credit: WHO Collaborating Center at CDC archives.

  1. Hopkins, D.R., et al., Dracunculiasis eradication: neglected no longer. Am J Trop Med Hyg, 2008. 79(4): p. 474-9.
  2. Ruiz-Tiben, E. and D.R. Hopkins, Dracunculiasis (Guinea worm disease) eradication. Adv Parasitol, 2006. 61: p. 275-309.
  3. Hopkins DR, et al., Update: Progress Toward Global Eradication of Dracunculiasis, January 2007-June 2008. MMWR, 2008.Oct 31;57(43):1173-6.
  4. Watts, S.J., Dracunculiasis in Africa in 1986: its geographic extent, incidence, and at-risk population. Am J Trop Med Hyg, 1987. 37(1): p. 119-25.
  5. Aylward, B., et al., When is a disease eradicable? 100 years of lessons learned. Am J Public Health, 2000. 90(10): p. 1515-20.
  6. Molyneux, D.H., D.R. Hopkins, and N. Zagaria, Disease eradication, elimination and control: the need for accurate and consistent usage. Trends Parasitol, 2004. 20(8): p. 347-51.
  7. Hopkins, D. and E.M. Hopkins, Guinea Worm: The End in Sight, in Medical and Health Annual, E. Bernstein ed. 1991, Encyclopedia Britanica Inc.: Chicago.
  8. Greenaway, C., Dracunculiasis (guinea worm disease). CMAJ, 2004. 170(4): p. 495-500.
  9. World Health Organization, Criteria for the Certification of Dracunculiasis Eradication, in WHO/FIL/96.187 Rev.1.
  10. WHO Collaborating Center for Research Training and Eradication of Dracunculiasis, Guinea Worm Wrap Up #232, 2015, Centers for Disease Control and Prevention (CGH): Atlanta.