Former President Jimmy Carter may be on the brink of celebrating the birthday wish he made last year: the global eradication of Guinea worm disease. This year, there are only two confirmed cases, compared to 3.5 million a year in the 1980s. It's a medical milestone that took a nearly 30-year effort by the Carter Center and its partners.
Carter spoke to NPR's Robert Siegel about the fight against Guinea worm. An edited version of the interview follows.
You must be gratified to see Guinea worm almost gone.
Well, it is very pleasing for me.
How did you first become aware of this disease, and what moved you to spend so many years supporting efforts to eradicate it?
My czar of drugs, Dr. Peter Bourne, became the assistant secretary general of the U.N. and they put him in charge of a "Decade of Water." And he came down to the Carter Center to give us a report on diseases caused by impure water. He talked about Guinea worm, and I decided at that time, since no one else was addressing the disease, that the Carter Center should take this on as a major responsibility. So we began to consult with the Centers for Disease Control — Dr. Don Hopkins was there — and eventually he came over to the Carter Center to take charge of the program. And later became in charge of all of our health programs.
Why has it taken 30 years to make this progress?
We had 203,600 villages that we had to contact and teach each one of them how to [filter their water and avoid going in water to ease the pain when a Guinea worm emerges]. And that's what's taking 30 years.
Guinea worm would be one of the many diseases that remind us how problematic humanity's relationship to water can be.
It's getting more serious every year because the population is increasing and the streams [that] provide drinking water for people are now shrinking up. So with smaller streams and more people, the competition for water is going to get increasingly more intense in years to come.
And when we speak of eradication of Guinea worms: Is there a possibility that there could be a recurrence of this disease?
Once a particular water hole — which has to be stagnant water — has Guinea worm [gone], the only way it can be revived in that particular area is for someone with Guinea worm coming out of their body to wade out into the water and let more eggs to be planted. So we've never had a case when we've completely eradicated from the village of Guinea worm recurring unless some stranger comes from a distant place and [contaminates] the water with Guinea worm. But the villagers know to keep people out of the water. And once they do that the Guinea worm is gone forever.
I've learned that river blindness is next on your hit list. Where does that effort stand?
We've taken up the task of eliminating river blindness in individual countries or entire sections of the world. We've shifted from controlling the disease to eliminating it completely. And we're making very good progress on that.
Speaking of health, you're doing OK?
I'm feeling fine. I'm doing quite well. We're checking very carefully to see if the brain cancer comes back and so far there's no sign of it. I just want to get rid of the last case of Guinea worm during my lifetime, that's what I want to do.
Well, with the number of cases this year, it's looking very good.
It does look good so far.