Fighting Disease:  Mali

Guinea Worm Eradication Program

Current Status:  Endemic
Indigenous cases reported in 2011: 12

For the most current 2012 Guinea worm case reports, read the Guinea Worm Wrap-Up newsletter >

Dracunculiasis, or Guinea worm disease, is a preventable parasitic infection contracted when a person ingests drinking water from stagnant sources containing copepods (commonly referred to as water fleas) that harbor infective Guinea worm larvae. Inside a person's body, the larvae grow for a year, becoming thin threadlike worms up to 1 meter long. These worms create agonizingly painful blisters in the skin through which they slowly exit the body, preventing the victim from attending school, caring for children, or harvesting crops. Learn more about the historic Carter Center-led campaign to eradicate Guinea worm disease >

In 1991, The Carter Center began working in conjunction with the Ministry of Health to eradicate Guinea worm disease in Mali.  Since then, the Mali Guinea Worm Eradication Program has reduced Guinea worm disease from 16,024 cases in 1991 to 12 cases reported in 2011. As of 2011, Mali was the second most endemic country remaining in the world, following Sudan.

Guinea worm prevention activities implemented in Mali's communities include: education on proper use of and distribution of nylon filters to strain out the water fleas hosting the infected larvae; monthly treatments of stagnant ponds with ABATE® larvicide (donated by BASF Corporation); direct advocacy with water organizations; and increased efforts to build safer hand-dug wells. Village volunteers, who are trained, supplied, and supervised by the program, carry out monthly surveillance and interventions.

In 2003, in conjunction with the U.S. Peace Corps, The Carter Center and the Mali Guinea Worm Eradication Program conducted the first in what has become a series of "Worm Weeks," five days of intensive health education in the three endemic districts of Gao, Ansongo, and Gourma Rharous. In 2005, Mali experienced an 85 percent increase in cases compared with 2004 – a constant reminder that Guinea worm eradication efforts must be maintained. Later that year, President Toumani Toure visited the country's most endemic region, Gao, to discuss appropriate measures to further eradication efforts. As a result of his meeting with politicians and health officials, he announced the transfer of program personnel to Mopti, more central to the country's endemic areas.

While the program in the south has successfully reduced Guinea worm disease, the majority of cases of the disease remain in the north where migratory communities travel. In Mali, as in other nations, migratory people often are some of the most marginalized. It is important that these people and other migrant populations are given the necessary tools to prevent the disease from traveling with them.

To improve surveillance of nomadic populations living in Guinea-worm-endemic areas, 32 supervisory zones were created and are covered by an equal number of supervisors who visit endemic camps by motorcycle or camel. Sociological and epidemiological studies have identified that more than 90 percent of cases reported from Mali are among Black Tauregs, a nomadic group.

Such vital information has allowed the program to better direct their health education messages and prevention measures. Living in difficult conditions in Mali's vast desert, the Taureg groups must migrate seasonally for their livelihood. Nomadic people like the Taureg do not consistently gather their water from a permanent water source but move in search of fertile pasture for their animals to graze.

Young men and boys who tend to their camels and goats, and women and children who harvest wild grains away from the camps, bear additional risks because they often are out in the field drinking from numerous water sources. The program is encouraging the use of pipe filters and developing alternative ways to provide health education to reach these groups. Guinea worm pipe filters – hard plastic straws with a stainless steel mesh inserted at one end – are used to filter out the microscopic water fleas from the water, thus preventing people from contracting Guinea worm disease.

So far, Mali has made vast improvements in surveillance and currently is implementing strategies to contain cases within 24 hours of detection at health centers. All regions, endemic or nonendemic, must report cases immediately to stop spread of the disease. It is vital for Mali to continue this kind of attention to detail, as well as it is critical for the nation to further invigorate efforts to prevent Guinea worm disease.

Until Mali completely eliminates the disease, it will continue to put neighboring Mauritania, Cote d'Ivoire, Burkina Faso, and Niger at risk for importing the disease. Mali has the resources, skill, and necessary support to eliminate this disease. The dedication of village volunteers must be paired with the political will of the national program to make Guinea worm eradication a priority at every level. Guinea worm eradication is a national issue.

Learn more about the Carter Center's Guinea Worm Eradication Program in Mali (in search result format) >