The Global Water Crisis and Guinea Worm Disease

By Jimmy Carter

This contribution is part of the 2006 Human Development Report, published by the United Nations Development Program.

It is distressing to see a child's future threatened or diminished by preventable disease. The rights to health services and to safe, clean, affordable water are fundamental to a life of dignity and are protected by international law. Yet millions of people die of water-related diseases annually, and millions more suffer needlessly. None of us should turn a blind eye to the shocking consequences of inadequate access to clean water and to sanitation set out in this report.

The scale of the problem in water and sanitation poses a daunting challenge, but one we can overcome. Just a few generations ago, people living in the great cities of America and Europe were facing grave public health threats as a result of unclean water and poor sanitation. At the end of the 19th Century, those threats were addressed through concerted political action at a national level. At the start of the 21st Century we need to extend the leadership that made progress possible in today's rich countries to the global stage.

My colleagues at The Carter Center and I are working to eradicate Guinea worm disease (dracunculiasis) and control trachoma, two horrible afflictions that can be prevented by providing access to clean water, sanitation, and health services.

As recently as 50 years ago, trachoma, which is the world's leading cause of preventable blindness, still affected parts of the United States, including my home town of Plains, Georgia. Though today we know how to avoid such diseases, more than 1.4 million children still die each year from intestinal parasites, and millions of people throughout the developing world continue to suffer from trachoma. But there has been progress.

Guinea worm, a parasitic water-borne disease, is poised to be the first disease to be eradicated without a vaccine or treatment. The presence of Guinea worm disease in a geographic area indicates abject poverty, including the absence of safe drinking water. The disease is so painful and debilitating that its effects reach far beyond a single victim, crippling agricultural production and reducing school attendance. It devastates already impoverished communities and further prevents them from achieving good health and economic prosperity.

Guinea worm became the second disease in history to be targeted for eradication following the inauguration of the International Drinking Water Supply and Sanitation Decade (1981-1990). In 1986, The Carter Center, the Centers for Disease Control and Prevention, UNICEF, the World Health Organization, and the countries plagued by Guinea worm embraced the challenge of eradicating it.

When the program began, there were approximately 3.5 million cases, crippling millions of people in 20 countries in Africa and Asia. Since then, Guinea worm disease has been reduced by more than 99.7 percent. In 2005, only 10,674 cases of dracunculiasis were reported in nine countries – all in Africa. Today, coalition partners, in collaboration with thousands of dedicated community health workers, continue to intensify efforts as we fight the last fraction of 1 percent of Guinea worm disease.

As an active participant in the Guinea worm campaign, my primary objective is the eradication of this terrible scourge. Our progress toward this goal gives me confidence that together we can eliminate this disease within my lifetime.

More must be done to eradicate Guinea worm, but the larger task is to provide safe drinking water and sanitation to all. Halving the number of people who lack water and sanitation by 2015 as envisaged under the Millennium Development Goals is the first step. Failure to achieve that target would setback the entire MDG project. Without progress in water and sanitation, we cannot accelerate social progress in other areas, such as child survival, access to education, and the reduction of extreme poverty.

It is fitting that as we approach the eradication of Guinea worm disease another major international effort is underway to provide safe water and sanitation to 1.1 billion people and adequate sanitation to 2.5 billon people. These noble efforts will help alleviate the greatest challenge of our time-to bridge the widening chasm between the rich and the poor in our world.

Jimmy Carter
39th President of the United States
Founder, The Carter Center
Nobel Peace Prize Laureate 2002