South Sudan

Current status: Endemic 

Since 1986, The Carter Center has led the international campaign to eradicate Guinea worm disease, working extensively in South Sudan where the disease is endemic. 

Our approach includes: 

• Deploying surveillance teams to track every case 

• Distributing water filters and providing health education 

• Supporting case containment and treatment centers 

• Training local health workers and volunteers 

The worms that infect animals are the same species (Dracunculus medinensis) as those that infect humans; therefore, eradication requires stopping infections in both.

Impacts 
South Sudan has seen dramatic reductions in Guinea worm cases from tens of thousands in the 1990s to approaching zero today. This achievement demonstrates that even in conflict-affected regions, sustained public health efforts can succeed with community engagement and dedicated local workers. 

The latest information about South Sudan and Guinea worm disease can be found in our news section.

In 2024, The Carter Center, in collaboration with South Sudan’s Ministry of Health, launched support for the elimination of lymphatic filariasis as part of the Reaching the Last Mile Fund’s expansion across Africa and Yemen. 

Mapping conducted in 2018–2019 found lymphatic filariasis present in 50 of South Sudan’s 79 counties.  

Our Work

Mass administration of the drugs Mectizan® (donated by Merck & Co. Inc.) and albendazole (donated by GSK) was implemented in all 50 counties.

The Carter Center’s River Blindness Elimination Program works to eliminate this debilitating disease in South Sudan through community-based drug distribution and health education. 

Our approach includes: 

• Training community drug distributors 
• Distributing Mectizan® (donated by Merck & Co. Inc.) 
• Supporting integrated disease surveillance 
• Building local health care capacity

Impacts 
By training local health workers and establishing sustainable distribution systems, we’re building health care infrastructure that benefits communities beyond a single disease. 

Since 2000, The Carter Center has partnered with the Ministry of Health to support trachoma control in South Sudan, which has some of the highest trachoma rates globally — with children as young as age 5 requiring surgery to prevent blindness.  

Our Work 

Our integrated approach addresses immediate medical needs and underlying conditions that spread disease. We work in partnership with the health ministry to implement the SAFE strategy, endorsed by the World Health Organization, which includes: 

• Surgery to reverse in-turned lashes caused by advanced trachoma, helping people at immediate risk of blindness 
• Antibiotics to treat active infections and reduce transmission 
• Facial cleanliness and improved hygiene to prevent the spreading of bacteria 
• Environmental efforts to improve access to clean water and basic sanitation to reduce the fly population 

Impacts 

• We’ve assisted with more than 14,500 sight-saving surgeries. 
• We’ve helped distribute more than 5.2 million doses of Zithromax® (azithromycin, donated by Pfizer Inc.) to control trachoma. 

The Carter Center provided comprehensive public health training to strengthen South Sudan’s health care workforce and build long-term capacity for disease control. 

Our approach included: 

• Training local health workers in disease surveillance 
• Building capacity for community-based interventions 
• Developing context-specific educational materials 
• Supporting integration of health services 

Impacts

Through decades of partnership, we trained thousands of community health workers who deliver essential services even in conflict-affected areas.  

Our training created a health care infrastructure designed to outlast individual disease programs, empowering South Sudanese to lead their own health initiatives and reach isolated communities that would otherwise lack access to care. 

From 1986 to 1992, The Carter Center worked in Sudan — including what is now South Sudan — to improve agricultural productivity and food security for small-scale farming families. 

Led by Nobel Peace Prize winner Norman Borlaug, the program provided training to farmers in sustainable practices and introduced improved grain varieties.  

Impacts 

Our agricultural program increased grain crop yields for thousands of farming families, providing a foundation for improved nutrition and food security.  

It also demonstrated how increased food production supports overall community well-being.  

Though this specific program concluded in 1992, its lessons continue to inform our integrated approach to health and development in South Sudan. 

“Looking to the Future: Peace is in Sight” was a collaboration between the Trachoma Control and Conflict Resolution programs.

In 2024, The Carter Center worked on a project to incorporate peace elements in Center-supported eye surgical camps and mass drug administration campaigns.

This project wrapped up in 2025.

 To help address unresolved tensions, following South Sudan’s 2011 independence, the Center facilitated dialogues between community members and civil society leaders. These efforts took place between 2013 and 2014.

The Carter Center pioneered the integration of health initiatives with peacebuilding through the landmark 1995 “Guinea worm ceasefire” in Sudan. 

Our approach included: 

• Negotiating six-month humanitarian ceasefires for health access 

• Combining disease surveillance with peace monitoring 

• Using health workers as bridge-builders across conflict lines 

• Creating neutral spaces for both sides to collaborate on health issues 

Impacts 
The Guinea worm ceasefire provided unprecedented access to war-torn areas, allowing not just Guinea worm treatment but also polio vaccinations, measles immunizations, and vitamin A distribution.  

This innovative approach demonstrated how health initiatives can create common ground in conflict zones, with health workers earning trust from all sides and establishing frameworks for broader cooperation. 

We observed two landmark electoral processes that shaped South Sudan’s path to independence: Sudan’s national elections in 2010 and the 2011 independence referendum. 

We deployed large teams of observers for both elections. The independence referendum election was led by President Carter and became one of our largest observation missions ever. We deployed several teams of long-term election observers to monitor processes like voter registration, and around 140 observers were in the country for the referendum vote.

More information about both of these elections is available in our publications section. 

Starting in 1986, The Carter Center persisted in peacebuilding efforts through Sudan and South Sudan’s complex cycles of conflict and fragile agreements. 
 

Our Work 

Our approach included: 

• Negotiating the 1999 Nairobi Agreement 

• Facilitating dialogue across political divisions 

• Supporting grassroots reconciliation 

• Maintaining neutral space for negotiations 

Impacts 
Our diplomatic work contributed to several milestones, including the 2005 Comprehensive Peace Agreement and the 2011 independence referendum.