Mali

Current Status: Endemic

In 2003, in conjunction with the U.S. Peace Corps, the Center and the Mali Guinea Worm Eradication Program began offering intensive health education in the three endemic districts of Gao, Ansongo, and Gourma Rharous.

A military uprising in March 2012 forced the president out and created a leadership vacuum, allowing rebels to seize the three northern regions, the most endemic areas of the country. As a result of the turmoil, Mali’s Guinea Worm Eradication Program was rendered nonfunctional as program participants fled the fighting.

In 2013, after the French retook the areas, the Guinea worm program reestablished itself.

Our Work and Methods
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 that host the infective larvae
• Monthly treatments of stagnant ponds with ABATE® larvicide (donated by BASF)
• Voluntary isolation of patients in case containment centers
• Direct advocacy with water organizations
• Increased efforts to build safer hand-dug wells

Village volunteers, who are trained, equipped, and supervised by the program, carry out monthly surveillance and interventions.

Insecurity has impeded program activities since the coup in 2012. Mali’s Ministry of Health, as well as regional and local health leaders, held a workshop with community representatives to discuss local peace, conflict, and health issues in September 2020, assisted by us.

In recent years, a small number of Guinea worm infections have been detected in animals in Mali; we are working to determine their origin and prevent transmission to humans.

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

Impacts

Mali made vast improvements in surveillance and implementation of the strategies to contain Guinea worm cases within 24 hours of detection at health centers, which is imperative to stopping spread of the disease.

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

Current status: No longer a public health problem
Validation of elimination as a public health problem: April 27, 2023

Health surveys found that trachoma was a major health problem in almost all parts of Mali in 1996. About 10 million people were at risk of getting this disease. Around 85,000 people already had advanced trachoma, which requires surgery to prevent blindness. 

Responding to the emergency, Mali’s Programme National de Santé Oculaire (PNSO or National Eye Health Program) created the National Trachoma Control Program in 1998. 

That same year, the Center, with funding from the Conrad N. Hilton Foundation, committed to assisting Mali to eliminate trachoma as a public health problem.

Our Work and Methods

Mali used the World Health Organization -endorsed SAFE strategy: 

• 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 

Mali, with our help, conducted mass distribution of needed medications, provided surgeries to prevent blindness, trained masons to construct latrines, and broadcast health education messages in over 7,500 villages through radio and with the support of community health workers. 

Impacts 

In April 2023, the World Health Organization validated Mali as having eliminated trachoma as a public health problem, making Mali the 17th country to achieve this status. 

Led by the late Nobel Peace Prize winner Norman Borlaug, a joint venture between the Center and the Sasakawa Africa Association helped farmers in Mali improve agricultural production. The program was part of a larger initiative that helped over 8 million small-scale sub-Saharan African farmers in countries where malnutrition is a constant threat. 

Our Work and Methods 

The program provided farmers with credit for fertilizers and enhanced seeds to grow test plots, often yielding 200% to 400% more crops.  

Participating farmers went on to teach others, creating a ripple effect to stimulate self-sufficiency. 

This project ended in 2011.

We help Mali’s Ministry of Health fight neglected tropical diseases, like Guinea worm and trachoma.

Since 2012, conflict has scarred northern and central Mali. Violence between communities and armed groups, some connected to terrorists, has forced tens of thousands of people to leave their homes. This makes our work to eliminate Guinea worm disease and control trachoma very difficult.

Our Work and Methods
To reach remote areas in dire need of basic health services, we use a community-based approach. By providing the tools and the platform for dialogue between health workers and local communities, we aim to:

• Reduce violence
• Create conditions that would allow for better access to health and disease-eradication services in central Mali

In November 2017, key stakeholders in Mali asked The Carter Center to serve as the Independent Observer of the implementation of a 2015 peace agreement. The agreement brought an end to a civil war that began in 2012, when a group of insurgents launched a campaign to win independence for northern Mali. 

The Independent Observer team participated in nearly all negotiations or activities related to the implementation of the agreement; conducted frequent visits to northern and central Mali; participated in more than 600 meetings with various stakeholders; and published regular reports on the status of implementation. 

From 2004 to 2007, we helped Mali improve transparency and reform its government systems.  

We worked with government, civil society, media representatives, parliamentarians, and donors to analyze the laws and practices that shaped information flows in Mali and identify options for improving public access to information. 

Our Work and Methods

In 2005, we partnered with the Mali government and stakeholders to develop a strategy and select pilot agencies to put it into practice. 

The strategy included creating welcome desks for people to ask for information, improving records management, launching a communications campaign, training government workers to help citizens, engaging with regular citizens to get them involved, and coordinating efforts through regular meetings.  

Mali decided to deepen the program in existing offices and expand to new ones, while our fieldwork ended in December 2007.  

From 1998 through 2002, the Center’s Global Development Initiative worked with the Mali government and civil society to: 

• Establish realistic and coordinated development priorities 

• Facilitate citizen input into setting those priorities 

• Improve government management of development policies and projects 
• Build the government’s capacity to coordinate needs with international financial institutions and donor countries 

The Carter Center set out to assist and promote Mali’s democratic process by sending a small team to monitor Mali’s 2002 elections. 

The team was impressed to see peaceful voting, strong competition, and diverse views from community groups and the media. Though our delegation noted irregularities in the voting, the elected president enjoyed legitimacy with both the people of Mali and the international community.  

More information about this election is available in our publications section.