South Sudan

Current status: Endemic
Indigenous human cases reported in 2024: 6
Animal infections reported in 2024: 16

Our Work
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

Lasting Impacts
South Sudan has seen dramatic reductions in Guinea worm cases from tens of thousands in the 1990s to approaching zero today. As one of the last countries still affected by the disease, South Sudan’s progress brings the world closer to making Guinea worm only the second human disease to be eradicated. This achievement demonstrates that even in conflict-affected regions, sustained public health efforts can succeed with community engagement and dedicated local workers.

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

How It Started

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

Our Work and Methods

Mass administration of the drugs Mectizan® (donated by Merck & Co. Inc.) and albendazole (donated by GSK) was implemented in all 50 counties, 34 of which were co-endemic for river blindness, which also is treated with Mectizan. 

Our Work
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
• Supporting integrated disease surveillance
• Building local healthcare capacity

Lasting Impacts
While still ongoing, our efforts contribute to protecting communities from river blindness, a disease that causes severe itching, skin damage, and eventual blindness. 

By training local health workers and establishing sustainable distribution systems, we’re building healthcare infrastructure that benefits communities beyond a single disease, creating lasting improvements in public health capacity.

Our Work

Since 2000, The Carter Center has supported trachoma control in South Sudan through the implementation of the WHO-endorsed SAFE strategy.

The strategy comprises:

• Surgery to reverse in-turned lashes caused by advanced trachoma, called trachomatous trichiasis or TT
• Antibiotics to treat infection and reduce transmission
• Facial cleanliness to prevent bacteria from spreading
• Environmental improvement to improve access to clean water and basic sanitation to reduce the fly population

By the Numbers

Surgeries

2000 – 2024

The Carter Center has assisted the national program with over 14,670 TT surgeries.

Antibiotics Distribution

In partnership with the Ministry of Health, we distribute antibiotics for trachoma control.

Adults and children older than six months are treated with Zithromax® (azithromycin, donated by Pfizer Inc). Those ineligible for Zithromax receive tetracycline eye ointment (TEO).

2000 – 2024

We supported the distribution of more than:

• 5.2 million doses of Zithromax

Lasting Impacts

South Sudan has some of the highest trachoma rates globally, with children as young as 5 requiring surgery to prevent blindness. 

Our work provides crucial sight-saving interventions to vulnerable populations while building sustainable local health care capacity. Our integrated approach addresses not just immediate medical needs but also the underlying conditions that spread disease.

Our Work

The Carter Center provided comprehensive public health training to strengthen South Sudan’s healthcare 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

Lasting 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 sustainable health care infrastructure designed to outlast individual disease programs, empowering South Sudanese to lead their own health initiatives.

These trained professionals serve as the backbone of rural health delivery, reaching isolated communities that would otherwise lack access to care.

Our Work

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.

Our approach includes:

• Teaching superior farming techniques
• Introducing improved grain varieties
• Training farmers in sustainable agricultural practices
• Led by Nobel Peace Prize laureate Dr. Norman Borlaug

Lasting Impacts

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

This early work demonstrated the interconnection between health and agriculture, showing 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.

Our Work and Methods
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

Lasting 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.

Our Work and Methods

Our Work
We observed two landmark electoral processes that shaped South Sudan’s path to independence:

2010 National Elections

• Deployed 70+ observers across Sudan
• Observed the first multiparty elections in 24 years
• Found significant challenges but vital for referendum preparation

2011 Independence Referendum

• Conducted one of our largest missions ever
• Deployed over 100 observers including long-term, medium-term, and short-term teams
• Found the referendum to be peaceful and credible, with overwhelming support for independence

Lasting Impacts

Our observation missions contributed to the credibility of South Sudan’s path to independence in 2011. While the democratic transition has faced severe setbacks with elections repeatedly delayed and power-sharing arrangements proving fragile, the referendum itself stands as a moment when democratic choice prevailed. Our continued engagement reflects an understanding that building democratic foundations requires long-term commitment through periods of progress and challenge alike.

Our Work and Methods
Since 1986, The Carter Center has persisted in peacebuilding efforts through Sudan and South Sudan’s complex cycles of conflict and fragile agreements.

Our approach has included:

• Negotiating the 1999 Nairobi Agreement
• Facilitating dialogue across political divisions
• Supporting grassroots reconciliation
• Maintaining neutral space for negotiations

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

However, the outbreak of civil war in 2013 and ongoing political instability demonstrate that peace-building requires sustained commitment through setbacks. 

Our continuing presence acknowledges that trust-building and reconciliation are generational tasks, not one-time achievements..