Historic Cease-fire Gave Guinea Worm Program the Break It Needed

Editor’s note: March 27 is the anniversary of the start of the Guinea worm cease-fire that former U.S. President Jimmy Carter brokered in 1995 during the Second Sudanese Civil War. This article, written by former Carter Center intern Andy Pavey, recounts the genesis and impact of that six-month truce.

  • Jimmy Carter waves to a crown in southern Sudan.

    Former U.S. President Jimmy Carter visits a village in Southern Sudan in 2010. During the war that ultimately led to Southern Sudan’s independence, President Carter negotiated a cease-fire that allowed health workers to move about safely in the combat zone. (Photos: The Carter Center/L. Gubb)

In 1995, former U.S. President Jimmy Carter negotiated the longest humanitarian cease-fire in history, relieving some of the suffering from Guinea worm disease during the Second Sudanese Civil War.

At that time, The Carter Center was both mediating peace talks in Sudan and leading the global Guinea worm eradication campaign. Human cases of the painful parasitic disease had been reduced worldwide from an estimated 3.5 million in 1986 to 129,852 in 1995.

“Sudan now has about 3 times as many cases as the rest of the world combined. Only access to villages in the South can let us deal with the problem,” President Carter wrote in a trip report dated March 26, 1995.

Then, the Carter Center’s two programmatic focuses — peace and health — came together in a novel way.

  • Boys drink water from pipe filters

    Two boys drink through pipe filters at Kuse Dam, Terekeka County, Southern Sudan, in 2010. During the 1995 Guinea worm cease-fire, health workers distributed 200,000 cloth household filters. Both types of filter strain Guinea worm larvae out of water, making it safe to drink.

“Epidemiologists working in the Center’s health program saw an opportunity to negotiate a cease-fire … [allowing Guinea worm disease] eradication efforts to reach high-conflict areas in southern Sudan,” former Carter Center staff members April Klein and John J. Goodman wrote in their paper “Reconsidering Peacebuilding and Public Health: A Potential Model for Action.”

The negotiation was up to President Carter. Sudanese President Omar al-Bashir and his advisors were difficult to sway: A cease-fire would mean conceding a key military advantage against the Sudan People’s Liberation Army and its leader, John Garang.

Negotiations with al-Bashir went in circles; the odds that the cease-fire would succeed grew slim. But President Carter persisted.

Finally, after Garang agreed to a truce, al-Bashir relented on March 27 — stipulating that the period of peace would not be used to build up military forces.

“Bashir decided to join me personally at our press conference, to announce a two-month cease-fire,” President Carter wrote. “This was something we had sought for ten years.”

The truce gave health organizations like The Carter Center access to villages in the South.

“Some regions that have been inaccessible for almost 15 years now are being surveyed to determine health needs,” President Carter said in a statement.

Health workers distributed 200,000 cloth filters to strain Guinea worm larvae out of drinking water, as well as treatment and education to prevent river blindness. They also immunized an estimated 100,000 children against measles, polio, and tuberculosis, according to President Carter’s statement.

The truce lasted about six months, making it the longest humanitarian cease-fire in history.

Even after hostilities resumed, southern Sudanese communities maintained disease prevention methods put in place during the truce.

Sudan has been certified free of indigenous Guinea worm since 2002. The Republic of South Sudan, which gained independence in 2011, reported five human cases in 2022 — among just 13 worldwide.

Inspired, in part, by the success of the 1995 Guinea worm cease-fire, The Carter Center blends peace and health work in its Peace-Health Nexus. By providing the tools and the common platform of health for dialogue, the Center brings people together and opens access to the health services they need.

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