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The Work Is Worth It, and It Isn’t Finished

By Dr. Kashef Ijaz, Vice President-Health, The Carter Center

The recent observance of the second annual World Neglected Tropical Diseases Day (Jan. 30) prompted me to reflect on my good fortune in overseeing the Carter Center’s tireless work to free people from an array of illnesses that cause untold misery and perpetuate the cycle of poverty.

This work started 35 years ago, in 1986, with former President Jimmy Carter’s decision to take on leadership of the worldwide Guinea Worm Eradication Program, well before the broader movement to eliminate neglected tropical diseases (NTDs) developed.

In the 1990s, building on the success and lessons of the Guinea worm campaign, The Carter Center added programs to eliminate several other NTDs regionally in Africa and Latin America, including the bold effort to eliminate transmission of river blindness in the Americas. With our partners, we have assisted in eliminating transmission of river blindness in Colombia, Ecuador, Guatemala, and Mexico; in the Americas, river blindness transmission continues only among the indigenous Yanomami people deep in the Amazon rainforest along the Brazil-Venezuela border. With the help of indigenous health workers, we are reaching them, too.

Carter Center-trained community volunteers and health workers have distributed more than 800 million doses of medicines to prevent river blindness, trachoma, lymphatic filariasis (aka elephantiasis), schistosomiasis (snail fever), and soil-transmitted helminths (intestinal worms). We have assisted more than 800,000 eyelid surgeries to reverse the effects of advanced trachoma, and we have supported the construction of more than 3.6 million household latrines to enhance sanitation and prevent disease.

Further, Ghana has eliminated trachoma as a public health problem, and numerous focus areas have been able to stop mass drug administration for some of these diseases because it’s not needed anymore.

During my almost 19 years in responsible roles at the CDC, I observed with admiration as The Carter Center forged strong, long-standing, mutually respectful and trusting partnerships with national governments, local communities, committed individuals, and other organizations. The Center has worked in some countries (Nigeria, Sudan, Ethiopia) for 30 years or more and has earned the trust of many local elected officials, traditional leaders, and communities to assist them in implementing efforts that harness the power of ordinary people to reduce disease.

Of course, our flagship NTD program is the Guinea Worm Eradication Program. When President Carter chose to take on that Herculean effort, an estimated 3.5 million cases occurred every year in 21 countries in Africa and Asia. Without a vaccine or a drug, eradication seemed like a wild dream. But, with the synergistic power of determination, hard science, innovation, and enthusiastic community trust and buy-in, the Guinea worm is being vanquished: Just 27 human cases were reported in six countries last year, half the number from 2019.

Furthermore, despite the worldwide disruption caused by COVID-19, the program remained up to 95% operational in 2020, and heroic work continues to be done to eradicate Guinea worm and eliminate other NTDs.

The pandemic has been a challenge for us as it has for everyone, but our resilient staff and partners have adroitly factored it into their work. Practically all organizations’ NTD work in the field halted for safety’s sake, but in August, following World Health Organization guidance, we assisted Uganda in carrying out one of the world’s first large-scale mass drug administration resumptions. This reflects Uganda’s determination to stay on track in eliminating transmission of river blindness from its final two focus areas.

We are taking every precaution, but COVID cannot stop us. It is vitally important that we in the NTD community understand the importance of how the pandemic has exacerbated longstanding social and health disparities. This knowledge must inform current and future activities for disease elimination and eradication.

These successes and the many others I haven’t mentioned are what drew me to join The Carter Center in October and what inspire all of us to keep pushing, keep working, keep believing that we can go the last mile to eradicate Guinea worm disease and make a difference in people’s lives in positive ways. We remain committed to innovating and collaborating with governments, partners, other agencies, and the smallest and most forgotten of communities to recover from the effects of the pandemic and defeat NTDs for the benefit of humanity. May it be so.


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