Honoring Jimmy Carter’s Efforts to Eradicate Guinea Worm | Bill – Bill & Melinda Gates Foundation

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Former U.S. President Jimmy Carter has been a longtime source of inspiration, counsel, and wisdom to many in the global health community. For decades, he has led the campaign to make Guinea worm disease the second-ever human disease (after smallpox) to be eradicated, and he has championed many other health causes, from the elimination of several other neglected tropical diseases to mental health and HIV/AIDs. By working to ensure that diseases long gone from rich countries aren’t left to ravage the world’s poorest communities, he has exemplified the push for health equity that is our foundation’s core mission. He has also shown that, with determination, political will, funding, and the power of innovation, it is possible to eliminate preventable diseases.
We asked some of President Carter’s friends and colleagues in the foundation’s orbit to reflect on the enormous impact he and his wife Rosalynn Carter have had on global health and communities around the world. Their reflections have been condensed and edited for clarity.
Dr. Helene Gayle is the president of Spelman College and a board member of the Bill & Melinda Gates Foundation. An epidemiologist by training, she previously worked at many global health organizations, including the U.S. Centers for Disease Control and Prevention (CDC) and the Gates Foundation, and she also served as president and CEO of the Chicago Community Trust and CARE, an Atlanta-based global humanitarian organization.
I’ve spent much of my professional career in Atlanta, so I’ve had the privilege of seeing President Carter in many different forums around town, especially those related to his tremendous work on global health. To say he’s a legend here is an understatement. There’s a real pride here that he came from a humble background as a Georgia farmer and made it to the highest position in our land.
My fondest memories of President Carter come from a trip I took with him and Bill Gates Sr. to South Africa, Nigeria, and Kenya (with a brief stop in the Central African Republic) in 2002. Our trip was focused on HIV/AIDS in the days before a lot of effective treatments were available in Africa. I’ll never forget seeing President Carter, Bill Sr., and Nelson Mandela—all, by that time, grandfather-aged men—holding babies who were HIV-positive. They wanted to show everyone that these babies were no harm to anyone, including world leaders.
I remember President Carter’s many talks with ordinary people during that trip, and how he tried to reduce the stigma of HIV/AIDS and help people from all walks of life feel that their lives had value. We spoke with commercial sex workers in Kenya and Nigeria about HIV/AIDS prevention and condom use. While President Carter came from a very traditional, religious Christian background, he was entirely nonjudgmental and really wanted to communicate to these women that their lives were worth protecting from HIV/AIDS. He even gave a sermon at the church of the then-president of Nigeria, and from the pulpit he talked openly and honestly about condoms and safe sex without judgment or recrimination.
From world leaders to migrant farmers, his ability to connect with people is remarkable: He’s just very down-to-earth and approachable. And because of his global stature as a former president, he can meet with people at the highest levels of government, capture their attention, and make the case for investing in local, regional, and global health. He has elevated the significance of global health around the world. And he has been incredibly persistent and diligent around the issue of Guinea worm eradication, helping to lead that campaign to the threshold of success.
President Carter is a brilliant individual with a rare combination of intellect and passion. Most importantly, he has the ability to listen and ensure that people feel heard, which is such an essential part of good leadership. I’m honored to know him.
Dr. Jordan Tappero is a deputy director on the Neglected Tropical Diseases team at the Gates Foundation. He previously served as a medical epidemiologist in the U.S. Public Health Service for 25 years, and as CDC country director in Botswana, Thailand, Uganda, and Haiti.
We are in the last mile of Guinea worm eradication. We’ve gotten this far only because of President Carter’s boundless energy and persistence—he never let setbacks derail the cause. In 2012, we started seeing an increase in animal infections among domesticated dogs in Chad, which started small and kept growing. But rather than give up on the ultimate goal, he and his incredible team at The Carter Center doubled down and said, No, we’re going to figure this out.
In 2018, I joined the Carter Center team in Chad to figure out a new strategy that could also mitigate Guinea worm infections in animals. We came up with one strategy that would require more resources, and the team didn’t blink—they set to work on finding those resources. As a result, over the past three years, we’ve seen declines of 65% to 70% in infections in domesticated animals and an all-time low of 13 human infections in 2022, and we remain hopeful that the goal of eradication can be achieved.
Guinea worm eradication is just one of the many ways President Carter has worked to improve global health and relieve the suffering of people all over the world. He’s also led efforts to eliminate several other neglected tropical diseases, such as onchocerciasis (river blindness), lymphatic filariasis, trachoma, and schistosomiasis. And he’s helped in countless other ways. In 2010, I became the CDC’s country director for Haiti immediately after the country experienced a terrible earthquake that killed 200,000 people and displaced 20% of the population. President Carter showed up in Haiti with his tool belt, and he and Rosalynn started building homes, just as they have for so many others through Habitat for Humanity.
I joined the CDC as a U.S. Public Health Service officer in 1992, and in 2016 I was promoted to rear admiral. After the pinning ceremony in Atlanta, my family wanted to do something together to commemorate public service, so we went to visit the presidential library at The Carter Center. Taking in the whole of President Carter’s career that day, I was deeply moved. He served his country in the Navy and in our highest office, and then he spent decades promoting peace, diplomacy, and free elections, building homes for the homeless, and taking on diseases that only afflict the poorest of the poor. I felt compelled then to continue doing my part as a commissioned officer and became increasingly interested in working on the elimination of neglected tropical diseases like lymphatic filariasis in Haiti and, years later through the foundation, the eradication of Guinea worm disease.
President Carter could have just had a cozy retirement, but instead he’s been working harder than ever for those most in need. He and Rosalynn are national treasures. I’m honored to help finish the job they started. As we say in the Guinea worm community, To the demise of the worm: Let’s get every last one of them!
Adam Weiss is the director of the Carter Center’s Guinea Worm Eradication Program.
I first met President Carter in 2004 in Ghana, where I was a U.S. Peace Corps volunteer. I had seen hundreds of people in the village where I was working suffering from Guinea worm. It’s a horrible and very, very painful disease caused by a waterborne parasite. There’s no vaccine, no cure, and no therapeutic—you just have to slowly, meticulously roll the three-foot worm from your body.
The Peace Corps country director asked me to brief President Carter about the disease. I’d never done a briefing like that before, but President Carter put me at ease. He understood the data and interventions and had clearly listened to many people speak about their experiences with the illness. At the end, even though I’d described some struggles we had faced in containing the disease, he told me, “I’m confident that with people like you working on this, we’re going to get this done.” That remains a point of motivation for me in my career.
When I briefed President Carter, he had been thinking about Guinea worm for a long time. The disease was first brought to his attention in the early 1980s, when Drs. Donald Hopkins and Bill Foege, who helped usher in the end of smallpox, were trying to figure out what other diseases could be eradicated. President Carter took trips to Nigeria and Ghana and saw entire villages just decimated by the disease—hundreds of cases, kids who couldn’t go to school, parents who couldn’t go to their farms or the market. And so he had the Carter Center take the lead in the campaign to eradicate Guinea worm.
We’ve gone from more than three and half million cases annually in 1986 all the way down to just 13 human cases last year. We’re on track to meet the 2030 target for eradicating Guinea worm forever. President Carter is at the center of this entire effort. But you wouldn’t necessarily know it from his remarkable humility.
I remember him visiting remote villages that would have just been a photo op for some other politician—take a few pictures and leave. But he would stay for hours consoling people who were suffering from Guinea worm. He’d hold a woman’s hand or put his arm on a child’s shoulder as their worm was removed. That’s President Carter. He refuses to turn his back on human suffering, and he strongly believes that we all have a responsibility to help. His empathy and persistence inspire us all to keep up the fight.
Makoy Samuel Yibi is the national coordinator for the Guinea Worm Eradication Program with the Republic of South Sudan’s Ministry of Health. He received the Jimmy and Rosalynn Carter Award for Guinea Worm Eradication from the Carter Center in 2008.
I first got involved with the Guinea Worm Eradication Program way back in 1995. I didn’t know it would become my life’s work. I happened to be one of the fortunate ones who had avoided infection, but I had seen my parents and other members of my family suffer terribly from the illness.
1995 was also the year that President Carter came to Sudan and helped negotiate a two-month ceasefire in the war that was raging then, so health workers could fight Guinea worm in the war-torn areas. This was a big, big deal, especially for those of us in the southern part of the country.
You have to understand, at the time the fighting was so bad in Sudan that nobody could imagine the leaders on either side talking to each other. It was basically a war of attrition, and the only objective on either side was eliminating the other. So the fact that President Carter was able to bring both sides to the table and get them to agree to a brief cessation of hostilities was really something. This was not easy diplomacy, and I think only a person like him, who could garner the trust of leaders on both sides, could have made it happen.
Just as important, President Carter’s intervention on behalf of peace in 1995 helped the warring parties in Sudan come to realize that actually it was possible to talk things through with each other. And so over the years, many rounds of talks followed, and eventually there was a peace agreement. So President Carter is part of our history.
Since he’s a former president of the United States, you’d expect he would be a remote figure, and that there would be so many protocols for interacting with him. But no, he is very warm, down-to-earth, and engaged. He listens and asks good questions, and he is always very eager to get out in the field. I remember when he visited in 2010 that he wanted to go into the villages and interact with the communities. It really empowered all of us. Whenever we faced challenges, we’d say, “Why should I complain? The President himself has been here!”
He made some very difficult work look easy, and he gives us all the confidence that we can eradicate Guinea worm disease. And, indeed, we are now getting very close—the interventions are working, and we are down to only a few cases now. What’s more, the health workers trained to detect Guinea worm are now building up the health systems across the country, and the systems that were created to fight that disease are now being replicated or adapted for other diseases. So the eradication campaign has been the backbone that has strengthened our health system.
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