Eradicating dracunculiasis

Dracunculiasis is the first parasitic disease set for eradication

Dracunculiasis is an eradicable disease for the following reasons:

• diagnosis is easy and unambiguous (it relies on visual recognition of the emerging worm);
• the intermediate host of D. medinensis (Cyclops spp.) is not airborne (like a mosquito) but restricted to stagnant water bodies;
• control interventions are simple, cost effective and relatively easy to implement;
• the disease has limited geographical distribution and transmission is seasonal;
• political commitment from governments is available;
• several countries in Africa, Asia and the Middle East have successfully eliminated the disease;

Road to eradication

In May 1981, the Interagency Steering Committee for Cooperative Action for the International Drinking Water Supply and Sanitation Decade (1981–1990) proposed the elimination of dracunculiasis as an indicator of success of the Decade.

In the same year, WHO's decision-making body, the World Health Assembly (WHA), adopted a resolution (WHA 34.25) recognizing that the International Drinking Water Supply and Sanitation Decade presented an opportunity to eliminate dracunculiasis.

This led to WHO and the United States Centers for Disease Control and Prevention (CDC) formulating the strategy and technical guidelines for an eradication campaign.

In 1986, the Carter Center joined the battle against the disease and in partnership with WHO and UNICEF has since been in the forefront of eradication activities.

To give it a final push, in 2011 the WHA called on all Member States through resolution WHA 64.16 to expedite the interruption of transmission and enforce nation-wide surveillance to ensure eradication of dracunculiasis.

The eradication strategy recommended by WHO in collaboration with its principal partners (UNICEF, CDC and The Carter Center) involves the following approaches:

• mapping of all endemic villages and establishing community-based surveillance systems in every known endemic village, with immediate detection and reporting of all cases, supervision and integration of surveillance for other major preventable diseases;
• implementing effective case containment measures in all endemic villages;
• implementing specific interventions such as ensuring access to safe water, health education, community mobilization, filters and providing vector control of potential unsafe water sources with temephos insecticide (Abate®);
• reporting on a regular basis, even if zero cases, and maintaining global and national dracunculiasis databases to monitor the epidemiological situation;
• consolidating advocacy for eradication of the disease;
• managing the certification process for global eradication country by country.