The world edges closer to eradicating Guinea worm disease, a debilitating parasitic infection, with only 10 human cases reported worldwide in 2025 – the lowest number ever recorded. This remarkable progress, announced by the Carter Center, marks a significant milestone in a decades-long effort to eliminate this ancient scourge.
The 10 cases were identified in three African nations: four in Chad, four in Ethiopia and two in South Sudan. This represents a 33% decline from the 15 cases reported in 2024, demonstrating the continued effectiveness of targeted intervention programs.
A History of Devastation
Guinea worm disease, also known as dracunculiasis, is caused by the parasitic nematode Dracunculus medinensis. Infection occurs when people drink water contaminated with copepods – tiny crustaceans – that harbor the worm’s larvae. Once ingested, the larvae mature and migrate through the body over approximately a year. The adult worm, which can grow up to three feet long, then emerges from the body, typically through a painful blister in the lower leg.
The emergence of the worm is excruciating, and patients often seek relief by immersing the affected limb in water. This, unfortunately, releases larvae back into the water source, perpetuating the cycle of infection. Beyond the immediate pain, Guinea worm disease can lead to secondary bacterial infections, sepsis, and long-term disability.
From Millions of Cases to Near Eradication
In 1986, when The Carter Center took the lead in the global eradication campaign, an estimated 3.5 million people were infected annually across 21 countries in Africa and Asia. The eradication strategy has not relied on vaccines or medications, but rather on a comprehensive approach focused on behavioral change and education. Key interventions include providing access to safe drinking water, distributing water filters, and educating communities about preventing contamination of water sources.
The success of the campaign is evident in the dramatic decline in cases over the years. By 2007, fewer than 10,000 cases were reported. This number continued to fall, reaching 542 in 2012, 126 in 2014, and 22 in 2015. In 2024, the number of cases dropped to 15, paving the way for this latest record low.
The Carter Center’s Legacy
The Carter Center’s commitment to Guinea worm eradication has been unwavering. Former U.S. President Jimmy Carter, for whom the center is named, famously expressed his desire to “outlast the last Guinea worm.” While he passed away in 2024, his vision and dedication continue to drive the eradication efforts.
“President Carter always said he wanted to outlast the last Guinea worm,” said Carter Center CEO Paige Alexander in a press release. “While he didn’t quite get his wish, he and Mrs. Carter would be proud to know there were only 10 human cases reported in 2025. And they would remind us that the work continues until we reach zero.”
The Final Push: Challenges and Strategies
Despite the remarkable progress, the final stages of eradication present unique challenges. Identifying and treating the last remaining cases requires intense surveillance and targeted interventions. Currently, six countries have not yet been certified by the World Health Organization (WHO) as Guinea worm-free.
Adam Weiss, MPH, director of the Guinea worm eradication program at the Carter Center, emphasizes the importance of continued vigilance. “Just because there’s very little of it left doesn’t mean that you can walk away,” he said. “It’s a parasite and it wants to survive.”
To accelerate the final push, the Carter Center is implementing new tools and strategies, including molecular and serologic diagnostic tests to detect past infections and environmental surveillance to identify the presence of Guinea worm DNA in water sources. These advanced techniques will help to pinpoint remaining reservoirs of infection and prevent re-emergence of the disease.
Weiss highlighted the logistical complexities of environmental surveillance, noting the need to determine how much water must be tested from each source to ensure accurate detection. He also stressed the importance of maintaining consistent intervention efforts to prevent transmission.
A Historic Achievement on the Horizon
Guinea worm disease is poised to become only the second human disease to be eradicated worldwide, following smallpox. This achievement would represent a monumental victory for public health and a testament to the power of sustained, targeted interventions. It is also notable that this eradication is on track to be achieved without the need for a vaccine or medication – a first in history.
Eradication, as Weiss explains, will have a profound impact on affected communities, offering relief from a debilitating disease and inspiring hope for a healthier future. It’s a story of perseverance, collaboration, and the unwavering belief that even the most challenging health problems can be overcome.
