Dracunculiasis eradication and the legacy of the smallpox campaign: what's new and innovative? What's old and principled?

Coming on the heels the declaration of smallpox eradication in 1980 was the launch of the dracunculiasis (Guinea worm) eradication program, as a key outcome indicator of the success of the United Nations 1981-1990 International Drinking Water Supply and Sanitation Decade (IDWSSD). The dracunculiasis eradication campaign has carried on well beyond the close of the IDWSSD largely due to the efforts of President Jimmy Carter and The Carter Center, to assist the national Guinea Worm Eradication Programs in collaboration with partner organizations, including the Centers for Disease Control and Prevention (CDC), UNICEF, and the World Health Organization. Dracunculiasis eradication efforts have as primary tools health education, filter distribution for drinking water filtration, and case containment, all guided by rigorous village based surveillance. Additional tools are treatment of selected water sources with ABATE(R) (temephos) larvicide and provision of protected drinking water supplies. Village volunteers provide monthly reporting of cases (including reports of zero cases). The global campaign has made remarkable progress through both innovation and adherence to eradication principles. Annual cases of dracunculiasis have decreased from 3.5 million in 1986 to less than 2000 in 2010. The challenge is to reach zero cases. The task, so often faced by eradication programs, is to finish the 'final inch' in some of the most difficult places on earth to work. In the case of dracunculiasis, that is the new Republic of South Sudan.