Dracunculiasis eradication: almost a reality.

The idea of a global campaign to eradicate dracunculiasis was first proposed by the Centers for Disease Control and Prevention in 1980, during the advent of the International Drinking Water Supply and Sanitation Decade (IDWSSD) (1981-1990). In 1981, the Steering Committee of the IDWSSD adopted eradication of dracunculiasis as a subgoal of their efforts to provide safe drinking water to unserved populations. In 1988, African ministers of health voted to eradicate dracunculiasis by the end of 1995, a target date that was endorsed by UNICEF in 1989 and the World Health Assembly in 1991. Although nine of 18 endemic countries, India (1980), Pakistan (1987), Nigeria and Cameroon (1988), Ghana (1989), and Mauritania, Benin, Burkina Faso, and Togo (1990) completed national searches for cases of the disease, only four countries, India (1983), Pakistan (1988), Ghana (1989), and Nigeria (1989), actually started eradication programs during the 1980s. The remaining 14 endemic countries began their eradication programs between 1991 and 1995. At the end of 1996, dracunculiasis had not been entirely eradicated, but its incidence had been reduced by 95%, from an estimated 3.2 million cases in 1986 to 152,805 cases in 1996. Sudan reported a total of 118,578 (78%) of the 152,805 cases of dracunculiasis reported during 1996. Insufficient funding and the civil war in Sudan continue to be the major obstacles to overcome. A primary aim of the eradication program in 1997 is to seek to ensure that all cases of dracunculiasis outside of Sudan are contained. In Sudan the challenge is to pursue all appropriate control measures in all accessible areas as vigorously as possible until political circumstances allow access to all of the remaining affected areas.