Dracunculiasis eradication: beginning of the end.

Beginning with the International Drinking Water Supply and Sanitation Decade (1981-1990), an increasingly broad coalition of international and bilateral agencies, organizations, private companies, and other institutions have joined forces to eradicate dracunculiasis (Guinea worm disease). From an estimated annual incidence of 10 million persons just before the campaign began, the remaining incidence of cases is now less than two million. More than 23,000 villages are known to be endemic. All 18 countries where the disease is still endemic have completed or begun nationwide searches to identify endemic villages, except Kenya. Dracunculiasis is nearly eradicated in Asia, where Pakistan found only 23 cases in 1992, and India found 1,081 cases. Cameroon and Senegal are close to achieving eradication in Africa, where the two formerly highest endemic countries, Nigeria and Ghana, reduced their combined total of cases from approximately 820,000 in 1989 to less than 240,000 in 1992. Much remains to be done, however, in francophone West Africa and especially in East Africa. The most serious current obstacles to eradicating dracunculiasis by 1995 are the civil war in Sudan, apathy of some national and international health officials, and inadequate funding for the campaign.