South Sudan vows to interrupt dracunculiasis transmission amid continued decline

Geneva | 23 May 2013

The Minister of Health of South Sudan says his country is determined to interrupt transmission of dracunculiasis (guinea-worm disease), as the number of reported cases continues to decline. Although South Sudan has been reporting the majority of all cases, progress in implementing eradication measures there over the past two years means the world is on course to defeat the disease by 2015.

Extract/Interview Dr Michael Milly Hissen

Yesterday evening, Dr Michael Milly Hissen addressed an informal meeting of ministers of countries affected by dracunculiasis at the Palais des Nations in Geneva where the Sixty-sixth World Health Assembly is taking place. The meeting noted the importance of continued surveillance for all countries and areas freed from the disease because of the risks of imported cases by nomadic populations and as a result of insecurity from neighbouring countries .

South Sudan, which reported more than 96% of the total of 542 cases in 2012 (representing 521 of all cases globally in 2012) launched a full-blown campaign in 2006. Since independence in 2011, the health authorities in South Sudan have strengthened their guinea-worm eradication programme with a strong focus on case containment, surveillance and reporting.

The other three endemic countries – Chad, Mali and Ethiopia – have all stepped up eradication efforts, as have neighbouring countries that have been recently declared free of the disease.

WHO, The Carter Center and various partners made presentations on progress towards interrupting dracunculiasis transmission and the status of eradication.

During the first quarter of 2013, only six cases of guinea-worm disease have been reported, with zero cases reported to WHO during the whole month of January. The six cases – all reported from South Sudan – represent a 90% reduction, compared with the 61 cases reported during the same period in 2012.

Ghana, which once reported the second highest number of cases annually, reported its last case in May 2010. Since then no cases have emerged in Ghana and the country is now in the precertification phase.

By contrast, Chad reported an outbreak in 2010 – 10 years after reporting its last case. Mali and Ethiopia have both been reporting small numbers of cases.

To date, 192 countries, territories and areas have been certified free of dracunculiasis transmission.

Of the 14 countries that remain to be certified, four (Angola, the Democratic Republic of the Congo, Somalia and South Africa) have no recent history of dracunculiasis and 10 are either endemic for the disease (Chad, Ethiopia, Mali and South Sudan) or in the precertification phase (Côte d’Ivoire, Ghana, Kenya, Nigeria, Niger and Sudan).


"Our main challenges are actually insecurity, which of late has involved some endemic areas, making it very difficult for our volunteers to access the endemic villages. The other challenge is the question of safe drinking-water. Last year we had some economic downturn, so we are not able to provide clean, safe drinking-water to the remaining endemic villages.

We also have problems with road infrastructure, making accessibility extremely difficult to some of the villages ... If you look at the trend, I can say it is very positive. If last year 2012[during the first quarter], the total cases reported [were]141, now in 2013 ... in May there are only 14 cases. So, you see the trend is positive and very promising. If we can't get rid of guinea-worm in 2013 or 2014, we'll definitely reach the target in 2015."