Guinea worm wrap-up ; # 155, August 26, 2005
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Guinea worm wrap-up ; # 155, August 26, 2005

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  • Journal Article:
    Guinea worm wrap-up
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    With the completion of this year’s program Review for the remaining endemic francophone countries (see below), it is clear that all of those countries are close to ending transmission of Guinea worm disease (GWD, dracunculiasis). The only question now is: How long will it take them to reach zero cases? The answer: there should be ZERO indigenous cases in all of those countries after one year from now – September 2006. Benin and Mauritania are about to report zero indigenous cases for an entire calendar year for the first time in 2005, and Burkina Faso and Cote d’Ivoire may also do so in 2006. Burkina Faso, Cote d’Ivoire, Ethiopia, Ghana, Mali, Niger, Nigeria and Togo each need to escalate their expectations and raise their program’s performance. We all need to change the way we think about this stage of the campaign. From now on, our ATTITUDE should be that we shall do everything that we can to stop ALL transmission of Guinea worm disease from now on. No one should be satisfied with reductions in cases of 60%, 70% or even 80% by this time next year. We should aim for reductions of 100% everywhere except Sudan. Allow no worms to pass! What would accepting that challenge mean? It means

    • From now on, every case of GWD is intolerable.

    • The entire country, including the head of state, minister of health, Guinea worm workers, government health workers, school children, and the general public nationwide should be primed to detect any case within 24 hours, report it urgently, and help contain it immediately.

    • Immediate cross notification of an imported case, and immediate response to receipt of such cross-notification.

    • Higher rates of case containment.

    • Intensified supervision at all levels of the program led by the National Program Coordinators.

    • Monthly monitoring of interventions, and response to any apparent deficiencies.

    • Redundant surveillance: village -based, school- based, market-based, reward-based, etc..

    • Putting as many interventions as possible in place in each endemic village.

    This final phase requires a much more aggressive attitude than before. This is a challenge to greatness this year and next year. Will we meet the challenge? Time, and The Worm will tell. The only thing standing between us and Guinea worm eradication a year from now in most of the remaining endemic countries is us. It is not The Worm.

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