dignitaries worldwide in celebration of the 97 percent eradication of Guinea worm disease. This tremendous accomplishment is due in large part to years of teamwork by an international coalition organized by The Carter Center in close collaboration with the U.S. Centers for Disease Control and Prevention (CDC). A primary goal of the coalition is to work closely with African health officials to identify infected villages and teach residents how to filter drinking water. Because of this successful initiative, Guinea worm disease is expected to be totally eradicated within the next two to three years.

Controlling river blindness is next on The Carter Center's agenda. In its chronic form, onchocerciasis, a parasitic disease, produces visual impairment and blindness through the accumulation of young microfilarial worms in the eyes. The worms are transmitted via bites from a certain species of female blackfly that breeds in fast flowing rivers. People living in endemic areas are constantly reinfected, experiencing rapid, unnatural aging of the skin, depigmentation, thickening of the epidermis and intense itching as well as visual damage. Currently, 18 million people are infected, 1 million are sight impaired and more than 350,000 have been blinded.

In 1995, The Carter Center's Global 2000 Program joined the ranks of the River Blindness Foundation (RBF), UNICEF, Africare, the International Eye Foundation and others in an effort to fight this devastating disease. The Global 2000 River Blindness Program, headed by Don Hopkins (who also heads The Carter Center's Guinea worm eradication program), is scheduled to assume responsibility for RBF projects in Nigeria, Uganda, Cameroon, and Latin America in late March and will assist other countries where the disease is endemic. Frank Richards, a medical epidemiologist with the CDC, has been detailed to help with the transition.

The primary means of fighting river blindness is via the oral drug Mectizan. Made and distributed by Merck and Company, Mectizan taken in a single dose kills most of the microfilaria in an adult human for one year. However, because it does not kill the adult female worm, it must be given annually for at least 10 years to prevent the number of microfilaria from reaching levels needed to cause blindness and skin disease. Merck and Company has pledged to donate the Mectizan free of charge to programs distributing it where needed. Various agencies have taken on this challenge, including The Carter Center.

As Richards summarized, "The Carter Center, in shouldering the task of achieving global control of both Guinea worm and river blindness, continues its long tradition of seeking to improve the lives of the world's most vulnerable populations."

Ann Carney is assistant communications coordinator

at The Carter Center.