The Guinea worm eradication program has employed a two-part strategy to interrupt the Guinea worm’s transmission cycle. The first part was to prevent people from getting infected from contaminated water and food. The program launched educational campaigns, ran surveillance programs and distributed millions of tools – like filtration cloths, filters and chemical water treatments – for people to secure clean water.

The second part of the plan was aimed at preventing reintroduction of the parasite into the environment. Again, education programs were a key component, but so were Guinea worm treatment centers. These centers acted as places where infected people and their families could receive care, food and shelter during the long treatment process. By giving infected people a place to stay, treatment centers prevent a person from putting their leg into a body of water and inevitably releasing the larva.

Since the eradication effort began in the mid-1980s, annual Guinea worm infections have fallen from the millions down to the dozens. But the final push to zero has been difficult and slow. In 2015, there were just 22 recorded cases, but infections have stayed in the low double-digits since then.

The massive drop in Guinea worm cases showed that this strategy was working, but there was a complication. In 2020, researchers discovered that a Guinea worm outbreak in the Central African country of Chad was driven by infected dogs, adding a new set of challenges to interrupting the transmission cycle. This led to public health officials returning to the field, increasing surveillance and urging people to report and contain infected dogs.

These many eradication efforts since 2015 have slowly brought case numbers down to the current record low of 12 total cases.

As the world approaches zero cases of Guinea worm disease, the laborious epidemiological detective work of chasing down infection reports and finding hidden water sources gets tougher. Some of the few remaining communities affected by Guinea worm are nomadic or very remote. And as Guinea worm infections grow rare, vigilance can wane and people revert to their old ways, opening the door for Guinea worm to reemerge.

The final push to full eradication will be a challenge that requires patience and faith on the part of institutions and governments supporting the effort. But it also requires that millions of people living in endemic areas do what they can to break the transmission cycle and kick Guinea worm out for good.

This article is republished from The Conversation, an independent nonprofit news site dedicated to sharing ideas from academic experts. If you found it interesting, you could subscribe to our weekly newsletter.

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Kimberly Paul receives funding from the National Institutes of Health.