The International Commission for the Certification of Dracunculiasis Eradication (ICCDE) commends national dracunculiasis eradication programmes, the World Health Organization, The Carter Center and other partners for achieving a remarkable 83% reduction in the number of human cases of dracunculiasis (guinea-worm disease). In 2015, only 22 human cases were reported to WHO; no cases were imported internationally during 2015 and none during the past four years.
This unprecedented decrease in the number of human cases (from the 126 cases reported in 2014) is a significant public health achievement. However, the ICCDE noted that the challenging target of achieving global interruption of human transmission of Dracunculus medinensis by the end of 2015 was not met. The Secretariat should initiate the development and endorsement of measures that reflect the new epidemiological information and acknowledgement of risks for dissemination to all WHO Member States, donors, academia and advocates to ensure continued global support for this last phase of the eradication programme.
The ICCDE is concerned that Dracunculus medinensis infection is occurring in dogs and other animals in association with human cases, particularly in Chad and Ethiopia. Research in support of eradication thus merits full support. The Secretariat should continue to engage with donors, the veterinary public health sector and wider advocacy groups to address the role of dogs in the end game of dracunculiasis eradication – a fact unknown at the time the WHO NTD Roadmap envisioned global interruption by the end of 2015.
ICCDE main recommendations
- Plan the development and launch of a Global Reward one year after the last human case has been detected.
- Continue with aggressive use of abate (temephos) to kill the intermediate host and minimize any risk of transmission.
- Ensure early containment of all cases, preferably within 24 hours.
- Thoroughly investigate all new cases through an intensive case control approach to obtain as much information as possible to define conditions through which the case was acquired;
- Enhance measures to achieve maximum awareness among all populations in endemic and pre-certified countries on the availability of a cash reward.
- Continue to scale-up active surveillance in at-risk villages and pursue the integration of guinea-worm disease surveillance into other programmes such as polio, mass drug distribution for neglected tropical diseases, national immunization days.
- Further increase surveillance in at-risk border areas, notably the Chad–Central African Republic border (if security permits).
- Initiate focused research to define the role of dogs (particularly in Chad) and understand the unique epidemiology through new technologies such as GPS tracking of dogs and stable isotope analysis of food sources to verify whether aquatic animals are a source of infection in Chad.
- Maintain and enhance measures to identify infected dogs-reward for reporting infections and promote the tethering of dogs to prevent contamination of water bodies.