Nigeria’s WHO Certification On Guinea Worm, By Chika Onuorah

Prof Onyebuchi


After defaulting several times to meet targets for the eradication of two major epidemics, polio and guinea worm, Nigeria has finally broken the myth.  The report that the World Health Organisation (WHO) has finally declared Nigeria free from guinea-worm came as a pleasant surprise to Nigerians.  While presenting the certificate signed by the Director-General of WHO, Dr. Margaret Chang, before the commencement of Federal Executive Council (FEC) meeting in Abuja on Wednesday15, January 2014, Health Minister, Prof. Onyebuchi Chukwu attributed the positive development to the renewed zeal and political commitment demonstrated by the President Goodluck Jonathan’s administration.

It was indeed a defining moment for the administration which has severally committed to eradicating the disease.  The WHO declaration, which took effect from last year, has indeed put smiles on the faces of Nigerians. Besides Nigeria, a few developing countries-especially in Africa and Asia- have also gained certification in the past six years alone. They include Cameroon, Central African Republic, India, Pakistan, and Yemen. 

To be certified as guinea worm-free by the WHO, endemic countries report to the International Commission for the Certification of Dracunculiasis Eradication and document the absence of indigenous cases of the disease for at least three consecutive years.   As of 2013, 197 countries have been certified as being free of guinea worm disease; 16 of these officially certified as having eliminated the disease.  Nigeria now joins the short list of 16 countries that are guinea worm-free, though about 2,500 cases of the disease remain in four other African countries.

Guinea worm disease is caused by drinking water contaminated by water fleas that host the Dracunculus larva which thrives in some of the world’s poorest areas, particularly those with limited or no access to clean water. While it was common in communities with low level of hygiene practice, acute shortage of safe drinking water was identified in developing countries as a major reason for its existence and spread.

Nigeria and many other African countries suffered from this disease since its inception which led to the global campaign to eradicate it.  While this campaign has been with us over time, President Jonathan has in the recent past, given it resurgence, mainly by preventing the spread by promoting behaviour change in the endemic areas through education and public enlightenment, alongside the provision of clean water sources and the treatment of contaminated drinking water with larvicides. 

We may have come to the end of the disease in Nigeria, but the years of battling the epidemic must be remembered.  The campaign, which began at the U.S. Center for Disease Control and Prevention (CDC) in 1980, was joined on a global scale in 1986 by former U.S. President, Jimmy Carter, and his not-for-profit organization, the Carter Center.  Organisations like the WHO and became interested when infected school children could not attend classes, infected were unable to provide care especially to infants, resulting in diarrhoea, malnutrition and skin infections.

 If the campaign being waged on guinea-worm by the Carter Center is notable globally, that of the Yakubu Gowon Foundation takes the price in Nigeria.  The vigorous campaign waged in the country by the like of Yakubu Gowon Foundation ensured that she was able to reduce the cases drastically.  As of 1988, Nigeria was topping the list of guinea worm endemic countries, recording 653,620 cases at a time when the global total was 3.5 million and reported in 21 countries.  Towards the turn of the century therefore, the figures have fallen to 13,000 cases only.  With the fillip provided by the present administration in providing the necessary wherewithal towards eradicating the disease, the country today records zero transmission of the disease.

Nigeria began the move to have its zero guinea worm transmission claim verified 2 years back, five years after the last reported case, because the investigation for the certification of any country as guinea worm-free can only begin after the country has not recorded any guinea worm transmission in at least four years.  A 58-year-old, Grace Otubo, is on record as the last carrier of the guinea worm disease in Nigeria which she has suffered since November 2008.  The fact that she can be specifically identified as the final victim of the disease in Nigeria shows the relentless tracking required to eliminate guinea worm disease.  It was a battle she and others before her won simply by changing their water drinking habits since guinea worm larvae in the water are microscopic, and a full year passes between ingestion of contaminated water and a worm actually emerging from the body.

Thousands of volunteers have worked in Nigeria since 1988, documenting every case of the disease and providing the tools and education necessary to defeat it.  The Nigeria Guinea Worm Eradication Programme (NIGEP) has been the organ constituted by the Federal Government to steer the required concerted efforts to fight the disease.

First, Nigeria’s former leader, predicted the end of the disease in these words “Nigeria is about to make a bold statement of eradicating guinea worm disease in Nigeria after many years.”  Then the Carter Center predicted that guinea worm disease “will be the first parasitic disease parasitic to be eradicated without the use of vaccines or medical treatment.” The predictions have both come to pass.

While the Carter Center, which has been in Nigeria since 1988 when the guinea worm eradication programme started, deserves all the commendation, President Jonathan’s administration needs to be commended for manifestly seeing to the prediction becoming reality in Nigeria.  With the recent developments in the health sector, there is no denial that the transformation agenda is, indeed, working in Nigeria.

Miss Onuorah, a Mass Communication graduate, sent this piece from Abuja.

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