'Watch out, Guinea worm, here comes Jimmy Carter'

This past fall, President Jimmy Carter, who won the Nobel Peace Prize in 2002, celebrated his 90th birthday. Looking ahead, he's also hoping to celebrate the global eradication of Guinea worm disease (also known as dracunculiasis).

It's a goal toward which the nonprofit Carter Center, whose motto is "wage peace, fight disease, build hope," has been working since 1986. At that time, an estimated 3.5 million people in 20 countries in Asia and Africa suffered from a parasitic infection Carter describes as "horribly painful ... caused by drinking contaminated water from rain ponds, which is often the only source of water for a village." Once ingested, the microscopic larvae begin to grow and within a year develop into stringy three-foot-long worms that slowly and agonizingly emerge from lesions that can appear anywhere in the body. With the help of the Carter Center, the number of infected people is now down to 126 in four countries. The continuing campaign — one of its major tools is teaching villagers to use simple cloth nets to filter water — is highlighted in the newly opened exhibition at New York's American Museum of Natural History, "Countdown to Zero: Defeating Disease."

President Carter, who describes himself and his wife, Rosalynn, as "constant listeners to NPR," spoke to us after attending the opening of the exhibition, which was developed in collaboration with the Carter Center. An edited version of the interview follows.

Happy belated birthday! How's the view from 90?

We have a lot to relish looking backward. Rosalyn and I feel grateful to have served this country as first family of America. I'm still getting on fine, and we have a chance to look forward, too. And so we're looking forward to getting rid of Guinea worm and making progress in health care, and we also help bring honest elections to people.

And how do you plan to celebrate the eradication of Guinea worm disease? It depends on where the last case will be. We don't yet know if it will be Mali or Chad or Ethiopia or South Sudan. And so wherever it is we'll have a celebration there, but we'll also have a tremendous celebration at the Carter Center with representatives from all 20 countries [where Guinea worm still existed when the campaign began]. How why and did you decide to focus on Guinea worm eradication? In the years 1980 to 1990, the United Nations had the Freshwater Decade [officially called the International Drinking Water and Sanitation Decade] emphasizing the importance of freshwater. The Assistant Secretary-General at the United Nations who headed that program was my former drug czar Dr. Peter Borne, who was a friend of mine. So he came to the Carter Center to describe some of the horrible diseases that resulted from drinking bad water, including Guinea worm. And the main reason he came to the Carter Center was because he couldn't get anyone else to tackle this problem. It's a despicable disease. And it was in such remote villages that no one wanted to take on the task. So we decided to take it on. We started in 1986 and we've been going at it ever since. Twenty-six thousand five hundred villages were affected — and [the Carter Center] has been to every one of them. Describe your visits to the villages. I've sometimes had thousands of students from schools lined up outside on the highway when I come into the village. In Nigeria, they had big signs that said, "Watch out, Guinea worm, here comes Jimmy Carter!" That makes you feel good.

One of the first cases of Guinea worm I ever saw was a beautiful young woman who I thought was holding a baby in her right arm. But it was actually her right breast, and it had a Guinea worm a foot long coming out of her nipple. She later had 11 other Guinea worms coming out of her body that year. On that visit we had a banker who volunteered to pay to dig a deep well for the village [so they could have clean water]. And when we went back there a year later, there was no more guinea worm. That's what happens quite often when the villages take advantage of the advice that we give them. We let them do the work, and we give them credit for it.

Why did you choose to focus on global health issues?

Our main commitment at the Carter Center is to fill vacuums in the world. We don't duplicate what others are doing. If the World Health Organization or the United Nations or the United States government or [other organizations] are doing work, we don't get involved. We tackle problems that other people aren't addressing.

We thought at first the Carter Center would just negotiate peace agreements for countries, like I did between Egypt and Israel, or help with troubled elections around the world, which we still do. It developed that the biggest need was to address the so-called neglected tropical diseases, to use a WHO phrase. We are now involved with malaria and with five other diseases, one of which is Guinea worm and the others are river blindness, trachoma, schistosomiasis, and lymphatic filariasis. It sounds like you're jumping in where others fear to tread? That's right. This year we've treated 25 million people for river blindness. That's more than the number of people who live in the state of New York. Copyright 2019 NPR. To see more, visit https://www.npr.org.