"Your article was fascinating ... but it did not tell the whole story," writes the 39th United States president, who aims to eliminate river blindness.
A National Geo September 2016 article “ Why There’s New Hope About Ending Blindness” examined some of the largest, most stubborn causes of blindness—untreatable retinal issues and a treatable but neglected the epidemic of cataracts in the developing world.
Below is a letter from President Jimmy Carter sent to National Geographic on behalf of the Carter Center, which is striving to eliminate onchocerciasis (river blindness), another cause of blindness.
To the Editors,
I read with interest David Dobbs' article "Why There's New Hope Around Ending Blindness" in the September 2016 issue of your magazine. While no general-circulation magazine article could possibly explore all the many causes of blindness, this one did not address a huge problem for people living in poverty: blindness caused by infectious diseases.
With the support and cooperation of numerous governmental agencies, foundations, nongovernmental organizations and other partners, the Carter Center has been working for decades toward eliminating blinding onchocerciasis (known as river blindness) and trachoma in the poorest parts of the world.Trachoma, a bacteria spread from one person to another and by certain flies, can be found in over 50 countries, most in Africa and the Middle East. Globally, 200 million people are at risk (with women and children at highest risk), with over 3.2 million at immediate risk for blindness from an advanced stage of the disease called trichiasis, in which the eyelashes turn inward and painfully scratch the cornea. Multiple agencies, including the Carter Center, control trachoma by digging latrines to deny the flies a breeding medium, teaching children to keep their faces clean so flies won’t land on them, distributing millions of doses of the antibiotic azithromycin (Zithromax®), donated by Pfizer, and training local practitioners to perform the simple eyelid surgery that reverses trichiasis.These are massive efforts. This year, for instance, the Carter Center expects to administer 59.9 million treatments.The loss of sight causes enormous human suffering and has public health, social, and economic consequences for the developing world. Your article was fascinating and the technological developments are encouraging, but it did not tell the whole story of the global partnerships and grassroots community-based actions that are preventing blindness among millions living in poverty today.
Guinea worm disease and river blindness are among 17 tropical diseases the World Health Organization considers neglected. Thanks to the efforts of the Atlanta-based Carter Center -- founded by former president Jimmy Carter and his wife Rosalynn -- focused treatment and prevention are leading to the elimination of one, and the extinction of another.
When Carter and the Carter Center staff started working to eradicate Guinea Worm disease in 1986, it was found in 21 countries in Africa and Asia.
“We had three-and-a-half million cases of guinea worm, and village by village we have done away with it. Last year, we only had 146 cases in the whole world,” he said.
Most of the remaining infections by the parasitic worm are found in South Sudan, where Carter said, despite the recent unrest, the Carter Center continues working to prevent transmission of the disease by monitoring and filtering water sources.
“At this moment we have about 212 people on our payroll, almost all of whom have been trained locally, and about 8,000 women who volunteer their services,” he said.
Eliminating river blindness
Elsewhere in Africa, the Carter Center has shifted its focus from controlling river blindness - another parasitic infection - to eliminating it.
While river blindness can’t be eradicated like Guinea worm, the Carter Center discovered that by modifying the dosage of the antibiotic ivermectin, the disease could be eliminated in the human body.
“If we gave two to four pills a year, then the adult worms that created the microfilaria would be eliminated. We found that out in Latin America, in six countries, we could completely do away with river blindness permanently. Now we've tried that in Africa and found it to be successful again,” said Carter.
The World Health Organization reports about 18 million people worldwide suffer from river blindness, 99 percent of them in Africa.
President and Mrs Carter are not just observers or administrators for the Carter center. They are both very hands on.