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Rx for Survival — A Global Health Challenge

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Global Health Champions

Donald R. Hopkins

Donald R. Hopkins

Associate Executive Director
The Carter Center

Donald R. Hopkins will never forget his first sight of a Guinea worm. "It was as awful as I imagined it to be," he says. "And that was a gentle introduction. I can show you pictures of a worm emerging from the back of a child's head. Another Guinea worm once came out under a man's tongue. The swelling was so painful he couldn't swallow, and he starved to death."

But today, Donald Hopkins stands on the brink of the worldwide eradication of Guinea worm disease, also called dracunculiasis. As associate executive director for health at The Carter Center in Atlanta, Hopkins has led the Guinea worm eradication initiative, which has brought down the number of Guinea worm cases from an estimated 3.5 million in 1986 to approximately 15,500 cases in 2004. "This disease affects the poorest of the poor," says Dr. Ade Lucas, a Nigerian physician. "For a long time, Don Hopkins was the only one who believed that Guinea worm could be eradicated."

Eradicating Guinea worm has long been the top health priority of The Carter Center, founded in 1982 by former U.S. President Jimmy Carter and his wife, Rosalynn, in partnership with Emory University.

Guinea worm is contracted when people drink water infested with microscopic fleas that are themselves infected with Guinea worm larvae. Inside the human body, the larvae can grow into string-like worms up to three feet long. After a year, the worms emerge through the skin in painful blisters. Working in an ambitious international collaboration involving UNICEF, the Centers for Disease Control, and the World Health Organization, Hopkins and The Carter Center have led the effort to fight Guinea worm by treating drinking water and teaching people about the origin of the disease. The campaign trains local health workers to teach people to use nylon filters to make their water safe, to avoid recontamination of ponds by preventing anyone with Guinea worm disease from entering water sources, and to report new infestations.

Hopkins considered locally targeted public education campaigns to be the fastest and most effective intervention, communicating simple messages through radio, T-shirts, posters, stamps, and sides of vehicles. During "worm weeks," intensive health education and community mobilization involved international volunteers staging plays, arranging ceremonies with prominent officials, and demonstrating the use of filters to prevent the disease. A true global partnership, the campaign has drawn on the participation of foundations, African governments, village volunteers, the private sector, and people infected with the disease themselves.

As a result of the worldwide campaign begun two decades ago, known cases of Guinea worm disease have been reduced by more than 99.5 percent in Asia and sub-Saharan Africa. The conflict-torn Sudan is one of the last bastions of the disease, and President Carter has visited rebel-controlled regions to negotiate inroads in its treatment there. If the eradication effort succeeds, Guinea worm will be the first disease conquered without medicines or vaccines.

With quiet determination, Hopkins has tackled some of the developing world's most serious public health challenges. A veteran of the smallpox eradication campaign, the first successful effort to eliminate a disease worldwide, Hopkins has also been a key player in international efforts to control measles and to eliminate onchocerciasis, or river blindness.

"People worry about bioterror," says Hopkins, "but nature is capable of things on a much bigger scale. To me, the real bioterror is seeing a child die of pertussis [whooping cough] or Guinea worm. These are the everyday threats. We need to protect locally and fight globally."

Commenting on Hopkins's leadership, President Carter says: "There have been few heroes in my life, and Dr. Donald R. Hopkins is one of them. He is a doctor and a public health professional committed to alleviating the suffering of millions who go unnoticed by the media. But he is ultimately an individual with the passion and heart to lead others down a similar path. Dr. Hopkins knows that with modest outside help, people can and will take effective action to improve their own lives."

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