Gates, Carter Target Disease

The Atlanta Journal-Constitution
April 6, 2005 - Wednesday Home Edition

The Carter Center received a blockbuster grant Tuesday that could yield $45 million for its quest to eradicate Guinea worm disease, an ancient affliction of the developing world.

The Bill & Melinda Gates Foundation will give the Carter Center $5 million this year and match other contributions up to $20 million. It is the largest "challenge grant" that the Carter Center has received in its 23-year history.

Eradicating Guinea worm disease has long been the Carter Center's top health priority. Since the center launched its campaign in 1986, the number of cases has declined from 3.5 million to 15,500. The Gates Foundation may help make Guinea worm the first disease stamped out since smallpox in 1979, former President Jimmy Carter said in a statement.

"It will be a historic moment when, working together," he said, "the global community eradicates this 3,000-year-old disease."

Since Microsoft Chairman Bill Gates created the foundation in 2000, it has given the Carter Center $27 million to combat elephantiasis, a debilitating condition that causes limbs to swell; river blindness, a preventable cause of blindness caused by the bite of a certain black fly; and Guinea worm. The Gates Foundation gave an additional $4 million in 2003 to support the Carter Center's endowment.

The Gates Foundation has become the largest institutional donor to the Carter Center's health programs, said Nicole Kruse, the center's top fund-raiser for health programs.

Carter has a warm relationship with Bill Gates Sr., the computer whiz's father and one of two leaders at the Gates Foundation, which has a $28 billion endowment and has awarded $7.7 billion, including $4.1 billion for health programs. The former president and Gates Sr. traveled together to Kenya, Nigeria and South Africa in 2002 to examine the impact of AIDS. The next year, Carter spoke at the dedication of a law school named for Gates.

The Gates Foundation's senior health adviser, Dr. William Foege, is a former executive director of the Carter Center. A professor at Emory's Rollins School of Public Health, Foege helped map strategy during the campaign to eradicate smallpox and led the Centers for Disease Control and Prevention during the Carter administration.

"He's what you call a public health giant. He's a true public health hero," Kruse said. "Dr. Foege knows our program very well. That certainly can't hurt."

David Bradling-Bennett, infectious disease program officer for the Gates Foundation, said Carter and Gates Sr. spoke about the grant at least once. He said Foege's ties to the Carter Center did not factor into the decision to award the Guinea worm grant. He said the center's record of ridding much of Africa and Asia of a debilitating disease impressed the foundation.

"The possibilities are quite high that we will succeed in eradication," Bradling-Bennett said.

People contract Guinea worm by drinking water infested with microscopic fleas with infected larvae. Inside a human body, larvae grow into worms up to 3 feet long. After a year, the worms emerge through the skin in painful blisters.

"People with the disease are often unable to go to school, farm their crops or do other work, resulting in serious economic losses and increased poverty," the Carter Center said.

The Carter Center and its partners fight Guinea worm by treating drinking water and teaching people about the disease's origin. Health workers also teach people to use filters to make their water safe. Since 1986, nine of 20 endemic countries have broken transmissions, the center says, and five of the remaining endemic countries had fewer than 100 cases last year. If the eradication effort succeeds, Guinea worm will be the first disease conquered without medicines or vaccines.

Most remaining cases are in Ghana and Sudan, where a recent peace agreement between the government and rebels may open parts of southern Sudan that have been inaccessible.

Carter's efforts
Carter's interest in fighting Guinea worm disease dates to at least 1988, when he saw more than 800 victims in Ghana, including a woman with a worm burrowing out of her breast.

The former president brokered a cease-fire in Sudan in 1995 so health workers could take on the disease. Officials in Mali knighted him three years later for his efforts. Carter has raised money from a variety of corporations, foundations and the governments that include Denmark, Japan, Norway and the United Kingdom.

In a recent interview, Carter mentioned his desire to eradicate Guinea worm.

"To consummate that goal would not only send a clear signal to the health agencies of the world that eradication is still possible," he said, "but it also encourages people in the rural villages to know that if they do work side-by-side with a benevolent organization like the Carter Center, they can achieve success and they can have hope for the future and a better life."