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Carter’s War on Worms

March 1, 2007


New York Times op-ed columnist, Nicholas Kristof, spent time with former President Jimmy Carter in Ethiopia where the former president is working to eliminate river blindness [“Let’s Start a War, One We Can Win,” 20 February 2007]. Kristof begins his piece writing about one of the patients who uses the clinic established by Carter in a war torn portion of that country. The patient, a nearly 80 year old male, suffers from river blindness and the worms that cause it. Kristof writes:

“He is so blind that he rarely leaves the house any more, but on this occasion he staggered to the village clinic to get a treatment for the worms inside him. His skin is mottled because the worms cause ferocious itching, especially when they become more active at night. He and other victims scratch until they are bloodied and their skin is partly worn away. Ultimately the worms travel to the eye, where they often destroy the victim’s sight. Ethiopia has the largest proportion of blind people in the world, 1.2 percent, because of the combined effects of river blindness and trachoma. As in many African countries, the wrenching emblem of poverty is a tiny child leading a blind beggar by a stick.”

Of course, not just the old are inflicted. There is a triple whammy associated with such preventable tragedies. There are the devastating personal effects (whammy one), then there is the fact that previously healthy people become unproductive members of society hurting the economy (whammy two), and they stress the limited (if any) social services available through governments struggling to invest in the future (whammy three). Here is where Carter is making his stand.

“In remote places like this, former President Carter, at 82, is leading a private war on disease that should inspire and shame President Bush and other world leaders into joining. It’s not just that Mr. Carter’s wars have been more successful than Mr. Bush’s; Mr. Carter is also rehabilitating the image of the U.S. abroad and transforming the lives of the world’s most wretched peoples.”

Kristof notes that Carter is also trying to reduce or eliminate the devastating effects of malaria and elephantiasis in such places. Simple things like mosquito nets are all that are needed to make a good start.

“Mr. Carter has almost managed to wipe out one horrific ailment — Guinea worm — and is making great strides against others, including river blindness and elephantiasis. In this area, people are taking an annual dose of a medicine called Mectizan — donated by Merck, which deserves huge credit — that prevents itching and blindness. Mectizan also gets rid of intestinal worms, leaving Ethiopian villagers stronger and more able to work or attend school. Among adults, the deworming revives sex drive, so some people have named their children Mectizan. Mr. Carter’s private campaign against the diseases of poverty, put together with pennies and duct tape, is a model of what our government could do. Imagine if the U.S. resolved that it would wipe out malaria and elephantiasis (both are spread by mosquitoes, so a combined campaign makes sense). What if we celebrated science not by trying to go to Mars but by extinguishing malaria? What if we tried to burnish America’s image abroad not only with press releases and propaganda broadcasts, but also with a bold campaign against disease?”

What great advertising for Merck! I’m not sure I’ll ever see a bunch of kids named Enterra® or ERMS, but then again our products do little to revive sagging sex drive! President Carter has repeatedly shown what the good intentions and unstoppable drive of a single individual can accomplish. Granted he has better credentials than most of us, which enables him to attract others more easily to his causes, but his example is nevertheless inspiring.


Kristof ends his piece with a bit of politicizing about the war in Iraq and how he wishes President Bush’s priorities would change. Government expenditures are always about prioritization. The span of government interests will always remain broad. The more focused an individual’s attention and goals the less this becomes a problem. That is one reason that President Carter has been so successful. His focus (although still amazingly broad) has permitted him to draw attention to and raise money for houses and illnesses in ways he could never have done as a sitting president. It is why our Development-in-a-Box™ approach stresses public/private partnerships and communities of practice. DIB looks to address challenges, whenever possible, in a non-political way. Such an approach helps provide focus where it is often desperately needed and applies resources against challenges in a way that donor governments, who must deal with corrupt administrations, simply can’t. Done right Development-in-a-Box, makes it difficult for corrupt regimes to benefiting directly from development assistance. DIB works even better when good political leaders become full partners. That is when an economic miracle can occur. At the moment, however, bottom-up efforts are proving most effective. Economic transformation generally has a greater transformational influence over politics than vice versa and Development-in-a-Box is primarily an economic approach.

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