Criteria for the certification of dracunculiasis eradication, 2023 update

This 2023 update of Criteria for the certification of dracunculiasis eradication supersedes the  documents published by the World Health Organization (WHO) in 1990, 1993 and 1996. The 1990 publication included the report of an informal consultation on the criteria for certification of dracunculiasis elimination (Geneva, 19–21 February 1990). The 1993 publication contained the outcomes of a round table on criteria for the certification of dracunculiasis eradication on the occasion of the second meeting of programme managers for dracunculiasis eradication (Cotonou, 23–26 March 1993). The 1996 publication included the recommendations of the International Commission for the Certification of Dracunculiasis Eradication (ICCDE) at its first meeting (Geneva, 5 March 1996). 

The present revised criteria include the recommendations of the thirteenth meeting of  the ICCDE (Addis Ababa, 25–26 April 2019) at which a Subgroup on certification of countries reporting animal infections was established. The revision was led by the Subgroup with contributions from ICCDE members, the WHO Secretariat and the participants at the fourteenth (virtual) ICCDE meeting (8 October 2020) as well as those attending ad hoc meetings of the ICCDE. 

Dracunculiasis (Guinea-worm disease) results from infection with the nematode parasite Dracunculus medinensis (the Guinea worm). The disease has been endemic in certain communities without access to safe sources of drinking-water and has had serious adverse effects on health, agricultural production and school attendance. A global campaign to eradicate dracunculiasis started in the early 1980s. In 1991, the World Health Assembly endorsed efforts to eliminate dracunculiasis country by country. Since the 1980s, the number of human dracunculiasis cases has  decreased substantially, from around 3.5 million cases per year to only 13 in 2022. In accordance with the recommendations of the ICCDE, WHO has certified 199 countries, territories and areas as free of dracunculiasis transmission, including 187 Member States. However, cases continue to occur in a few African countries, and global eradication remains elusive. A critical challenge is the emergence of new patterns of infection in animal hosts, particularly domestic dogs, which has required revision of definitions and protocols for eradication and its certification.