{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:45:15Z","timestamp":1785836715519,"version":"3.56.0"},"reference-count":13,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Trop. Med. Infect. Dis.","TropicalMed"],"abstract":"<jats:p>Guinea worm disease is approaching eradication, with only 10 human cases reported worldwide in 2025, the lowest annual total recorded. Yet the final phase of eradication presents complex clinical and public health challenges that differ from earlier stages of control. Persistent animal infections, particularly in dogs, civil conflict, fragile health systems, financing disruptions, and the need for prolonged surveillance threaten progress at the point when global attention may wane. Unlike smallpox, Guinea worm has been driven to near-eradication without a vaccine, curative drug, or rapid diagnostic test, relying instead on safe water, filtration, vector control, case containment, community education, reporting incentives, and sustained field operations. This Perspective argues that eradication remains achievable but requires a specific policy agenda: protected financing for surveillance, animal-source transmission control, safe-water measures, operational access, and certification through 2030. Completing the final mile would represent a permanent preventive achievement and a durable victory for neglected populations too often overlooked.<\/jats:p>","DOI":"10.3390\/tropicalmed11080218","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:02:19Z","timestamp":1785830539000},"page":"218","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Guinea Worm Eradication: New Clinical and Public Health Challenges at the Last Mile"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6943-5673","authenticated-orcid":false,"given":"Barry R.","family":"Davis","sequence":"first","affiliation":[{"name":"Biostatistics and Data Science, Center at the University of Texas-Houston, School of Public Health, University of Texas Health Science, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Population Health, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7339-1124","authenticated-orcid":false,"given":"Lisette V.","family":"Alcantara","sequence":"additional","affiliation":[{"name":"Department of Population Health, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6762-2291","authenticated-orcid":false,"given":"Dennis G.","family":"Maki","sequence":"additional","affiliation":[{"name":"School of Medicine and Public Health, University of Wisconsin, Madison, WI 53705, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D.","family":"Dye","sequence":"additional","affiliation":[{"name":"Department of Population Health, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Hennekens","sequence":"additional","affiliation":[{"name":"Department of Population Health, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL 33431, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025). Dracunculiasis (Guinea-Worm Disease), World Health Organization. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/dracunculiasis-(guinea-worm-disease)."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2026, July 02). About Guinea Worm, Available online: https:\/\/www.cdc.gov\/guinea-worm\/about\/index.html."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"648","DOI":"10.15585\/mmwr.mm7442a2","article-title":"Progress Toward Eradication of Dracunculiasis (Guinea Worm Disease)\u2014Worldwide, January 2024\u2013June 2025","volume":"74","author":"Hopkins","year":"2026","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_4","unstructured":"The Carter Center (2026). Guinea Worm Disease Eradication Program, The Carter Center. Available online: https:\/\/www.cartercenter.org\/programs\/guinea-worm\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"991","DOI":"10.15585\/mmwr.mm7344a1","article-title":"Progress Toward Global Dracunculiasis (Guinea Worm Disease) Eradication, January 2023\u2013June 2024","volume":"73","author":"Hopkins","year":"2024","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_6","unstructured":"The Carter Center (2026). Guinea Worm Disease Reaches All-Time Low: Only 10 Human Cases Reported in 2025, The Carter Center. Available online: https:\/\/www.cartercenter.org\/news\/guinea-worm-announcement\/."},{"key":"ref_7","unstructured":"World Health Organization (2023). Criteria for the Certification of Dracunculiasis Eradication, 2023 Update, World Health Organization. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240073333."},{"key":"ref_8","unstructured":"World Health Organization (2025). WHO Issues Guidance to Address Drastic Global Health Financing Cuts, World Health Organization. Available online: https:\/\/www.who.int\/news\/item\/03-11-2025-who-issues-guidance-to-address-drastic-global-health-financing-cuts."},{"key":"ref_9","unstructured":"World Health Organization (2025). Dracunculiasis Eradication: Global Surveillance Summary, 2024. Wkly. Epidemiol. Rec., 100, 165\u2013191."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"317","DOI":"10.4269\/ajtmh.24-0673","article-title":"Proactive Tethering to Prevent Guinea Worm Infections among Dogs in Chad: An Analysis of the Impacts of Timing and Dog Selection","volume":"113","author":"Smalley","year":"2025","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Dupper, A.C., Cleveland, C.A., Haynes, E.K., Yabsley, M.J., Torres-Velez, F., Sidouin, M.K., Oaukou, P.T., Weiss, A.J., and Garabed, R. (2026). Concurrent Therapeutic and Behavioral Interventions Are Associated with a Reduced Number of Emerging Dracunculus medinensis Worms in Dogs in Chad. PLoS Negl. Trop. Dis., 20.","DOI":"10.1371\/journal.pntd.0012896"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e00328","DOI":"10.1016\/j.parepi.2023.e00328","article-title":"Dog Screening as a Novel Complementary Guinea Worm Disease Control Tool to Mitigate Persistence in Chad: A Modeling Study","volume":"23","author":"Helikumi","year":"2023","journal-title":"Parasite Epidemiol. Control"},{"key":"ref_13","unstructured":"World Health Organization (2024). Three Central African Countries Commit to Global Eradication of Guinea-Worm Disease, World Health Organization. Available online: https:\/\/www.who.int\/news\/item\/17-09-2024-three-central-african-countries-commit-to-global-eradication-of-guinea-worm-disease."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/11\/8\/218\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:58:22Z","timestamp":1785833902000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/11\/8\/218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":13,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["tropicalmed11080218"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed11080218","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}