Logistics of Guinea worm disease eradication in South Sudan

Abstract

From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical-logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries.

Figure 1.

Guinea worm lifecycle.

Figure 2.

GWD-endemic focal areas and ethnic groups in 2006.

Figure 3.

Logistical hubs and field offices with cloth and pipe filters distributed by logistical hubs in 2012.

Figure 4.

Continuous quality improvement cycle for SSGWEP logistical system.

Figure 5.

SSGWEP logistical and technical management structure in 2012 (Ministry of Health, Republic of South Sudan, unpublished data).

Figure 6.

Total pipe and cloth filters distributed and villages under active surveillance from 2006 to 2012 (Ministry of Health, Republic of South Sudan, unpublished data).

Figure 7.

New GWD cases by year and endemic village annual intervention coverage rates from 2006 to 2012 (Ministry of Health, Republic of South Sudan, unpublished data).

Figure 8.

SSGWEP non-personnel logistical costs by type (2006–2012).