[Update on the dracunculosis eradication program]

Dracunculiasis has been described since antiquity and will be forever associated with the image of the method of extraction consisting of winding a few centimeters of the worm around a stick every day. For nearly ten years a worldwide effort to eradicate this infection has been under way. Achieving this apparently simple goal is hindered by the difficulties in accessing infected areas and by the dire poverty in the regions involved which include the "poorest of the poor". Spectacular results have been accomplished in Pakistan thanks to the concerted efforts of political, financial, and technical officials from a number of national and international organization. While the rate of infestation has decreased by 90% worldwide, the final push to complete eradication is the most difficult and, as in India and Mali, is being oriented towards a strategy involving an integrated approach. Results are slow and gradual but notable and durable progress has been made in terms of village water supply. It is necessary that intervention in these areas be associated with other poverty-fighting programs. Successful eradication without accompanying improvements would be a technical victory but in terms of public health and welfare such a victory would correspond to an unjustifiably missed opportunity.