In Papua New Guinea, children are playing
like they do anywhere in the world.
But these kids are at high risk of a tropical
skin disease that causes big ulcers.
Yaws is caused by a bacterium
that infects through wounds and scratches,
usually on the legs.
It doesn’t kill, but if left untreated,
it can destroy bone tissue and cause
permanent pain and disfigurement.
In May 2018, Martin Enserink
travelled to Papua New Guinea.
I went to meet a Spanish doctor and scientist,
Oriol Mitja. He spends most of his time on
a tiny, very remote island named Lihir.
I wanted to learn about his efforts to not
just treat yaws but to wipe it
from the face of the world.
Lihir is very poor.
Most people don’t have running water or electricity.
Medical care is rudimentary.
When Mitja arrived in Lihir in 2010, he was
really surprised to see lots of cases of yaws
he had never heard of the disease,
even though he was trained in tropical medicine.
Until the 1950s, yaws was a huge global problem.
There were as many as 50 million cases.
Yaws bacteria thrive in hot, humid, poor, and rural regions.
In 1954, the World Health Organization launched
an ambitious campaign to eliminate the disease
using penicillin.
More than 50 million people received injections.
Cases dropped by 95%.
But the job was never finished.
By the 1990s, yaws was almost completely forgotten.
But the bacterium wasn’t gone,
and eventually it bounced back.
What made eradication difficult was that
infected people who no longer had symptoms
often receive no treatment.
If they became sick again,
they could infect others.
The only way to prevent that
would be to treat everyone, with or without symptoms.
But penicillin injections are not ideal.
If done unsafely, they can transmit
blood-borne pathogens.
They’re also painful and cumbersome.
Six years ago, Mitja found a solution in Lihir.
He did a clinical study and showed that a single
dose of a well-known antibiotic, named azithromycin,
cures yaws just as well as a penicillin injection.
Azithromycin is cheap, safe, and easy to administer.
Mitja’s research has changed
the way patients are treated.
It has also revived the dream of yaws eradication.
The World Health Organization said:
This is great, now we can eradicate yaws after all
because with this drug, it's fine to
treat entire populations.
On a neighboring island, Mitja is working with
the Papua New Guinea government to test this strategy.
Seeing the researchers at work on this island
made me really appreciate just
how daunting a study like this is.
They're trying to reach 60,000 people
in hundreds of remote villages. Very poor area.
And they’re doing not just one,
but three rounds, six months apart.
The hope is that this will make yaws disappear.
If it works, the same strategy might be used
to eradicate yaws globally.
But obstacles remain.
Nobody knows how widespread yaws is today.
Only 14 countries report cases,
but others may still have yaws as well.
And eradication could cost a billion dollars or more.
No one has offered to foot the bill.
Some scientists even wonder whether we can ever fully
eradicate yaws, because the bacterium has also been
found in primate some primate species.
That raises the question: could it jump
back to humans from those animal reservoirs?
But one thing is clear: Mitja has
put a forgotten disease back on the agenda.
More people are getting treatment.
Research on yaws is flourishing again.
What struck me, talking to people about yaws
is that the optimism of the 1950s seems to be back.
Maybe it's possible for them to finish the job after all.