Until recently, the world was on the verge of eradicating its first human disease in more than three decades. And then the Mali crisis erupted, putting the progress in jeopardy.
Guinea worm disease, a horrific parasitic infection that has sickened millions of people for centuries in Africa and Asia, has been 99.9 per cent eradicated since 1986 in a relentless campaign led by former U.S. president Jimmy Carter.
But today the stalled campaign against Guinea worm is among the widening humanitarian costs of the Mali crisis. The latest fighting has triggered a refugee exodus and growing shortages of food and medicine in front-line towns and regions, under siege since the beginning of the French airstrikes last week.
Guinea worm is a disease so ancient it was found in Egyptian mummies and mentioned in biblical texts, where it was called "the fiery serpent."
Yet it was on track to become the first global disease to be eradicated since the elimination of smallpox in 1980. It would also be the first disease to be wiped out without a vaccine, using instead cheap preventive devices and public-health measures.
This week, Mr. Carter announced another dramatic cut in the number of Guinea worm cases, reducing the new cases by half in the past year. Less than 550 new cases were reported globally last year, compared to 3.5 million in 21 countries in 1986.
But the continuing rebellion and military conflict in Mali, one of only four countries where the disease still exists today, is a "primary obstacle to success," Mr. Carter said.
There were only seven cases of Guinea worm in Mali last year, yet those final cases can be the hardest to eliminate, since even a single case can spread to hundreds of people within a year.
Meanwhile, as the Mali war continues, leading relief agencies such as Médecins sans frontières (Doctors Without Borders) and the International Committee of the Red Cross have been blocked from reaching survivors who were injured or forced from their homes in towns such as Konna and Diabaly in central Mali.
"There is acute concern about the fate of civilians who remain in Konna and Diabaly," the ICRC said in a statement on Friday.
"Currently unable to access either town, the ICRC and the Mali Red Cross will try to assess the need for humanitarian aid in villages on the edge of the conflict zones."
According to an MSF official, Mali's army has blocked all roads to Konna, where French airstrikes drove out the Islamist insurgents who captured the town last week. As a result, MSF has been unable to send in medical teams to help the injured.
"Since the Malian and French forces began their offensive, we have not been able to cross the front lines, despite our neutrality. Entire regions are now cut off from outside aid," said a statement by MSF operations director Malik Allaouna.
A local medical group, Cri de Coeur, said it was prevented from reaching the towns of Konna, Gao and Douentza, all of which had been bombed by French warplanes.
"Is it normal to leave the wounded to die like flies without assistance?" asked the group's president, Almahady Cisse, according to a report by a UN agency.
Nearly 400,000 people have been forced from their homes in Mali over the past year, including nearly 150,000 who took shelter in neighbouring countries. Thousands have fled their homes since the French airstrikes began and the UN refugee agency is preparing for as many as 700,000 more to be displaced by the new fighting.