As Jimmy Carter approaches 90, he is reaching for victory in a 15-year war against an infection spread by houseflies that blinds millions in developing countries and posed a threat to his own family and neighbors as a child on a Georgia farm.

“Our goal is to eliminate blinding trachoma from the face of the earth by 2020,” the former U.S. president said during a visit on Tuesday to the New York headquarters of Pfizer Inc, which donates the antibiotic Zithromax used to treat the disease.

Trachoma, the world’s leading cause of preventable blindness, affects more than 20 million people worldwide, of whom about 2.2 million are visually impaired and 1.2 million are blind, according to the World Health Organization.

The disease is caused when houseflies, attracted to the moist eye, spread Chlamydia bacteria. It is spread further through contact with eye discharges on towels, fingers or other infected surfaces.

After years of untreated trachoma infections, the eyelids turn inward and scrape the cornea, causing blindness. The disease was eliminated in the United States in the 1970s but is still a threat to an estimated 320 million people worldwide, especially in developing nations, according to Pfizer.

Largely through the combined efforts of the Carter Center and an independent nonprofit program called the International Trachoma Initiative co-founded by Pfizer in 1998, blindness associated with the disease may have been eradicated in Morocco and Ghana.

But blinding trachoma remains a threat in other developing nations, especially Ethiopia, where almost a third of the population is considered at risk.

“When you go to a village, quite often from a distance you see children and think they’re wearing eyeglasses,” Carter said. “And you get close to them and you see instead of eyeframes, it’s a circle of flies around their eyeballs sucking out moisture. That causes the disease and they don’t even know that they should wash their faces.”

Carter said other necessary elements of controlling the disease, besides routinely washing the face, are surgery, antibiotics and building latrines so human waste does not provide a breeding ground for flies.

TRAINING HEALTH WORKERS

In Ethiopia, Carter said his center has helped train more than 30,000 health workers, most of them women, and that half of them have the skills of a licensed practical nurse.

He noted that in some African nations, he has had to deal with dictators and corrupt or ineffective ministers who have been at odds with each other or slow to recognize the potential of eliminating blinding trachoma.

Especially important, he said, is cooperation from ministers of transportation because many or most villages are practically inaccessible.

“These are the kinds of things you have to overcome,” he said. “It’s a long tedious slow process, but once you teach the top leaders in a country or surrounding village this can be done, there’s almost an overwhelming reaction of enthusiasm and cooperation.”

The Carter Center, in partnership with national programs, is still trying to eliminate blinding trachoma in the African nations of Mali, Nigeria, Niger and Sudan.

Carter said he has been partly motivated by his own childhood memories of trachoma, in rural Georgia.

“I was always afflicted with houseflies around my eyes and I had sore eyes almost all the time. My mother happened to be a registered nurse, and so she knew I had to wash my face and try to control the flies, which was almost impossible.”

Carter said six families lived on the farm, and his family was the only one with a latrine. “So I was blessed by being in a family that had the medical knowledge.”

Carter in “retirement” has also been heavily involved with building houses for the poor through Habitat for Humanity, monitoring elections in nations with histories of fraudulent voting processes and mediating disputes between the U.S. State Dept and volatile foreign leaders.