When the Carter Center hired Dr. Frank Richards from the Centers for Disease Control and Prevention in 1996, he and Jimmy Carter had a goal: eliminate river blindness from the earth.

River blindness doesn’t get as much press as the Carter Center’s work on Guinea worm or observing elections, much less Carter’s own work building houses with Habitat for Humanity. Guinea worm is close to eradication, a monumental achievement, where river blindness is still a work in progress.

Carter even held up the Guinea worm success as he announced his cancer diagnosis in 2015: “I’d like the last Guinea worm to die before I do.”

Richards had a passion for fighting tropical diseases that tend to affect the poor in developing countries but don’t get much attention, and that fit the description of river blindness. The CDC in 1996 agreed to detail him to the Carter Center to direct Carter’s newly established program to eliminate river blindness.

River blindness is a disease caused by microscopic worms living in the human body. The worms spread as embryos, carried by tiny black flies that breed in fast-flowing rivers and then fly around biting people. After the embryos take root they grow and reproduce, spreading inflammation in the eyes and skin. Their eyes go blind.

It’s a disease afflicting poor people who live in remote areas near fast-flowing rivers. People go blind and develop such itchy, disfigured skin that they can no longer work, trapping them in a Catch-22 of poverty.

In broad swathes of Africa and in a handful of Latin American countries where it was brought by enslaved Africans, it endangers perhaps 200 million people.

Richards thought with the right strategy it could be eliminated. But it wasn’t a global priority. That’s where Carter came in with his personal gifts.

The pharmaceutical company Merck had come up with a drug that could stop the disease, if administered often enough. They were willing to donate the drug itself, called Mectizan, or ivermectin, if someone else wanted to fund and manage the distribution.

Carter used his gravitas as a former president to get meetings with countries that have the disease, and countries that had the money to fund a program like that. He used his political skills to sell the political benefits of signing on.

When Carter met with Richards and their staff, as a trained engineer he wanted details on how it works. But then when he met with countries’ leaders he spoke differently.

“He understood the models, he understood the data. He wanted me to talk to him about that, he did not want an elevator speech,” Richards said. “But he was marvelous in translating that into elevator speeches.”

They made progress. River blindness has been eliminated from most of Latin America, except a remote Amazon border region between Brazil and Venezuela. It’s been removed as a threat from millions of African people.

Carter never gave up. In 2014 — when he was 90 — Richards was anguished about the last area of Latin American transmission. Venezuela and Brazil had no diplomatic relations.

Carter, 90, agreed to go to Mexico City to try to talk to them at the edges of a conference taking place there.

That was Carter, Richards said: It didn’t work in the end, but he kept trying.

And in an era with politicians focused on fighting and winning, Carter had wins.

“The Nigerian tailor whose vision is so improved the he can now thread his needles thanks to the Mectizan treatments. He lives in Plateau state, which the government has declared now free of river blindness,” Richards said.

“He fought the good fight,” Richards said. “He won a lot. There are 20 million people that no longer have river blindness. When I started working on river blindness in 1982 as a young medical officer it was untreatable — untreatable.”

Richards’ back straightened and his eyes filled with tears.

“That’s something.”

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