“They need to put more skin in the game,” Dr. Ruiz-Tiben said. He described Chad’s President Idriss Déby, who took power in a 1990 coup, as “passive” about the effort.

“He says the right things on the phone to President Carter, but doesn’t visit the villages to talk to people and make the local governors do more. They’re happy for us to do the work, but they don’t contribute money.”

Bureaucrats are paralyzed by fear of losing their jobs, and simple tasks like license plates for the center’s vehicles take months.

Local officials say they are aware that the world is watching.

“Yes, I feel pressured,” said Youssouf Mbodou Mbami, the newly appointed governor of Moyen-Chari province, where many of Chad’s worm cases are. “I might not have chosen this job because this problem persists, but I won’t hesitate to help.”

Dr. Ouakou said the government is keenly aware that national pride is on the line. But “since the dogs and even cats have entered the dance, it is difficult to predict when we will have mastered the situation,” he said.

President Déby wants to finally end the plague, Dr. Ouakou said — but has not, he conceded, given him a deadline.