NAIROBI, Kenya (AP) — Jimmy Carter was the first U.S. president to make a state visit to sub-Saharan Africa. He once called helping with Zimbabwe’s transition from white rule to independence “our greatest single success.” And when he died at 100, his foundation’s work in rural Africa had nearly fulfilled his quest to eliminate a disease that afflicted millions, for the first time since the eradication of smallpox.

The African continent, a booming region with a population rivaling China’s that is set to double by 2050, is where Carter’s legacy remains most evident. Until his presidency, U.S. leaders had shown little interest in Africa, even as independence movements swept the region in the 1960s and ’70s.

“I think the day of the so-called ugly American is over,” Carter said during his warm 1978 reception in Nigeria, Africa’s most populous country. He said the official state visit swept aside “past aloofness by the United States,” and he joked that he and Nigerian President Olesegun Obasanjo would go into peanut farming together.

Cold War tensions drew Carter’s attention to the continent as the U.S. and Soviet Union competed for influence. But Carter also drew on the missionary traditions of his Baptist faith and the racial injustice he witnessed in his homeland in the U.S. South.

“For too long our country ignored Africa,” Carter told the Democratic National Committee in his first year as president.

African leaders soon received invitations to the White House, intrigued by the abrupt interest from the world’s most powerful nation and what it could mean for them.

“There is an air of freshness which is invigorating,” visiting Zambian President Kenneth Kaunda said.

Carter observed after his first Africa trip, “There is a common theme that runs through the advice to me of leaders of African nations: ‘We want to manage our own affairs. We want to be friends with both of the great superpowers and also with the nations of Europe. We don’t want to choose up sides.’”

The theme echoes today as China also jostles with Russia and the U.S. for influence, and access to Africa’s raw materials. But neither superpower has had an emissary like Carter, who made human rights central to U.S. foreign policy and made 43 more trips to the continent after his presidency, promoting Carter Center projects that sought to empower Africans to determine their own futures.

As president, Carter focused on civil and political rights. He later broadened his efforts to include social and economic rights as the key to public health.

“They are the rights of the human by virtue of their humanity. And Carter is the single person in the world that has done the most for advancing this idea,” said Abdullahi Ahmed An-Naim, a Sudanese legal scholar.

Even as a candidate, Carter mused about what he might accomplish, telling Playboy magazine, “it might be that now I should drop my campaign for president and start a crusade for black-majority rule in South Africa or Rhodesia (now Zimbabwe). It might be that later on, we’ll discover there were opportunities in our lives to do wonderful things and we didn’t take advantage of them.”

Carter welcomed Zimbabwe’s independence just four years later, hosting new Prime Minister Robert Mugabe at the White House and quoting the Rev. Martin Luther King, Jr.: “Injustice anywhere is a threat to justice everywhere.”

“Carter told me that he spent more time on Rhodesia than he did on the entire Middle East. And when you go into the archives and look at the administration, there is indeed more on southern Africa than the Middle East,” historian and author Nancy Mitchell said.

Relations with Mugabe’s government soon soured amid deadly repression and by 1986 Carter led a walkout of diplomats in the capital. In 2008, Carter was barred from Zimbabwe, a first in his travels. He called the country “a basket case, an embarrassment to the region.”

“Whatever the Zimbabwean leadership may think of him now, Zimbabweans, at least those who were around in the 1970s and ’80s, will always regard him as an icon and a tenacious promoter of democracy,” said Eldred Masunungure, a Harare-based political analyst.

Carter also criticized South Africa’s government for its treatment of Black citizens under apartheid, at a time when South Africa was “trying to ingratiate itself with influential economies around the world,” current President Cyril Ramaphosa said on X after Carter’s death.

The think tank Jimmy and Rosalynn Carter founded in 1982 played a key role in monitoring African elections and brokering cease-fires between warring forces, but fighting disease was the third pillar of The Carter Center’s work.

“The first time I came here to Cape Town, I almost got in a fight with the president of South Africa, Thabo Mbeki, because he was refusing to let AIDS be treated,” Carter told a local newspaper. “That’s the closest I’ve come to getting into a fist fight with a head of state.”

Carter often said he was determined to outlive the last guinea worm infecting the human race. Once affecting millions of people, the parasitic disease has nearly been eliminated, with just 14 cases documented in 2023 in a handful of African countries.

Carter’s quest included arranging a four-month “guinea worm cease-fire” in Sudan in 1995 so that The Carter Center could reach almost 2,000 endemic villages.

“He taught us a lot about having faith,” said Makoy Samuel Yibi, who leads the guinea worm eradication program for South Sudan’s health ministry and grew up with people who believed the disease was simply their fate. “Even the poor people call these people poor, you see. To have the leader of the free world pay attention and try to uplift them is a touching virtue.”

Such dedication impressed health officials in Africa over the years.

“President Carter worked for all humankind irrespective of race, religion, or status,” Ethiopia’s former health minister, Lia Tadesse, said in a statement shared with the AP. Ethiopia, the continent’s second most populous country with over 110 million people, had zero guinea worm cases in 2023.

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Associated Press reporters Farai Mutsaka in Harare, Zimbabwe, and Michael Warren in Atlanta contributed.