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Chagas: Neglected disease neglected once again

Chagas disease not addressed by World Health Assembly

 

MSF urges affected countries to scale up diagnosis and treatment on 100th anniversary of the disease’s discovery

 


NEWS | 19 May 2009

The World Health Organization (WHO) has cut short its annual health ministers’ meeting due to influenza A (H1N1) preparations and postponed discussions about Chagas disease. Yet much-needed progress in increasing the number of people receiving diagnosis and treatment for this neglected disease must not be delayed, warns international medical humanitarian organization Médecins Sans Frontières (MSF).

This week’s World Health Assembly (WHA), the annual gathering of health ministers in Geneva, was an opportunity for countries to commit collectively to stepping up the fight against Chagas, a largely neglected tropical disease endemic in many Latin American countries, affecting an estimated 14 million people and killing about 15,000 every year.

“At the 100th anniversary of Chagas’ discovery we had expected that the WHA would adopt a resolution where all affected countries agree to integrate care of acute and chronic Chagas patients into their primary healthcare systems and to invest more in research,” said Roger Teck, a director of operations for MSF. “People affected by this neglected disease are once again neglected. However, even though Chagas is now off the WHA agenda, this should not be used as an excuse for inaction. Governments of endemic countries should step up through developing and implementing better national and international protocols to fight against Chagas.”

Chagas is an infectious disease caused by the Trypanosoma cruzi parasite. Originating in Latin America, more and more cases are being reported in the U.S., Europe, Australia and Japan as a result of migration and mobility. In its chronic form, Chagas causes heart and gastrointestinal tract disease, leading to disability and death.

Chagas programs have traditionally focused on preventing the disease by controlling the "kissing bugs," the blood-sucking insects that transmit the disease. But MSF's experience in Honduras, Nicaragua, Guatemala and Bolivia since 1999 has shown that prevention is far from enough.

“The focus on prevention ignores the needs of those who are already infected and are suffering in silence. In endemic countries, governments should do active screening, diagnose and treat many more patients,” said Gemma Ortiz, senior advocacy officer for Chagas with MSF. “Access to diagnostics and treatment must be made a priority.”

MSF also urges WHO member states to review a range of alternative financing mechanisms, such as prize funds, to stimulate research and development for better tools to diagnose and treat Chagas patients in all stages of the disease. The lack of commercial incentives to invest in research and development has meant that Chagas has been neglected for decades.

Since 1999, MSF has implemented Chagas projects in Honduras, Nicaragua, Guatemala, and Bolivia. Currently, MSF is working in three suburban districts in Cochabamba in Bolivia, the country with the highest recorded Chagas prevalence. MSF works with the Bolivian Ministry of Health in five primary healthcare centres, where children and adults up to 50 years of age are diagnosed and treated. A new Chagas project will open in the rural area of Cochabamba this year. MSF has continuously advocated for scaled up access to diagnosis and treatment and its integration into primary healthcare.


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