Chagas disease: still a neglected emergency

Abstract

A report from the Pan American Health Organization (PAHO), released on Oct 19, describes progress in the spread and control of Chagas disease. The report—Control, interruption of transmission and elimination of Chagas disease as a public health problem—describes the troubling issues confronting regions dealing with this neglected infectious disease. The statistics are worrying. 70 million people in South and central America are at risk of infection, of whom 6 million are infected, with the majority unaware. The report estimates 14 000 deaths per year are a direct result of Chagas disease, a burden affecting mainly low-income populations who do not have access to diagnosis and treatment. In 2009, we published an Editorial entitled “Chagas disease: a neglected emergency”. Unfortunately, there has been little progress over the past decade because of the complex nature of the disease. PAHO's report describes Chagas disease as “an intricate plot of sociocultural, political, biological, environmental, and health aspects”. Elimination mainly relies on insecticide treatment, and patients face the combined barriers of access to treatment, lack of information, and the extreme length of the asymptomatic phase of the disease. Treatment itself has not progressed meaningfully in several decades and consists of old, highly toxic drugs that lead many patients to terminate the course. In an increasingly interconnected world, it is dangerous to view a disease historically restricted to one specific region as someone else's problem. This report should be proof enough that international collaboration with a focus on improving control and treatment of Chagas disease is long overdue and that this infection requires a truly international response. As the report says, Chagas disease is now present in North America, Europe, Asia, and Oceania. Greater collaboration earlier in the century could have prevented this spread. We hope not to have to write the same Editorial in 2029. Chagas disease: still a neglected emergency?10 years after highlighting the health consequences for millions of people infected with Trypanosoma cruzi, a 2019 report from the Pan American Health Organization concluded that there has been little progress in the prevention and treatment of Chagas disease, a problem that now extends beyond Latin America.1 Full-Text PDF