PAHO Calls for Stepped-Up Efforts on Chagas

The Pan American Health Organization (PAHO) has called on its member countries to boost their efforts to fight Chagas' disease, an insidious parasitic illness that affects some 18 million people in the Americas.

Experts gathered at the 6th Meeting of the Andean Initiative to Control Chagas' Disease, convened by PAHO in May, called on countries to step up efforts to control the disease's vector, the so-called "assassin bug" (T. cruzi), and to improve surveillance and treatment.

Participants recommended that countries that lack surveillance and control programs start to develop them and that "countries that do have national control programs strengthen them and provide them with the best possible conditions for their sustainability."

The experts also called for more research on and production of drugs to treat Chagas and for inclusion of these drugs in countries' lists of essential medicines.

Chagas is considered one of the region's "neglected diseases," which have traditionally been marginalized in the health sector. Spread by insects that thrive in substandard housing, the disease disproportionately affects poor people, and treatment for it is not widely available.About 80 percent of all cases are transmitted by the vinchuca, known also as the "kissing bug," which lives in cracks and holes in dirt walls and bites people, often near the mouth, while they sleep. The parasite enters the body when people scratch their skin or rub their eyes, then reproduces in the internal tissues and causes problems in the heart, the esophagus, the colon, and the nervous system.

Chagas can also be transmitted through blood transfusions and organ transplants, and from mother to child at birth.An estimated 40 million people in the region are considered at risk of contracting the disease.

Effective control measures against Chagas include fumigation and improvements to housing, blood screening, and testing of pregnant women.

PAHO's Chagas program, headquartered in Uruguay,is supporting a number of international efforts to fight the disease, including subregional initiatives by the countries of the Southern Cone, Central America, the Amazon, and the Andean region.

The Southern Cone initiative succeeded in reducing the incidence of Chagas' disease by 94 percent in seven countries between 1991 and 2000. The initiative was recently cited as one of the 17 most cost-effective international public health interventions in the book Millions Saved, published by the Center for Global Development.

PAHO's Chagas program has provided technical cooperation, facilitated country-tocountry cooperation, and partnered with the Japan International Cooperation Agency, the Canadian International Development Agency, Doctors without Borders, the Inter-American Development Bank, the Red Cross, and the European Community, among others.