In recent years Venezuela has faced a severe economic crisis precipitated by political instability and a significant reduction in oil revenue. Public health provision has suffered particularly. Long-term shortages of medicines and medical supplies and an exodus of trained personnel have occurred against the backdrop of a surge in vector-borne parasitic and arboviral infections. Herein, we aim to assess comprehensively the impact of Venezuela's healthcare crisis on vectorborne diseases and the spillover to neighbouring countries. Methods Alongside the ongoing challenges affecting the healthcare system, health-indicator statistics have become increasingly scarce. Official data from the Ministry of Health, for example, are no longer available. To provide and update on vector-borne disease in Venezuela, this study used individualized data from nongovernmental organizations, academic institutions and professional colleges, various local health authorities and epidemiological surveillance programs from neighbouring countries, as well as data available through international agencies. Findings Between 2000-2015 Venezuela witnessed a 365% increase malaria cases followed by a 68% increase (319,765 cases) in late 2017. Neighbouring countries such as Brazil have reported an escalating trend of imported cases from Venezuelan from 1,538 (2014) to 3,129 (2017). Active Chagas disease transmission is reported with seroprevalence in children (<10 years) as high as 12.5% in one community tested (N=64). There has been a nine-fold rise in the mean incidence of dengue between 1990 to 2016. Estimated rates of chikungunya and Zika are 6,975 and 2,057 cases per 100,000 population, respectively, during their epidemic peaks. Interpretation The re-emergence of many arthropod-borne endemic diseases has set in place an epidemic of unprecedented proportions, not only in Venezuela but in the region. Data presented here demonstrates the complex determinants of this situation. National, regional and global authorities must take action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders.

Traditionally, there has been a frequent, yet incorrect assumption that phlebotomine vectors, animal reservoirs, and human hosts are susceptible to Leishmania infection by a single parasite species. However, current evidence supports that these new vector-parasite-reservoir associations lend vectors and reservoirs greater permissiveness to certain Leishmania species, thus promoting the appearance of coinfection events, particularly in disease-endemic regions.

In February 2017, a diphtheria outbreak occurred among Amerindians of the Pemón ethnic group in Wonken, Venezuela. A field investigation revealed ≈10 cases; clinical presentation did not include cutaneous or neurologic signs or symptoms. To prevent future outbreaks in Venezuela, Amerindian communities need better access to vaccination and healthcare.

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