Chagas disease: review of needs, neglect, and obstacles to treatment access in Latin America

Abstract

After more than one century since its discovery, Chagas disease is still extremely prevalent in 21 Latin American countries. Chagas disease is one of the most concerning public health problems in Latin America; the overall cost of CD treatment is approximately 7 billion United States dollars per year and it has a strong social impact on populations. Little progress has been made regarding the access to diagnosis and treatment at the primary health care level, calling into question the current policies to ensure the right to health and access to essential medications. In this article, diverse dimensions of access to treatment for Chagas disease are reviewed, illustrating the present state of benznidazole medication in relation to global production capacity, costs, and needs. The findings are based on an investigation requested by Médecins Sans Frontières Brazil through a consultancy in 2015, aiming to estimate the current costs of benznidazole production.

The continuous challenge of Chagas disease treatment: bridging evidence-based guidelines, access to healthcare, and human rights

“…Alberto Novaes Ramos Junior [1] and Andréa Silvestre de Sousa [2], [3] [1]. Federal University of Ceara, School of Medicine, Department of Community Health, Fortaleza, Ceara, Brazil.…”

“…Oswaldo Cruz Foundation, Evandro Chagas National Institute of Infectious Diseases, Rio de Janeiro, Rio de Janeiro, Brazil. [3]. Federal University of Rio de Janeiro, School of Medicine, Department of Internal Medicine, Rio de Janeiro, Rio de Janeiro, Brazil.…”

“…The globalization of the disease is increasingly recognized and has thereby broadened the debate on the right to health, demanding an integrated response between countries [1][2][3] . Despite its relevance as a public health problem, great failures persist in national health systems in providing access to diagnosis and treatment for affected people [3][4][5][6] .…”

“…In fact, the literature emphasizes the urgent need for the development of new treatments for chronic Chagas disease 2,6 . In this context, there are affected people with no guarantee of the right to health, who sustain the high burden of the disease and perpetuate the cycle of poverty in their families 3,4 . The primary care teams should be articulated with other levels of health care (greater technological complexity) for reference and counter-referencing of the more complex cases, keeping the clinical management also at the local level 1,4 .…”

“…The disease-related stigma and the impact on quality of life enhances the cycle of neglect and poverty 1,3 . The different possible dimensions to care, such as psychological and social approaches, appear to be forgotten, further limiting access to health.…”