The Resolution ‘Chagas Disease: Control and Elimination’ to be adopted by the WHO is a step in the right direction but lacks essential elements
At the ‘World Health Assembly’ (May 17-22, 2010) in Geneva, the resolution ‘Chagas Disease: Control and Elimination’ is about to be adopted by the World Health Organization (WHO). Although this is a step in the right direction, the resolution lacks essential elements. Médecins Sans Frontières/Doctors Without Borders (MSF) and Drugs for Neglected Disease initiative (DNDi) call on WHO Member States to include in the resolution the integration of treatment and diagnosis at the primary healthcare level and increased efforts in research and development.
“After more than 10 years of experience treating patients with Chagas, MSF has successfully treated thousands of patients. We would like to see equal importance given to treatment and diagnosis as to prevention strategies,” says Fran Román, MSF Vice President. “The countries affected must agree to integrate diagnosis and treatment at the primary health level if they want to reach all patients, children and adults, in both acute and chronic phases of the disease,” he adds.
“Chagas patients have been forgotten because they are poor and fall outside the mainstream market interest, but science exists to develop better treatments and diagnostic tools for all,” said Dr. Bernard Pecoul, Executive Director of DNDi. “The first steps to make progress at an international level are through sustainable and predictable funding, and strong public support. The delegates at WHA now have the opportunity to move forward and take concrete action,” says Pecoul.
The intent of the resolution is to control and eliminate Chagas disease, yet there is no focus on the diagnosis of infected patients, treatment of patients, or research and development of new diagnostic tools and medications. The resolution lacks a clear statement to address patient needs and the lack of access to diagnosis and treatment.
The Chagas resolution by the WHO, the world’s highest health policy setting body, is an opportunity for millions of people infected by this disease, which remains the leading parasitic killer in the Americas. An estimated 10 to 15 million people are infected every year, and 14,000 people die.
In 2009, the Member States of Pan American Health Organization (PAHO) adopted the resolution ´Elimination of neglected diseases and other poverty-related infections,´ in which the primary strategy includes disease-specific treatment for children and offering other medical care for adults, in whom Chagas-specific drugs have limited effectiveness. This strategy is in line with the key messages of MSF and DNDi.
Urgent actions must be taken to scale up diagnosis, treatment and patient access to care and to boost research and development for new tools. MSF and DNDi also call on Member States to reinforce the supply chains of existing treatments so that they are available to health staff and national programmes and to promote urgent research and development, which is virtually non-existent. R&D is needed for better treatment (less toxic, of shorter duration, and efficient in all stages of the disease for children and adults), for diagnostic tools adapted to the limited resources settings, and for a test of cure to control Chagas disease.
Read the Resolution EB124.R7.
About American Trypanosomiasis or Chagas Disease
Each year over 10 to 15 million people worldwide are infected with Chagas disease. Every year 14,000 people die of the consequences of the disease. Endemic in 21 Central and Latin American countries, the disease also has growing presence in non-endemic countries through migration of people. In Central and South America, Chagas disease kills more people than any other parasite-borne disease, including malaria. Chagas occurs in two stages and is caused by the parasite Trypanosoma cruzi, transmitted primarily by insects known as “kissing bugs.” The existing treatments have an unsatisfactory cure rate and can have toxic side effects. DNDi aims to develop affordable, safe, and effective treatments for children and adults, which ideally treat both stages of Chagas.
Médecins Sans Frontières/Doctors Without Borders (MSF)
MSF has screened more than 60,000 people for Chagas and has treated over 3,000 patients with the disease since 1999. In Honduras, MSF opened its first Chagas Project in 1999. Since then, the medical organization has developed several programs in Nicaragua and Guatemala, and currently , MSF screens, diagnoses and treats children and adults in Bolivia and Colombia and is now starting a new project in Paraguay.
The Drugs for Neglected Diseases initiative (DNDi) is a not-for-profit product development partnership working to research and develop new and improved treatments for neglected diseases, in particular human African trypanosomiasis (sleeping sickness), leishmaniasis, Chagas disease, and malaria. With the objective to address unmet patient needs for these diseases, DNDi was established in 2003 by the Oswaldo Cruz Foundation from Brazil, the Indian Council for Medical Research, the Kenya Medical Research Institute, the Ministry of Health of Malaysia, the Pasteur Institute, and Médecins sans Frontières (MSF). WHO/TDR acts as a permanent observer. Working in partnership with industry and academia, DNDi has the largest ever R&D portfolio for kinetoplastid diseases. Since 2007, DNDi has delivered three products: two fixed-dose anti-malarials “ASAQ” and “ASMQ,” and a combination treatment for the advanced stage of sleeping sickness, “NECT” (nifurtimox-eflornithine combination therapy).
The first Chagas treatment for children, pediatric strength benznidazole, will be made available as public good in the near future by DNDi and Pharmaceutical Laboratory of Pernambuco (LAFEPE) in Brazil. Furthermore, in 2009 DNDi signed a collaboration and license agreement with the Japanese pharmaceutical company Eisai Co. Ltd. for the clinical development of the promising compound E1224, to treat Chagas disease.For more details go to www.dndi.org
For more information, please go to www.dndi.org or www.msf.org or contact:
Eva van Beek at email@example.com or +41 (0)79 309 39 10 / +41 22 906 92 50
Guillaume Bonnet at firstname.lastname@example.org or: +41(0)79 2031302/+41228498403
Clara Tarrero at email@example.com or +34 680 598 677/+34 93 304 61 15