A World Health Assembly (WHA) resolution on Chagas disease control
and elimination, to be adopted this week, is a step in the right
direction but does not go far enough to fully tackle the disease since
it focuses only on prevention, the international medial humanitarian
organization Doctors Without Borders/Medecins Sans Frontieres (MSF) and
the Drugs for Neglected Disease initiative=
(DNDi) said today.
The groups are calling on WHA member states to also focus on the
integration of diagnosis and treatment of Chagas at primary health care
levels and to increase research and development of effective drugs to
treat the parasitic disease, common in parts of Latin America.
"After more than 10 years of experience, MSF has successfully treated
thousands of patients with Chagas," said Fran Roman, vice-president of
MSF. "We would like to see equal importance given to treatment and
diagnosis as to prevention strategies. 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."
While the intention of the resolution is to control and eliminate
Chagas disease, it includes no clear statement addressing diagnosis,
treatment once patients are diagnosed, or the research and development
of new tools to the fight the disease.
"Chagas patients have been forgotten because they are poor and fall
outside mainstream market interest," said Bernard Pecoul, executive
director of DNDi. "But science exists to develop better treatments and
diagnostic tools for all. The first steps toward progress at an
international level are through sustainable, predictable funding and
strong public support. The delegates at the WHA now have the opportunity
to move forward and take concrete action," he said.
The WHA resolution has the potential to impact millions of people
infected by Chagas, the leading parasitic killer in the Americas, with
an estimated 10 to 15 million people infected per year.
The WHA should follow the example of the Pan American Health
Organization (PAHO), which prioritized treatment in its 2009 resolution
"Elimination of neglected diseases and other poverty-related
infections," said the organizations.
Urgent actions and measures to increase medical response 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 programs and to
promote much-needed research and development, which is virtually
non-existent. They also urge a focus on better treatment (less toxic,
shorter and more efficient treatment courses in all stages of the
disease for children and adults), diagnostic tools adapted to the
limited resources settings and a test of cure to control Chagas disease.
About American Trypanosomiasis or Chagas Disease
Each year, an estimated 10 to 15 million people across the world are
infected with the Chagas disease. Every year 14,000 people die as a
consequences of the disease. Endemic in 21 Central and Latin American
countries, it also has growing presence in non-endemic countries through
migration of people. In Central and South America, Chagas kills more
people than any other parasite-borne disease, including malaria. The
disease 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 efficacious treatments for
children and adults.
Doctors Without Borders /Medecins Sans Frontieres/ (MSF)
has screened more than 60,000 people for Chagas and has treated over
3,000 patients with the disease since 1999. MSF opened its first Chagas
treatment program in Honduras. MSF has developed programs in Nicaragua,
Guatemala and currently screens, diagnoses and treats children and
adults in Bolivia and Colombia. A new project is opening in Paraguay.
About DNDi
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, 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 Doctors Without Borders/Medecins Sans Frontieres (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 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.