Lessons Learned: 'Chagas disease, an invisible threat in Nicaragua'

In Latin America, approximately 90 million people are at serious risk of contracting Chagas. This disease takes up to 50,000 lives each year, and affects primarily poor communities. Nicaragua is no exception; Chagas affects thousands of people from communities in the north and center of the country (the provinces of Matagalpa, Madriz and Nueva Segovia).

MSF is aware that resources are needed to fight this disease and to improve diagnosis and treatment tools, but, above all, political will is the key factor to lift out of the silence and oblivion this disease which can cause death.

For more then two years, MSF supported the Nicaraguan Ministry of Health to reduce the incidence and prevalence of Chagas in the municipality of Esquipulas and seven months in Totogalpa.

The problem is that Chagas is a "forgotten" disease. Why? Because it is the illness of the poor people. Chagas is practically "invisible" because in most cases its effects are only manifested up to ten years after infection by the transmitting insect (chinche) , which makes it difficult for the health staff to diagnose the disease. On the other hand, Chagas has been very much neglected by the pharmaceutical industry. No new medication has been developed in the last thirty years. Chagas patients must take obsolete, highly ineffective treatment with many side effects.

For all these reasons, this book is meant for everyone who wants to know more about Chagas and obtain realistic information on the diagnosis and treatment of this disease. On the eve of leaving the country after 22 years of supporting Nicaragua's major health programs, MSF invites health authorities, pharmaceutical industries, NGOs, and the general public, to make a contribution so that Chagas disease will no longer be invisible but that it will be addressed as the threat it really is in Nicaragua.

MSF asks that national health authorities, donor countries, PAHO and WHO assume their responsibility and address Chagas disease from a public health point of view. The current approach, based on vector control and the expensive management of chronic patients with severe cardiac anomalies must evolve to an integral public health approach. MSF has already established the following objectives:

Research and development on adapted medications, effective, easy to use, non-toxic and within the reach of Chagas patients.

To ensure the manufacturing and availability of the only two existing medications: Benznidazol and Nifurtimox.

To increase research and development to improve effective diagnosis tools for all the stages of the disease.

With the publication of this book, MSF (MSF) wants to share the experiences they obtained during the realization of the Chagas Project, carried out during three years in Nicaragua. (2002 - 2005). It was not our idea to produce a pure technical document, but to provide a tool to better understand the Chagas disease and the difficulties implied in preventing and controlling this disease.