World Health Assembly: MSF and DNDi call for a more rounded resolution on Chagas disease

The resolution, ‘Chagas Disease: Control and Elimination’, is about to be adopted this week at the World Health Assembly (WHA). While a step in the right direction, the resolution lacks elements essential in tackling Chagas disease and only focuses on prevention. Médecins Sans Frontières (MSF) and Drugs for Neglected Disease Initiative (DNDi) call on Member States to include the integration of treatment and diagnosis at primary healthcare level and increased efforts in research and development.

“After more than 10 years of experience, MSF has successfully treated thousands of patients with Chagas. We would like to see equal importance given to treatment and diagnosis as with prevention strategies,” said Fran Román, MSF Vice-President in Barcelona. “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.

The intention of the resolution is to control and eliminate Chagas disease, yet there is no clear statement addressing diagnosis, treatment once patients are diagnosed, or the research and development of new tools.

“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 Bernard Pecoul, Executive Director of DNDi. “The first steps to making progress at an international level are through sustainable, predictable funding and strong public support. The delegates at WHA have now the opportunity to move forward and take concrete action.”

This is an opportunity for millions of people infected by this disease, which remains the leading parasitic killer in the Americas, with an estimated 10 to 15 million being infected and 14,000 people dying each year.

In 2009, the Member States of Pan American Health Organization (PAHO) adopted the resolution ´Elimination of neglected diseases and other poverty-related infections´, where the primary strategy includes etiological treatment of children and medical care for adults, which is in line with the key messages of MSF and DNDi.

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 programmes 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 the Chagas disease.

About American trypanosomiasis or Chagas disease Each year over 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. Occuring in two stages, 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, which ideally treat both stages of Chagas

Médecins Sans Frontières (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 organisation has developed several programmes in Nicaragua, Guatemala and, currently , MSF screens, diagnoses and treats children and adults in Bolivia and Colombia and is now starting a new project 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 disease, 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 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 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.