MSF staff test a mother and child for Chagas disease. Bolivia, 2006.
Juan Carlos Tomasi
Chagas is a parasitic disease found on the American continent, where it affects 18 million people and kills up to 50,000 every year. The disease is transmitted by an insect that lives in the walls and roofs of mud and straw houses, common among rural areas and poor urban slums in South America.
Millions of people, including those infected decades ago, go undetected and untreated. This is because symptoms can lie dormant for years and determining whether a patient is infected or not requires several blood tests. About 20-30% of those infected will go on to develop the chronic symptomatic form of the disease, which causes irreversible damage to the heart, oesophagus and colon.
Existing drugs and diagnostic tests for Chagas disease are inadequate, expensive and in short supply. The drugs used cannot eliminate the parasite in the blood during the chronic phase of the disease and they are ineffective against some strains of the parasite. There is currently no drug formulation adapted for young children and the existing drugs cannot be prescribed to pregnant women (who risk passing the disease on to their babies).
Because people who have been treated can easily be re-infected, treatment is more effective in areas with active vector control (the vector in this case is the insect that transmits the disease). Through our programmes in Latin America, we aim to show that by following patients up on a weekly basis, existing drugs can be used more widely than previously understood, with manageable side effects.
However, significant funding is needed from the international community to support national programmes in Latin America. In addition, the production and availability of the two existing drugs (nifurtimox and benznidazol) must be secured, and paediatric versions developed. MSF has also called for the development of new diagnostic tests and better treatment.
In the field, MSF doctors are constantly frustrated by the lack of adequate medical tools. In response, Médecins Sans Frontières set up the MSF Access Campaign in 1999 to improve access to existing medical tools and to stimulate the development of urgently needed better tools. Campaign for Acces to essential medecins.
MSF is well known for its humanitarian medical work, but it has also produced important research based on its field experience with vulnerable populations. This website archives MSF's scientific articles and makes them available free, with full text, and in an easily searchable format. MSF Field Research website.
For 30 years, MSF has directly witnessed the human cost of the lack of drugs for neglected diseases and has raised its voice against this inequity. In 2003, seven organisations from around the world joined forces to establish DNDi, Drugs for Neglected Diseases Initiative.