Towards control of Chagas disease: the contribution of the new brazilian consensus

The continuous challenge of Chagas disease treatment: bridging evidence-based guidelines, access to healthcare, and human rights

“…The globalization of the disease is increasingly recognized and has thereby broadened the debate on the right to health, demanding an integrated response between countries [1][2][3] . Despite its relevance as a public health problem, great failures persist in national health systems in providing access to diagnosis and treatment for affected people [3][4][5][6] .…”

“…In fact, the literature emphasizes the urgent need for the development of new treatments for chronic Chagas disease 2,6 . In this context, there are affected people with no guarantee of the right to health, who sustain the high burden of the disease and perpetuate the cycle of poverty in their families 3,4 . The primary care teams should be articulated with other levels of health care (greater technological complexity) for reference and counter-referencing of the more complex cases, keeping the clinical management also at the local level 1,4 .…”

“…In this context, there are affected people with no guarantee of the right to health, who sustain the high burden of the disease and perpetuate the cycle of poverty in their families 3,4 . The primary care teams should be articulated with other levels of health care (greater technological complexity) for reference and counter-referencing of the more complex cases, keeping the clinical management also at the local level 1,4 . The current political-economic scenario in Latin America has accelerated social inequalities, while at the same time weakening the role of the State in the development and regulation of health care actions, including surveillance and control of neglected diseases, such as Chagas disease 1 .…”

“…In particular, Brazil in the last three years has regressed rapidly in its social policies, with a deepening of income concentration, placing it again on the list of one of the most unequal countries in the world. This situation has enhanced individual and social vulnerability that was responsible for old and new determinants of disease transmission 4 . At the same time, the weakening of the health care network in the Unifi ed Health System (SUS) further limits access to services, generating situations of serious program vulnerability, with a strong restriction on access to health, especially in areas of greater endemicity 1 .…”

“…In addition, the best strategies for comprehensive care in the specifi c contexts of the countries must be provided for the people affected 4,9 . Besides the parasitological treatment, other aspects of care are fundamental to ensuring quality of life in people affected and must be evaluated.…”