Myths that ChaDA Works to Dispel to Create Awareness
1."There is no plague that has lasted 100 years"
False, This year Chagas Disease turned a century-old, ever since Dr. Carlos Justiniano Ribeiro Chagas first discovered the parasite in a patient on April 15, 1909.
2."Chagas Disease only affects impoverished populations"
False, Not all of the Neglected Tropical Diseases (NTD) exclusively affect impoverished populations. Chagas Disease and Dengue, both affect the middle and upper-classes of developing countries but their incidence is also increasing in urban zones of developed-countries.
2.1 In the case of Chagas Disease, the increasing incidence in urban zones is a consequence of migration of infected-individuals from endemic zones to cities where the parasite is transmitted via routes other than directly from vector to host. Mother to child (vertical transmission), transfusion (from infected blood in blood banks), and transplantation (from infected organs that are donated) all account for this emergence. No control measures have existed until the last couple of years to intervene in these routes of transmission.
2.2 In the case of Dengue, the presence of populations of the vector, mosquitos Aedes aegypti and Aedes albopictus, has expanded due to a combination of environmental, political, and social factors.
3. "Chagas Disease is a responsibility of local governments in endemic zones"
False, the search for alternative methods of control are not "exclusively" the obligation of public leaders with budgets that have been granted by the government. The consolidation of a team of specialists in this search down an alternative road has permitted Chagas Disease Alliance- ChaDA to get to know some of the keys in the development of these diseases and be able to define a strategic short-, medium-, and long-term plans. The plans are rooted in a platform of action called Global Action Plan (GAP), which is in sync with the current public health regulations and with the constant support, since 2008, of global companies with evidence-based solutions. ChaDA, in the short time since its creation, has achieved to convince these companies to invest in the subsistence of various programs and products that allow us to project objective results.
4. "Vector-transmitted diseases are eradicable"
There is no general consensus about the eradication of these diseases. ChaDA concedes with the CDC in the statement, "the hemispheric eradication of Aedes aegyti is no longer realistic" and we believe that the same holds true in the eradication of the vector that causes Chagas Disease.
4.1 Chagas Disease, like Dengue and other vector-transmitted diseases, has multiple components that sustain it. For several decades, we continue to condemn people to live a life of disability or pre-mature death because we are not prepared to face such preventable diseases. This lack of preparation is due to systems and programs that don't permit the appropriate assignment of resources and the use of technology for entomologic surveillance (for example) and research.
4.2 The designated resources for research are insufficient in addition to being poorly-distributed. In the majority of cases, the institutions that receive funding are NOT associated with the companies that SHOULD be evaluating the technical and economic feasibility of the development of products (medications and entomologic control), whom can do it on a innovative scale with a maximum cost-benefit relationship; granted that it would permit an efficient use of the assigned public resources and maximize efficiency.
4.3 The successful achievement of a preventative vaccine would bring us to the "finishing line"- eradication, but in the case of Chagas Disease we are still far from achieving this. In order to prove the efficacy of such a vaccine to bring it to the market, there would have to be extremely long-lasting clinical trials carried out in patients that manifest symptoms of the disease after 40-50 years of age. Of course it would be ideal to count on a preventative vaccine for Chagas Disease, but we must act today.
The companies with the capacity for research look at the opportunity to develop a vaccine for Dengue with more enthusiasm than for Chagas Disease since the magnitude of people at risk for Dengue is much greater. The market for a vaccine to prevent Dengue has a potential to benefit 1.8 billion people, in Asia alone.
4.4 While ruling out a program for a preventation for the century year-old plague of Chagas Disease, there is not going to be motivation for long-term investment, which is what is needed. At ChaDA, we hope this new awareness arrives to all involved-parties and decision-makers. Chagas Disease is a market.
What validates the previous statement is evident in the following: If we continue ignoring the fact that Mexico has 8 million infected people, all infected via blood banks, the problem will never be resolved. The number of infected people in the endemic areas can help call attention and bring an identity to the people affected in non-endemic countries, such as the population infected via contaminated blood transfusions. (Read: The Neglected Tropical Diseases of Latin America and the Caribbean: A Review of Disease Burden and Distribution and a Roadmap for Control and Elimination).
Since 2007, the United States has controlled transmission from blood banks. While a diagnosis continues to be put off in patients that could have received a blood transfusion or organ donation before that year, the world, the market, the companies, the governments, and the community with the power to create a difference continue to not recognize the real magnitude of the reemerging problem in the USA. An example to follow is Spain, as part of a preliminary investigation just diagnosed 68,000 people in the community of immigrants from endemic countries and their children.
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Traducido por / Translated by: Matt Romo, PharmD candidate 2011, MCPHS, mattromo.blogspot.com