South-south cooperation for Chagas disease

摘要

Between 1992 and 2004, the Pan American Health Organization (PAHO) and the WHO led the creation of several south-south cooperation initiatives to accelerate control and elimination of Chagas disease in South and Central America (appendix). These include the Southern Cone Initiative (Argentina, Bolivia, Brazil, Chile, Paraguay, and Uruguay) created in 1992, followed by the Central America Initiative in 1997 (Belize, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, and Panama), the Andean Initiative in 1998 (Colombia, Ecuador, Peru, and Venezuela), and the Amazon Initiative in 2005 (Bolivia, Brazil, Colombia, Ecuador, Guyana, French Guiana, Peru, Suriname, and Venezuela). These cooperation initiatives function through annual meetings of intergovernmental commissions that assess advances, set goals, and analyse issues on control, prevention, and care, and periodic field assessments by international expert missions, which have allowed the exchange of experiences at the technical level and have given the system sustainability. These inter-country initiatives contributed to the interruption of transmission of Trypanosoma cruzi by Triatoma infestans and Rhodnius prolixus, through intensive vector control efforts. In 2012, 54% of the area that was affected by vector transmission of T cruzi in 1992 had stopped the transmission, resulting in roughly 200 million people under protective measures against infection by vector transmission. Annual deaths estimates fell from more than 45 000 in the early 1990s to 12 000 in 2008. Between 1990 and 2006, the number of new cases of Chagas disease decreased from 700 000 to 56 000 per year, and the total number of infected individuals dropped from 30 million to 6-8 million.