The shortage of benznidazole leaves thousands of Chagas patients without treatment

Introduction

Médecins Sans Frontières (MSF) has been working on Chagas disease since 1999 in a number of Latin American countries, providing access to diagnosis and treatment to people infected by this neglected parasitic disease. From 1999 to the beginning of 2011, a total of eight projects were implemented in Honduras, Nicaragua, Bolivia, Guatemala, Colombia and Paraguay. During this period, MSF tested more than 80,000 people, diagnosing 6,185 and treating 4,160 with benznidazole (BZD) as a first-line option for treatment.

Until recently, treatment with benznidazole was thought to be safe and effective only for the acute phase of Chagas disease. But evidence began to converge on the benefits of treating during the chronic phase. At the same time, greater political prioritisation of Chagas treatment at the World Health Organization (WHO) and Pan-American Health Organization (PAHO) levels is encouraging countries to actively tackle the disease, with screening, diagnosis and etiological treatment for all children and offered to all adults.

Just as this promising turn of events unfolds, however, a major shortage of benznidazole threatens to stop this progress, and leave patients without access to the mainstay of treatment against Chagas disease. Already, MSF’s programme in Paraguay has been forced to suspend diagnosis of new patients in a bid to mitigate the effects of the shortage, and in Bolivia stocks will run out early 2012. Any plans for new projects have been put on hold.

This crisis could have been prevented, but the major player involved, the Brazilian Ministry of Health, has shirked its responsibilities and seen to be unwilling to overcome the various challenges.