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

On behalf of the Brazilian Society of Tropical Medicine (BSTM), we present the Second Brazilian Consensus on Chagas Disease, which was developed through intense collaboration among Brazilian experts specialize in different aspects of the disease. In formulating the consensus, these experts partnered with the Ministry of Health (through the Secretariat of Health Surveillance) to strengthen evidence-based control activities in in Brazil. Such activities include epidemiological research, management, provision of comprehensive care to people with Chagas disease and their families, communication and education, and clinical/ operational research. Indeed, we must ensure that the knowledge amassed by the scientific community contributes effectively to real problem solving related to Chagas disease in our society. Founded in 1962, the BSTM has maintained, throughout its history, a technical-scientific and political commitment to the health reform movement, as well as an aim to strengthen the Unified Health System (SUS) of Brazil. The strategic role played by the BSTM is based on a boundless respect for democracy and the pillars of the Brazilian constitution, as well as for human rights around the world. The organization is committed to strengthening public and private agencies that address and control tropical, infectious, and parasitic diseases, as well as to respecting the principles of the UHS. Specifically, the BSTM supports studies and research, technical and scientific advice, continuing education, exchanges between institutions, and dissemination of scientific and technological developments. More than 100 years since the discovery of Chagas disease by Carlos Ribeiro Justiniano Chagas in 1909, there are still important gaps in technical, scientific, and political knowledge that must be filled if we are to effectively treat this widelyneglected condition. In this regard, Brazil plays a central role, and the country has a responsibility to gather scientific evidence that will allow us to face this disease globally. It is for this reason that the BSTM has sought to act in the case of Chagas disease. The challenges of Chagas disease are magnified further when we consider that, in 2016, more than 90% of those affected by Chagas disease worldwide did not have access to diagnostic testing or systematic treatment; hence, the high impact of morbidity and the social cost of illness persist. Furthermore, the programmatic and sociopolitical context in which vulnerable individuals find themselves, as reported by Carlos Chagas, makes coping with the disease even more challenging; that is, patients with the disease are often hampered by neglect and exclusion. Generally, the more unequal a society, and the more culturally accepted the inequality, the worse the control of Neglected Tropical Diseases. On this note, Brazil is recognized worldwide as having extreme economic and social inequality(1). Despite considerable advances in the range of social protections that are guaranteed to the population(2) (3), the current political and economic climate in Brazil warrants careful analysis. It is necessary, now more than ever, to strengthen joint actions within society and focus on the great majority of the Brazilian population, which depends on public services in the sectors of education, health, and social assistance. Furthermore, the situation described above raises concerns about the development of science, technology, and innovation in Brazil(4) (5). Beyond these challenges, the next five years will bring opportunities for more concrete, shared actions in the fight against Chagas disease. Brazil and other Latin American countries play a key role in this process and are committed to internationally agreed action under the seals of the Pan American Health Organization (PAHO) and World Health Organization (WHO). These organizations have supported intergovernmental initiatives to combat Chagas disease since 1991. In addition, the constitution of the International Federation of Associations of People Affected by Chagas Disease (FINDECHAGAS: http://www.findechagas.com) was published in 2010, and various representatives of Brazil and other endemic and non-endemic countries made important contributions to this constitution. Moreover, during the 31st Annual Meeting of Applied Research in Chagas Disease, and the 19th Meeting of Applied Research in Leishmaniasis, which occurred in MaceióAlagoas, Brazil, the delegates created the Brazilian Social Forum to Face Neglected and Infectious Diseases(6). Some initiatives stemming from this forum have worked towards instituting an effective and efficient care plan within the health : l t I, doi: 10.1590/0037-8682-0504-2016