Press Release WHO/13
26 January 1998
EXECUTIVE BOARD REINFORCES CHAGAS
DISEASE, LEPROSY ELIMINATION EFFORTS
Great strides have been made recently toward the control and elimination of Chagas Disease and Leprosy as public health threats, the 101st session of the Executive Board noted today. The elimination of the transmission of Chagas Disease could be achieved by 2010, while leprosy could be eliminated as a public health problem by the year 2000.
But to be successful down the final stretch, international efforts must be maintained and the Executive Board, in two resolutions which will be submitted for adoption by the World Health Asssembly in May, outlined what it felt should be the major thrusts of action against these two public health threats.
Chagas disease exists only on the American continent and has already affected 16 to 18 million people, while some 100 million, or 25% of the population of Latin America, are at risk of acquiring the disease. The disease is caused by a parasite, Trypanosoma cruzi, transmitted to humans by triatomine bugs ("kissing bugs") and it extends from Mexico to Argentina.
After an asymptomatic period of several years following the acute stage, people infected develop cardiac symptoms, which may lead to sudden death and digestive damage.
In 1991, the Ministers of Health of Argentina, Bolivia, Brazil, Chile, Paraguay and Uruguay launched the "Southern Cone Initiative for elimination of transmission of Chagas disease". Peru joined the Southern Cone initiative in March 1997. The Andean countries, Colombia, Ecuador, Peru and Venezuela, launched a detailed plan for the elimination of transmission of the disease by vectors in February 1997, while the central American countries, Costa Rica, El Salvador, Guatemala, Honduras, Mexico, Nicaragua and Panama, launched a similar plan in October 1997.
The extrapolation of current data on the disinsecting of houses, screening for Chagas disease in blood banks and serology tests in children and young adults indicates that the interruption of the transmission of Chagas disease by vectors and through blood transfusion was achieved in Uruguay in 1997, and that it will be achieved in Chile in 2000 and in Brazil and Argentina in 2003.
While expressing its satisfaction with the progress made by Member States in eliminating the transmission of Chagas disease, the Executive Board called on WHO and its Director-General to support ongoing efforts to eliminate transmission by 2010, to provide WHO certification of elimination country by country, to support Member States in surveillance, programme development and implementation, and to continue to seek extrabudgetary resources for this purpose.
The Executive Board also called on Member States still affected by Chagas disease to, among other measures, develop a plan of action to eliminate the disease and explore possibilities for mobilizing additional resources to eliminate the disease within the context of primary health care.
In May 1991, the World Health Assembly, in resolution WHA44.9, set a target of prevalence at below one case per 10 000 population as a gauge for the global elimination of leprosy as a public health problem by the year 2000. This resolution has helped stimulate increased programme coverage and implementation of multidrug therapy throughout the world, resulting in a 76% reduction in the global prevalence since 1990. The number of endemic countries has been reduced from 122 in 1985 to 55 at the beginning of 1997, while the cumulative number of individuals cured had reached 8.4 million by the beginning of 1997.
WHO continues to provide country-level support in accelerating leprosy elimination activities. Political commitment was promoted through two international conferences on the elimination of leprosy, the first in Hanoi, Vietnam in July 1994, and the second in New Delhi, India in October 1996. Coordination of activities between ministries of health, international nongovernmental organizations and WHO is steadily improving in most countries and WHO is also collaborating with the World Bank in India and Bangladesh.
Despite the considerable progress made towards elimination, activities must be intensified in some major endemic countries and in parts of others to give sufficient access to and coverage of multidrug therapy, the Executive Board concluded.
While noting its satisfaction with the progress made by Member States in eliminating leprosy as a public health threat, the Executive Board requested WHO and its Director-General to continue to strengthen technical support to Member States, to continue to mobilize technical and additional financial resources, and to strengthen collaboration with national and international nongovernmental organizations in order to ensure the attainment of the goal of elimination of leprosy as a public health problem.
The Executive Board adopted a resolution on each of the above subjects and recommended their adoption by the World Health Assembly in May.
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