The particular question of specific treatment of Chagas disease

Since some years ago, the scientific community who deals with HCD has been more and more involved with the theme of specific treatment: the classical drugs (nifurtimox and benznidazole) were employed over many years and several experimental, clinical, and epidemiological evidences of concrete benefits for acute cases were well established. Moreover, recent data have shown that parasitological cure is possible in young chronic patients and in a minor proportion (20%) of chronic older individuals.^14,15,22

The social aspects related to specific treatment correspond mainly to drug availability, medical expertise, and the political and administrative problem concerning case detection and the organization of a public system for treatment provision. Drug production also has been a social problem, since the market is very weak, considering the miserable chagasic population and the lack of political priority in endemic regions.^1,14

The possibility of new and more effective drugs has been also a considerable constraint since the research for new molecules is very expensive and HCD does not interest the pharmaceutical industry. The particular strategy to take advantage of already existing products which would be effective against T. cruzi has been attempted and shows good possibilities. For example, third-generation antimycotic drugs are able to inhibit the sterol metabolism of the parasite. The problem once more has been social and economic since these drugs are very expensive and the pharmaceutical industry absolutely has no interest in the making of “social” (philanthropic) products.^1,23