World Chagas Disease Day: the Central Role of Women in the Collective Challenge to Eliminate the Disease

[This is a manifesto promoted by the Pan American Health Organization and the organisations that make up the Global Chagas Coalition, including the Barcelona Institute for Global Health (ISGlobal)]

In the response to Chagas disease, women play a role that goes far beyond being mere recipients of interventions. Their active involvement in family and community care dynamics, as well as their closer contact with health services—particularly during pregnancy—places them at the centre of strategies for early detection, prevention and care. This year’s World Chagas Disease Day recognises and highlights this central role.

And it does so at a time when decisive action is more necessary than ever. Chagas disease, transmitted by kissing bugs, but also through oral, transfusional and congenital routes, affects people throughout their lives. From an often asymptomatic acute phase to chronic cardiac and digestive complications that may appear decades later. In the 21 endemic countries of mainland Latin America, 7.5 million people live with the infection and a further 100 million are at risk of contracting it, while each year around 30,000 new cases and approximately 10,000 related deaths are recorded.

This disease burden translates annually into an estimated healthcare cost of 500 million US dollars and the loss of approximately 770,000 disability-adjusted life years, whether due to premature death or lost productive years.

While significant progress has been made compared to previous decades, these figures also highlight the need to intensify efforts to achieve the regional elimination target.

Without altering the long-standing link between infection and populations living in conditions of poverty and vulnerability, migratory movements have increased the relative importance of non-vector transmission routes, such as mother-to-child transmission, allowing the disease to spread beyond the boundaries of its vectorial transmission area, breaking unprecedentedly the endemic barrier.

In this context, mother-to-child transmission represents a growing challenge, as between 2% and 8% of pregnant women transmit the parasite to their babies, resulting in 9,000 new cases annually through this route. 

The central role of women in the fight against Chagas must not, and should not, translate into an additional burden or an exclusive responsibility placed upon them. On the contrary, it represents a strategic opportunity to strengthen more equitable, accessible and responsive health systems that recognise and respect women’s needs, decisions, and sexual and reproductive rights.

The challenge is clear: to ensure that all women of childbearing age fully exercise their right to timely diagnosis, appropriate treatment and high-quality information. This requires sustained public policies, the full integration of screening into maternal and child health programmes, and the strengthening of primary health care, ensuring services that are accessible, timely and free from discrimination.

In this context, the Pan American Health Organization, Member States and the organisations of the Global Chagas Coalition, together with a valuable group of strategic partners, are working in coordination to raise awareness across society as a whole in order to promote a collective and intersectoral response, guided by the principle of leaving no one behind. Only through shared commitment and coordinated action will it be possible to make sustained progress towards eliminating Chagas as a public health problem.