CASE 12: Controlling Chagas disease in the southern cone of South America

Map showing the southern cone of South America

How do we know

Data on the prevalence and distribution of Chagas disease was collected through demographically representative cross-sectional studies. Certification of the interruption of vectorial transmission was completed by independent commissions.


Health Condition: In the early 1990s, Chagas disease was ranked as the most serious parasitic disease in Latin America. The disease was endemic in all seven countries in the southern cone, and wavering political commitment and reinfestation of the insect vectors across borders hampered efforts to control disease. Today an estimated 11 million people in 15 Latin American countries are infected with Chagas disease. The disease also plagues northern South America, Central America, and Mexico, as well as the remaining pockets in the southern cone.

Intervention or Program: The Southern Cone Initiative to Control/Eliminate Chagas was launched in 1991, under the leadership of the Pan American Health Organization. Spray teams operated by ministries of health have treated more than 2.5 million homes across the region with long-lasting pyrethroid insecticides. Houses in poor rural areas have been improved to eliminate the insect's hiding places, and blood is screened for Chagas disease.


Cost and Cost-Effectiveness: Financial resources for the regional program, provided by each of the seven countries, have totaled more than $400 million since 1991. The intervention is considered among the most cost-effective interventions in public health, at just $37 per disability-adjusted life year saved in Brazil.