Prioritizing the implementation of a comprehensive care roadmap for Chagas disease

DNDi and the Ministry of Health of Colombia have elaborated this Policy Brief summarizing the main results of the Chagas Treatment Access Project six years after its launch in 2016.


The Chagas Treatment Access Project was implemented in four departments of Colombia: Casanare, Boyacá, Santander and Arauca. Each department saw a substantial increase in the number of people diagnosed and treated with Chagas disease (CD) as a result of the project, demonstrating that it is possible to provide timely diagnosis and treatment for this highly neglected disease via primary healthcare. A key feature of the project is the Chagas comprehensive care roadmap (RIAS), which defines the necessary steps and actions in the health system to assure effective care of patients, with a central role for the primary healthcare level. Making timely care more accessible increases the benefits for patients, since early diagnosis and treatment is key to improving clinical outcomes. This not only reduces the suffering of the affected population, but also decreases costs for both families and the health system.


One impact of the roadmap has been to reduce the need for patients to travel to distant health centers. An economic analysis conducted by the Chagas Access Project indicated that when CD patients had to attend medical appointments in secondary and tertiary care centers, which tend to be more distant from communities where patients live, they had to spend significantly more (an average of $68,453 Colombian pesos, or more than two days’ earnings at minimum wage) on out-of-pocket expenses such as food, transportation and lodging, compared to patients who received care in primary healthcare facilities. Moreover, these patients on average lost an average of COP $36,360 (in excess of one day’s earnings at minimum wage) because of missed workdays.


The health system should be able to guarantee that patients with chronic diseases have access to healthcare facilities close to their home, ensuring adherence and continuity of treatment. Comprehensive care for CD that does not promote services at the primary healthcare level is inevitably doomed to failure, because it does not facilitate patient care, nor does it improve coverage.


  • The implementation of a comprehensive care roadmap (RIAS) for Chagas at the primary healthcare level allows the most vulnerable patients to minimize medical and non-medical costs (out-of-pocket expenses), resulting in greater adherence to treatment and benefits for the entire health system.


  • The data shows that early diagnosis and treatment of Chagas disease has a significant impact on the management and quality of life of patients, in addition to reducing health system costs by $38,000 million Colombian pesos (almost 9 million dollars) over three years.


  • The commitment and support of Colombian healthcare providers and insurers in the implementation of the RIAS at the primary level of care guarantees an effective response to this public health problem, reducing out-of-pocket expenses of those affected by CD who are often economically vulnerable.



Marchiol, A., Galvão, D., Herazo, R., Vera MJ. (2022)., The care roadmap for Chagas and the need of its priority implementation (Policy brief).


Find here the Policy Brief in its original version: Policy Brief 2022


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