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Chagas disease, caused by Trypanosoma cruzi, affects millions of people globally and is associated with significant underdiagnosis and undertreatment. Current diagnostic algorithms face challenges in remote regions. We aimed to review the potential of rapid diagnostic tests (RDTs) for screening or diagnosing chronic Chagas disease in endemic areas. An expert panel representing scientific and academic institutions from the Americas convened with the aim of discussing the use of RDTs. The study employed the nominal group technique, gathering insights from diverse experts during a 3-day meeting. Panel discussions covered RDT application, research protocols, and regulatory mechanisms. The results indicate that RDTs play a crucial role in surveillance and screening, although limitations in sensitivity and specificity exist. The expert group recommends standardized protocols, emphasizes the importance of cost-effectiveness assessments, and highlights the need to consider geographic validation. Despite these challenges, RDTs present a promising avenue for improving Chagas disease diagnosis in resource-limited settings. Future research and a collaborative approach are deemed essential for effective implementation. Author summary: Chagas disease, caused by the Trypanosoma cruzi parasite, affects approximately 7 million people globally, with potential cardiac or digestive complications in 30% of cases. Underdiagnosis and undertreatment in Latin America result from its often-silent progression, emphasizing the need for early and accurate diagnosis. A meeting of representatives from scientific and academic institutions discussed the use of rapid diagnostic tests (RDTs) for chronic Chagas disease covering RDT application, research protocols, and regulatory mechanisms, emphasizing the important role of this tool in rapidly detecting T. cruzi-specific antibodies. RDTs offer breakthroughs for remote areas. Currently recommended for screening, experts suggest evaluating their expanded use for definitive individual diagnosis, emphasizing their portability, minimal blood requirement, and rapid results. Challenges, including variability in RDT sensitivity and specificity, call for further research and evidence-based recommendations. The expert group highlights the need for standardized diagnostic protocols, reviewing regulatory aspects, and advocating for updates to diagnostic lists and improved supply management. In conclusion, the expert meeting provided a roadmap for optimizing RDTs in chronic Chagas disease diagnosis, balancing potential benefits with existing challenges. The proposed generic protocol aims to guide multicenter studies, positioning RDTs as valuable tools in addressing this public health issue across the Americas. [ABSTRACT FROM AUTHOR]

Background: This paper identifies opportunities and challenges for leishmaniasis control and elimination in Colombia, emphasizing the role of pooled procurement of essential medicines and supplies. Colombia is among the countries most affected by leishmaniasis globally, and also faces the dual challenge of procuring critically needed medicines in the context of limited national resources. It recently renewed its commitment to the control and elimination of leishmaniasis under its 2022–2031 Public Health Plan (PDSP) through a comprehensive public health approach. Methodology/Principal findings: The methodology comprises a comprehensive literature review and key informant interviews with leishmaniasis experts from the Colombian national control program and PAHO/WHO, focusing on cutaneous, mucocutaneous, and visceral leishmaniasis. Leishmaniasis is endemic throughout Colombia, with over 11 million people at risk, many of whom live in poverty-stricken, remote and isolated rural areas with limited access to health services. Leishmaniasis care, including medicines, is provided free of charge, but many barriers were nonetheless identified at environmental, population, and health system levels, including the supply of quality-assured medicines. Opportunities to alleviate these barriers were identified, including the support of the PAHO Strategic Fund. Within the context of the sustainable development goals and international leishmaniasis control and elimination targets, Colombian officials have established their own priorities, the highest of which is the reduction of deaths from visceral leishmaniasis. Conclusions/Significance: The elimination of leishmaniasis as a public health problem presents significant challenges, given its biological complexity and diversity, physical and clinical manifestations, social and economic impacts, frequently burdensome treatment regimens, and insufficient supply of necessary medicines. However, rigorous prevention and control efforts through strong political commitment and a highly motivated workforce can dramatically reduce its burden. Colombia's new PDSP, which highlights leishmaniasis control, is an opportunity for a revitalized health system response through committed leadership, intersectoral actions, and partnerships with international organizations that share a common vision. Author summary: Leishmaniasis is a vector-borne disease transmitted by female sand flies to humans and animals, causing infections ranging from asymptomatic and self-healing cutaneous leishmaniasis to visceral leishmaniasis which is highly lethal if untreated. Although all forms of leishmaniasis are treatable and curable with early diagnosis and treatment, the disease presents many challenges for affected populations, many of whom live in remote rural areas of the developing world, with limited access to public health facilities. Health services also face major constraints in supplying critically needed, yet costly medicines, in the context of limited financial resources. This paper presents the case of Colombia which is among the countries most affected by leishmaniasis globally, and discusses its many challenges in responding to the disease, including the guaranteed supply of necessary medicines. Our results uncover new opportunities for a revitalized health system response through committed leadership, intersectoral actions, such as a One Health approach, and partnerships with like-minded international organizations. These include Colombia's new 10-Year Public Health Plan that contains specific time-bound goals for leishmaniasis control and elimination as a public health problem, prioritizing a reduction in deaths from visceral leishmaniasis, and potential cost-savings from the acquisition of essential medicines and supplies through the Strategic Fund of the Pan American Health Organization. [ABSTRACT FROM AUTHOR]

Neglected infectious diseases (NID) affect mainly isolated populations living in isolation and in poor socioeconomic conditions. These diseases, by their chronic and silent nature, often affect communities with a weak political voice. This translates into very little attention or political priority; which is reflected in minimal and insufficient preventive measures, monitoring and control. However, there is evidence this situation is changing favorably in some countries of the Americas. In recent years, several resolutions (official agreement of the member countries of the Pan American Health Organization / World Health Organization-PAHO / WHO), regional and global agreements on public health; with a greater commitment from the pharmaceutical industry, and other donors and international partners in combination with the development and use of integrated action plans have allowed countries to intensify public interventions to control these diseases and thus achieve target elimination of NID. Onchocerciasis, lymphatic filariasis, Chagas disease, leprosy and trachoma blindness, among others, have been eliminated in several countries and endemic areas, regardless of the level of development of the country or geographical area where they are located. The political decision reflected in adequate financial resources in the next decade will be crucial to achieving the goals of elimination of NID (regional and national). [ABSTRACT FROM AUTHOR]

Neglected infectious diseases (NID) affect mainly isolated populations living in isolation and in poor socioeconomic conditions. These diseases, by their chronic and silent nature, often affect communities with a weak political voice. This translates into very little attention or political priority; which is reflected in minimal and insufficient preventive measures, monitoring and control. However, there is evidence this situation is changing favorably in some countries of the Americas. In recent years, several resolutions (official agreement of the member countries of the Pan American Health Organization / World Health Organization-PAHO / WHO), regional and global agreements on public health; with a greater commitment from the pharmaceutical industry, and other donors and international partners in combination with the development and use of integrated action plans have allowed countries to intensify public interventions to control these diseases and thus achieve target elimination of NID. Onchocerciasis, lymphatic filariasis, Chagas disease, leprosy and trachoma blindness, among others, have been eliminated in several countries and endemic areas, regardless of the level of development of the country or geographical area where they are located. The political decision reflected in adequate financial resources in the next decade will be crucial to achieving the goals of elimination of NID (regional and national).