Chagas Disease Prevention
According to the Centers for Disease Control (CDC), “Chagas disease is caused by the parasite Trypanosoma cruzi, which is transmitted to animals and people by insect vectors that are found only in the Americas (mainly, in rural areas of Latin America where poverty is widespread) ... It is estimated that as many as 8 million people in Mexico, Central America, and South America have Chagas disease, most of whom do not know they are infected. If untreated, infection is lifelong and can be life threatening.”
Since the early 1990s, MAP International—a faith-based nonprofit that provides medicines and health supplies to communities in developing countries—has worked to fight this preventable disease in Morochata and Tiquipaya; two municipalities nestled in the western highlands of Bolivia. Today, MAP International is the only external NGO allowed to operate in these municipalities, and one of only a few external NGOs allowed in the country at all. In recent years, the Bolivian government has expelled other external non-governmental, bilateral, and multilateral organizations, including USAID in 2013. This has made MAP International’s work in Morochata and Tiquipaya all the more essential.
In 2014, the AbbVie Foundation began investing significant resources into MAP International’s Chagas Program and between 2015 and 2018 the two organizations worked in tandem to provide sustainable, human-centered solutions to combat Chagas. These solutions have included community health worker training; educational public health campaigns; working with the government to provide improved hygiene and residential infrastructure; and offering diagnosis and treatment support.
In 2018, AbbVie Foundation commissioned the Pulte Institute for Global Development to implement an evaluation of the Chagas program in an effort to better understand the relevance, coherence, sustainability, coverage, effectiveness, transparency, and impact of program activities over the course of implementation. The Pulte Institute research team, led by Paul Perrin and Marie Donahue, associate professor of the practice in Notre Dame’s Eck Institute for Global Health, held a series of evaluation workshops before traveling to Bolivia in summer 2018.
Broadly, Perrin and Donahue found that the Chagas Program has consistently achieved its targets for program reach and service delivery over the course of its implementation. Between 2015 and 2017, Perrin found that the Chagas Program served over 30,000 unique individuals; trained or educated over 500 health care workers and over 400 community members; and screened nearly 7,500 people for the disease.
Community members, local health care workers, and government staff in Morochata and Tiquipaya largely offered positive feedback about several facets of the Chagas Program; and all three groups noted that the Chagas Program’s educational components increased their working knowledge about the disease and the national government strategy to prevent and treat it. A final report built upon the findings and subsequent discussions with MAP International and the AbbVie Foundation to articulate evidence-based next steps for the project, including expanding the Chagas Program into additional affected communities; producing audiovisual and print materials about disease control and prevention in Quechua; and supporting test kit and medication procurement.