In News:

• Chagas disease, or American trypanosomiasis, is an infection caused by the protozoan Trypanosoma cruzi and is transmitted primarily through the feces of triatomine bugs—commonly known as “kissing bugs.”
• It can also spread via congenital transmission (from mother to child), contaminated food or water, blood transfusion, organ transplant, or during laboratory handling.
• Though initially endemic to South and Central America, and Mexico, the disease has now emerged as a global health concern, partly due to migration and local vector presence in places like the southern United States.

Clinical Progression & Treatment

• Many infected individuals remain asymptomatic initially, but chronic infection can lead to severe cardiac and digestive complications if left untreated.
• In the acute phase, antiparasitic treatment is aimed at eliminating the parasite. In the chronic phase, therapeutic focus shifts to managing symptoms since parasite clearance becomes difficult.

Alarming Underinvestment in R&D

• R&D investment for Chagas disease is startlingly low—accounting for only 0.6% of all neglected disease research globally.
• This share is even smaller when compared to other tropical diseases: less than US$1 million was spent on new drug development in 2007, constituting a mere 0.04% of neglected disease R&D funding.
• Between 2009 and 2018, US$236 million was invested in Chagas-related R&D—just 0.67% of the total neglected disease investment. Only a handful of funders (NIH, industry, Wellcome Trust) accounted for the majority.
• Patent data reflect this disparity, especially in vaccine development—highlighting significant underinvestment relative to the global health threat posed by Chagas.
• To put it in perspective, malaria receives 20 times more funding than Chagas.

Pathways to Progress

• Innovative Therapies: Research shows promise in novel, low-cost immunotherapeutic agents derived from cyanobacteria that may offer safer and more tolerable options than current drugs.
• Campaigns and Advocacy: Initiatives like the “Chagas: Time to Treat” campaign by DNDi (Drugs for Neglected Diseases Initiative) emphasize urgent need for:
  • Affordable, pediatric formulations
  • Safe, field-ready treatments for chronic phases
  • Greater public and private funding for R&D.

Broader Significance and Current Calls to Action

• Chagas disease remains among the most neglected tropical diseases, impacting an estimated 6 million people, causing approximately 12,000 deaths annually, and contributing to over 30,000 new cases each year—mainly in Latin America.
• Effective solutions require:
  • Improved surveillance and mandatory case notification systems
  • Enhanced training and diagnostic tools for health workers
  • Integration of One Health approaches (veterinary, environmental control, and human health) in vector management.
• Investment in neglected disease R&D delivers substantial societal returns—studies suggest $1 spent yields $405 in broader economic and health benefits.

In News:

The 2024 edition of The Lancet Countdown on Health and Climate Change presents critical insights into the intersection of health and climate change.

Key Findings from the 2024 Report

• Air Pollution and Mortality in India:
  • In 2021, air pollution was responsible for 1.6 million deaths in India.
  • Fossil fuels (coal and liquid gas) were identified as major contributors, accounting for 38% of these deaths.
  • India was ranked as the second-highest emitter of PM2.5 globally in 2022, contributing 15.8% of consumption-based and 16.9% of production-based PM2.5 emissions.
• Impact of Heat Stress:
  • In 2023, India experienced 2400 hours (or 100 days) of moderate to high heat stress, particularly during light outdoor activities like walking.
  • Heatwaves have become more frequent, with adults over 65 years experiencing 8.4 heatwave days per year, a 58% increase from 1990-1999.
  • This increased heat exposure has led to a loss of 181 billion labor hours globally, translating into an economic loss of approximately $141 billion.
• Global and National Trends in Air Pollution:
  • PM2.5 is particularly hazardous because it is fine enough to enter the lungs and bloodstream, leading to severe health risks like respiratory and cardiovascular diseases.
  • Nitrogen Dioxide (NO?), Sulphur Dioxide (SO?), Carbon Monoxide (CO), and Ozone (O?) were identified as other pollutants contributing to poor air quality in India.
• Health Impact of Extreme Weather:
  • The 2023 heatwave was one of the hottest years on record, exacerbating health risks worldwide, especially for the elderly.
  • Droughts and heatwaves also contributed to a rise in food insecurity, affecting millions globally.
• Disease Transmission and Climate Change:
  • Dengue transmission potential rose by 85% from 1951-1960 to 2014-2023.
  • Coastal areas suitable for the spread of Vibrio pathogens, which cause cholera, expanded by 23%, affecting over 210 million people.
• Health Effects of Fossil Fuel Pollution:
  • Continued reliance on fossil fuels worsens air quality, leading to health problems such as respiratory diseases, cardiovascular issues, and adverse pregnancy outcomes.

Government Efforts to Tackle Air Pollution in India

• National Clean Air Programme (NCAP):
  • NCAP is a national strategy to reduce air pollution across India, with specific action plans for 131 non-attainment cities. The initiative is supported through various central government schemes such as:
    1. Swachh Bharat Mission (Urban)
    2. Atal Mission for Rejuvenation and Urban Transformation (AMRUT)
    3. Smart City Mission
    4. Faster Adoption and Manufacturing of Hybrid and Electric Vehicles (FAME-II)
• Bharat Stage VI (BS-VI) Emission Norms:
  • BS-VI standards aim to significantly reduce vehicular pollution, lowering permissible limits for NOx and particulate matter (PM) emissions from vehicles.
• System of Air Quality and Weather Forecasting and Research (SAFAR):
  • SAFAR measures air quality and provides forecasts for metropolitan cities based on real-time data, helping authorities take preventive actions.
• Promotion of Renewable Energy:
  • India achieved a record 11% of electricity from renewable energy in 2022. However, 71% of India’s electricity still comes from coal, underscoring the need for a faster transition to cleaner energy sources.