The present situation, challenges, and perspectives regarding the production and utilization of effective drugs against human Chagas disease.

The fi rst effective drugs against human Trypanosoma cruzi infection (nifurtimox, produced by Bayer, and benznidazole, produced by Roche) became available in the 1960s1,2. Because these drugs were initially only recommended for acute cases, the international demand for their production was very low. In the subsequent 20 years, good treatment results for chronic infection in children stimulated several studies in adults with the chronic indeterminate form of the disease and even in adults in the initial stages of chronic cardiomyopathy3,4. At the end of the twentieth century, Roche transferred the production of benznidazole to LAFEPE (Laboratório Farmacêutico de Pernambuco), a Brazilian public enterprise that received its last GMP (Certifi cate of Good Manufacturing Practice) in 20095. Because of the increased demand for the product and several problems with its production and distribution, the World Health Organization and the scientifi c community involved in research on Chagas disease have become worried in recent years about the worldwide shortage of the product, which could result in a reduced opportunity to treat millions of infected individuals6,7. The present situation can be summarized as follows: