Conferencia Dra. Santini

Science in the service of Health: Making the Invisible Visible, Managing Parasites in a Virus-Driven Agenda

SANTINI, María Soledad^1,2

¹ Instituto Nacional de Parasitología Dr. Mario Fatala Chaben-ANLIS-Malbrán-Ministerio de Salud de la Nación Argentina.
² CONICET, Buenos Aires, Argentina.
E-mail address: mariasoledadsantini@gmail.com

Viruses are the undisputed protagonists in the global health governance. All major international emergencies declared by the World Health Organization (WHO) in the last fifteen years have been linked to viral pathogens: H1N1 flu in 2009, polio in 2014, Ebola in 2014 and 2018, Zika in 2016, COVID-19 in 2020, and monkeypox in 2022. These events shaped global preparedness, surveillance and research, reinforcing a virus-driven view of health security. Priorities were defined by WHO and supported by international financial organizations that channeled loans and cooperation programs in line with that agenda, confirming the prominence of viruses over other infectious diseases.

Data, however, tells a different story. Disease burden attributable to parasites in 2019 was comparable to that of viruses. Malaria, Chagas disease, leishmaniasis, schistosomiasis, and other food-borne helminths account for millions of cases annually and result in significant losses in healthy life years. Malaria alone caused over 170 million cases and approximately 800 disability-adjusted life years (DALYs) per 100,000 inhabitants. Despite this, these diseases receive a minimal fraction of global funding for research and development, inequity that is also reflected in scientific output and clinical trials. In recent years, studies on viral infections have multiplied, even for diseases with cyclical outbreaks like dengue, which recently saw the development and approval of specific vaccines. Experience with COVID-19 showed the ability to deploy innovative vaccine platforms in record time, going from the lab to mass application in months. In contrast, progress on parasitic diseases is much slower. Chagas disease still relies on the same two drugs discovered in the 1960s, with few therapeutic alternatives that are still in development and no immediate prospects for a preventive vaccine. The situation is similar for leishmaniasis, which has only a few vaccine candidates in the preclinical phase, and for helminths, where none of the existing experimental developments have reached advanced phases or approval for human use.

When science is in the service of health, evidence is transformed into health policies, priorities on the public agenda are contested, and the invisibility of parasitic diseases is recognized as a reflection of structural inequalities. Managing parasites in the face of viral dominance is a political and scientific challenge, and it requires a science committed to the needs of the population, capable of mending inequities and strengthening health sovereignty. In this scenario, the National Institute of Parasitology (INP) “Dr. Mario Fatala Chaben”-ANLIS-Malbrán plays a strategic role. As the organization responsible for implementing the Argentine National Ministry of Health’s policies in prevention, reference diagnosis, research, and treatment of parasitic diseases, and as a PAHO/WHO collaborating center, the INP links science, public health, and community health. Its approach goes beyond the biomedical aspect, integrating social determinants, fieldwork, and intersectoral collaboration. Thus, it stands as an example of how science can make that which is invisible visible and actively contribute to equity and collective health.

Keywords: Parasitic Diseases, Public Health, Neglected Diseases.