Cadernos de Saúde Pública
On-line version ISSN 1678-4464
COURA, José R.. The false dilemma about antivectorial strategies and possibilities for controlling Chagas' disease in Brazil: BHC or BNH?. Cad. Saúde Pública [online]. 1993, vol.9, n.4, pp. 514-518. ISSN 1678-4464. http://dx.doi.org/10.1590/S0102-311X1993000400013.
The technical basis for the control of Chagas' disease in Brazil was established with the creation of the Oswaldo Cruz Institute's research center in Bambuí, in western Minas Gerais, at the beginning of the 1940's, under the leadership of Emmanuel Dias. However, only with the creation of the National Department for Rural Endemic Diseases, in March 1956, did control of rural endemic diseases become systematic in Brazil. From the 1960's onwards, the Chagas' disease control program in Brazil started to suffer from postponements and lack of systematic action: first because the priority ascribed to the malaria control program, since this was an acute, "explosive" disease that was hampering land settlement and development in the interior; second the "new ecologists" began calling for "BNH" (referring to the initials for the national low-cost housing program) and not "BHC" (insecticides program) for Chagas' disease control, ignoring a number of issues and difficulties; and third, other priorites given to the Special Program for Schistosomiasis Control and the meningococcal meningitis epidemic in the 1970's and the dengue epidemic in the 1980's. In 1983, however, a new phase in Chagas' disease control began, with the allocation of ten billion cruzeiros from FINSOCIAL for this program which covered two thousand municipalities, in 19 Brazilian States, to the benefit of 47 million people potentially at risk. Finally it was concluded that in the short term, insecticide spraying is the most effective and manageable control measure against natural transmission of Chagas' infection. Other methods of control and urbanization of Chagas' disease are also discussed.
Keywords : Chagas' Disease; Vector Control; Insecticides; Urbanization.