Challenges and opportunities for diagnosis and tre

Authors: Carlos Pineda Carlo V CaballeroUribe

Publish Date: 2015/07/17

Volume: 34, Issue: 1, Pages: 5-7

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Abstract

Latin America LA is a multicultural region with an estimate of just over 600 million inhabitants displaying great heterogeneity among their nations LA countries exhibit complex demographic characteristics because of the interaction of factors such as the different ethnic background of its population a history of colonialism and varying immigration patterns resulting in a diversified population that differs in every country within the region 1The LA region has experienced a health transition characterized by fast and complex epidemiological changes in the past decades combining increasing rates of noncommunicable diseases and injuries while keeping uncontrolled many existing endemic and emerging diseasesThe national health care systems within the LA area are heterogeneous in their organizational structure and complex in their operational configuration and in the principles guiding the public and private sector roles in the provision of health care services In LA medical attention for rheumatoid arthritis RA faces a dual challenge on one side competes with a budget designed to fight poverty lack of education an increasing number of patients and on the other hand the demographic and epidemiological transitions the insufficient number of rheumatologists and concentration of the workforce in large cities an insufficient budget for education and research and the backlog of accumulated problems characteristic of underdeveloped societies 2 In consequence RA is not yet considered a public health priority for the national health care systems Therefore explaining why only 56  of RA patients had access to full medical health coverage thus often excluding biologics only 58  had more than 7 years of education and 58  were of a low/lowmiddle socioeconomic status 3Previous efforts has been made to overcome this situation including the identification of barriers to health care 4 promoting access to a prompt diagnosis and treatment developing algorithms according these realities 5 educating patients and doctors 6 or estimating the economic impact of the disease in the region 7 and recently setting the standards to harmonize the treatment provided to RA patients in LA by developing a program focused in establish centers of excellence that would offer to RA patients a better care 8Additionally technological progress drug development and diagnostic capabilities advanced in the past two decades has resulted in major improvements in health outcomes for RA patients in developed countries but the cost of these innovations including joint prostheses access to biological medications and the lack of trained health personnel to deliver the specialized care still puts these out of the reach of people with RA in most low and middle income countries Education and training of health professionals also remains an unmet key priority 2Promote the educational activities and organize in conjunction with the national societies the Pan American Congress of Rheumatology as well as to promote national or regional meetings and encourage publication and dissemination of the scientific proceedings of meetings

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