El programa de eliminación de la filariasis linfática en Bangladesh: ¿un modelo exportable?
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En 1971, al final de la sangrienta guerra de separación de Pakistán, Bangladesh aparecía como un país sin esperanza. El elevadísimo crecimiento demográfico –uno de los mayores del mundo– las calamidades naturales como aluviones y tifones, la grave y difundida pobreza –con un porcentaje de la población por debajo del umbral de la pobreza, en torno al 30%– la situación política interna, con inestabilidad social y conflictos étnicos latentes, hacían el pronóstico más que verosimil. A distancia de 40 años, BGD ha logrado desmentir en gran parte tal previsión, consiguiendo éxitos en el desarrollo económico, en la salud pública y en la transformación social. El control de la tasa de fertilidad, la lucha contra el “BIG KILLER” (gran asesino) como la TBC1 y la diarrea infantil, el mejoramiento de las condiciones higiénicas y la instalación de clínicas territoriales de salud de primera asistencia (comunity-clinic), campañas sanitarias eficaces, la lucha contra enfermedades endémicas; han sido obtenidas gracias al uso coordinado de las medidas de salud de los programas internacionales. Resultados, estos, conseguidos a través de una política sanitaria basada en una proficua colaboración entre el Ministerio de Salud Nacional (Ministry of Health and Family Welfare), ONG, organismos internacionales de salud, instituciones y fundaciones internacionales. BGD ha conseguido así la meta de la casi total eliminación de las enfermedades endémicas por descuido en el país (leishmaniasis visceral, filariasis linfática, dengue, lepra, parasitosis intestinales infecciones por helmintos). El artículo valora los factores que han caracterizado el éxito en el programa de eliminación de la filariasis linfática. Del análisis de tales factores ha derivado un posible modelo de GOVERNANCE (gestión) para la lucha contra las enfermedades por descuido en regiones endémicas comparables en el perfil geo-político
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