SA instrumental in WHO recognition of Rheumatic Fever as a global health priority

WHO-logoAt the recent 71st World Health Assembly in Geneva, Switzerland, Member States of the World Health Organization unanimously adopted a Global Resolution on Rheumatic Fever and Rheumatic Heart Disease. This historic decision marks the first time Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD) have been recognised as global health priorities on the world health stage.

Local scientists have been instrumental in driving the agenda to achieve this landmark decision1, 2. The Resolution was co-sponsored by countries from all six WHO regions, including South Africa. Rheumatic heart disease is a preventable condition arising from acute rheumatic fever.

‘We have worked consistently to demonstrate the urgent need for a unified response to these serious conditions,’ says Professor Liesl Zühlke, associate professor at the Red Cross Memorial Children’s Hospital, who specialises in paediatric heart disease. ‘According to the WHO, rheumatic heart disease affects around 30million people each year. In 2015, the disease was estimated to have caused 250 000 deaths.3 The disease most commonly occurs in childhood and adolescence and disproportionately affects girls and women,’ continues Professor Zühlke.

At the WHA, there was strong consensus among governments that action was needed on a range of fronts, including strengthening primary and secondary prevention of RF and RHD, integrating RHD services into primary health care, securing a reliable supply of benzathine penicillin G, and ensuring a well-resourced and trained health workforce to provide RHD services.

Zühlke is the newly elected president of the RHD Evidence, Advocacy, Communication and Hope (Rheach) organisation. Rheach is a global organisation, which aims to identify, describe and disseminate solutions for this neglected disease and to reduce the burden on vulnerable populations around the world.  Rheach will partner the WHO to implement, monitor and provide advice on RF and RHD to endemic countries. Several members of the South Africa Cardiology community have also been key figures in driving the adoption of this resolution, including Prof. Karen Sliwa, president-elect of the World Heart Federation and Prof. Bongani Mayosi, dean of the Faculty of Health Sciences at UCT.

Discussions at the WHA highlighted that vulnerable groups and marginalised communities are the most affected by RF and RHD, and that its prevention and control is essential to achieving the Sustainable Development Goals and universal health coverage.

‘Now that this policy has been adopted by the full World Health Assembly, the Resolution stands as the first global commitment on RHD to be endorsed by all governments. It now serves as a high-level global policy that demands national and international decision-makers to take action to prioritise and fund RHD prevention and control in all endemic settings,’ concludes Zühlke.

  1. Zuhlke L, Engel ME, Karthikeyan G, Rangarajan S, Mackie P, Cupido B, Mauff K, Islam S, Joachim A, Daniels R, Francis V, Ogendo S, Gitura B, Mondo C, Okello E, Lwabi P, Al-Kebsi MM, Hugo-Hamman C, Sheta SS, Haileamlak A, Daniel W, Goshu DY, Abdissa SG, Desta AG, Shasho BA, Begna DM, ElSayed A, Ibrahim AS, Musuku J, Bode-Thomas F, Okeahialam BN, Ige O, Sutton C, Misra R, Abul Fadl A, Kennedy N, Damasceno A, Sani M, Ogah OS, Olunuga T, Elhassan HH, Mocumbi AO, Adeoye AM, Mntla P, Ojji D, Mucumbitsi J, Teo K, Yusuf S and Mayosi BM. Characteristics, complications, and gaps in evidence-based interventions in rheumatic heart disease: the Global Rheumatic Heart Disease Registry (the REMEDY study). Eur Heart J. 2015;36:1115-22a.

  2. Mayosi B. The four pillars of rheumatic heart disease control. S Afr Med J. 2009;100:506.

  3. Watkins DA, Johnson CO, Colquhoun SM, Karthikeyan G, Beaton A, Bukhman G, Forouzanfar MH, Longenecker CT, Mayosi BM, Mensah GA, Nascimento BR, Ribeiro ALP, Sable CA, Steer AC, Naghavi M, Mokdad AH, Murray CJL, Vos T, Carapetis JR and Roth GA. Global, Regional, and National Burden of Rheumatic Heart Disease, 1990-2015. N Engl J Med. 2017;377:713-722.

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