The Lancet: Eliminating acute rheumatic fever and rheumatic heart disease

A comment in today’s print issue of The Lancet starts:

‘Acute rheumatic fever and its major sequela rheumatic heart disease are conditions of poverty… Both conditions continue to be a major cause of death and suffering in low-income and middle-income countries with an estimated 33 million people living with rheumatic heart disease worldwide and more than 300,000 deaths each year, most among people younger than 30 years. Importantly, acute rheumatic fever and rheumatic heart disease can be prevented by improvements in socioeconomic conditions and public health measures, including penicillin for streptococcal sore throat in endemic areas.’

And concludes:

‘The World Heart Federation worked with WHO to create a draft resolution document in 2016. Member states accepted the memorandum in January, 2017, and debated and agreed the resolution text at the 141st WHO Executive Board meeting in June, 2017. The World Heart Federation will now marshal the rheumatic heart disease community to help ensure that member states are politically invested in passing the resolution text at the 71st World Health Assembly in May, 2018…’

CITATION: Eliminating acute rheumatic fever and rheumatic heart disease
Magdi Yacoub, Bongani Mayosi, Ahmed ElGuindy, Alain Carpentier, Salim Yusuf
The Lancet, Volume 390, No. 10091, p212–213, 15 July 2017
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31608-2/fulltext

An earlier paper (Carapetis and Zühlke 2011) notes ‘There have been three surges of activity in RF/RHD research and control over the past half-century.’… ‘the Global Programme on Rheumatic Fever and Rheumatic Heart Disease… was disbanded in 2001… The first decade of the 21st Century saw RF/RHD research and control steadily recede from the global public health agenda.’
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104531/

The periodicity of global interest, action and political and financial investment in RHD is a feature of other diseases too and presumably has causes (largely political?) and impacts, both positive and negative. Can anyone on HIFA say more about these phenomena?

For more information on RHD and current global advocacy see:
http://rhdaction.org

Best wishes, Neil

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