Call to Action: Ending Rheumatic Fever and Rheumatic Heart Disease

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CALL TO ACTION: ENDING RHEUMATIC FEVER AND RHEUMATIC HEART DISEASE

21 APRIL 2021

We, the undersigned, a group of dedicated public health advocates, doctors, cardiologists, rheumatic heart disease experts, women's and children's health experts and advocates, frontline health workers, patients, academics, researchers, Members of the World Heart Federation, and other organizations from around the world,

DEEPLY CONCERNED that rheumatic heart disease, a completely preventable non-communicable disease, has become the leading cause of acquired heart disease in children and young adults worldwide; and FURTHER CONCERNED that this disease, which disproportionately affects girls and women of childbearing age, contributes to a high level of maternal and perinatal morbidity and mortality;

NOTING that, despite the considerable public health and economic burden of this disease, many governments have yet to adopt an integrated approach to the prevention and control of rheumatic fever and rheumatic heart disease at the national level;

RECALLING that Resolution WHA71.14 of the World Health Organization on Rheumatic Fever and Rheumatic Heart Disease, adopted in May 2018 by the World Health Assembly, outlines specific actions to be carried out to reduce the global burden of these diseases; and RECOGNIZING that inaction threatens the achievement of the Sustainable Development Goals;

CALL UPON our respective Ministries of Health to become more actively engaged in the fight against rheumatic fever and rheumatic heart disease.

WE HEREBY RECOMMEND OUR GOVERNMENTS TO CONSIDER THE FOLLOWING KEY ACTIONS:

In the area of governance, we request our countries to establish national advisory groups on rheumatic fever and rheumatic heart disease; develop national plans on rheumatic fever and rheumatic heart disease that take into consideration other relevant plans and strategies; and develop national investment cases on the costs of rheumatic fever and rheumatic heart disease.

In the area of primary prevention, we request our countries to develop and implement national guidelines regarding the diagnosis and treatment of pharyngitis.

In the area of secondary prevention, we request our countries to develop and implement national guidelines regarding the diagnosis and treatment of rheumatic fever and rheumatic heart disease; establish functioning registers on rheumatic fever and rheumatic heart disease; and integrate the delivery of rheumatic fever and rheumatic heart disease care within existing primary health care structures and systems.

In the area of access to medicines, we request our countries to ensure reliable access to high-quality Benzathine Penicillin G; and make Benzathine Penicillin G available and free of charge to all patients.

In the area of surveillance and monitoring, we request our countries to collect reliable data on the burden of disease of rheumatic fever and rheumatic heart disease at the national and subnational levels; monitor the burden of disease of rheumatic fever and rheumatic heart disease; and identify vulnerable groups.

In the area of health workforce, we request our countries to provide appropriate training to community and primary health care workers on the diagnosis of pharyngitis and rheumatic fever, on the treatment of pharyngitis and rheumatic fever, and on the administration of Benzathine Penicillin G.

In the area of community awareness, we request our countries to educate the communities on rheumatic fever and rheumatic heart disease; ensure that communities understand the association between Group A Streptococcal infections, rheumatic fever, and rheumatic heart disease; and dedicate particular attention to communities and schools in high-risk areas.

In the area of tertiary care, we request our countries to ensure access to echocardiography in order to guide the diagnosis, the monitoring, and the treatment of People Living with Rheumatic Heart Disease; invest in national cardiac surgery capacity; and develop a specialized medical workforce to provide care for People Living with Rheumatic Heart Disease.

Finally, we invite our countries to develop, through a strong communication framework, partnerships with development agencies, civil societies, donors, philanthropies, and other relevant stakeholders to ensure the successful implementation of the aforementioned actions.