When I was a little kid, around five years old, I came down with a series of raging fevers. Mum, a nurse during the war, was worried sick. But we lived 100 miles from the nearest city hospital. And rural medicine back in 1960s Australia was not the best. By the age of 12, I was struggling to keep up in cross-country running and was exhausted when playing schoolboy rugby. Only then did the doctors – by this time Mum had taken me to specialists in the city – realize that my earlier fevers had been more than your average childhood bug. I had caught rheumatic fever, which if left untreated with effective penicillin, can damage the valves of the heart.

In my case, it resulted in an impaired aortic valve. Around the world today, this is known as rheumatic heart disease (RHD). Currently, there are 32 million sufferers, primarily in ‘developing’ countries, resulting in 275,000 premature deaths each year. Thanks to the support of my family and the Australian health system, my rheumatic heart disease has never held me back. I served as Prime Minister of Australia twice, sporting a heart valve replacement from a generous donor family, which has since been upgraded to a ‘newer model’ valve (all replacement heart valves wear out over time). With close monitoring, regular penicillin, and clinical interventions every 15 years or so, people with this  condition can lead long, normal, healthy lives.

Former Australian Prime Minister @MrKRudd gives a personal account of growing up with rheumatic fever #RHDAction pic.twitter.com/zVmynJngqx

— RHDAction (@RHDAction) September 29, 2015

Of course, RHD is entirely preventable. If we had clocked my rheumatic fever when I was a kid, I could have been given penicillin to prevent that fever from damaging my heart in the first place. So how to prevent this disease for others? We’ve had the science behind RHD control for over 50 years, and managed to eradicate it completely in many of the world’s ‘developed’ countries. Yet in the countries and communities worst affected by RHD, our progress is limited and uneven. To close these gaps, we need to focus on the Three P's that together have the best chance of eradicating RHD once and for all: People, Policy and Programmes.

People are the defining part of RHD prevention and control. From patients, to community nurses, to researchers in the lab, there is a heap of work being done around the world to help people struggling with this disease. While attending the launch of the RHD Action movement at the United Nations General Assembly in 2015, I was struck by the diversity, energy and commitment of so many individuals working on RHD. We need to work together, strategize how best to use our talents, and reach out to bring more exceptional people into the RHD family.

Policy, while sometimes opaque and hard to pin down, has huge potential to instigate change across the RHD community. As a politician myself, I can see the impact of major policies at the global, regional and national levels that trickle down into good action and opportunities locally. But this is not always obvious for people engaged in crucial, lifesaving work on the ground. For RHD, it is not only important that good policy is set, but that it is carried out in a practical way. Only then will people living with and working with RHD see progress being made.

Programmes for RHD are where progress can be seen and measured. Every endemic country experiences RHD differently, therefore every endemic country should have tailored and nationally-relevant RHD programmes. For example, in my country, the vast majority of people living with RHD are young Indigenous Australians – shockingly, Aboriginal and Torres Strait Islander people are more than 20 times more likely to die of RHD than non-Indigenous Australians. This is why, when I established the RHDAustralia programme as Prime Minister, we first rolled out the programme in areas with a high Indigenous population, including my home state of Queensland.

I’m very pleased that RHD Action is leading the global movement to consign RHD to the history books and am proud to be its Global Ambassador. We know how to prevent, control and end this disease. Now is the time for action: let’s get cracking.

The Honourable Mr Kevin Rudd
Former Prime Minister of Australia and Global Ambassador for RHD Action

This text is the foreword from the recently released RHD Global Status Report 2015-17: People, Policy, Programmes, Progress