On Monday 30 January Joanna Markbreiter of the World Heart Federation – a founding member of RHD Action – delivered a statement under the section Promoting Health through the Life Course at the 140th Session of the WHO Executive Board in Geneva, Switzerland.

The statement addressed Agenda Item 11.3 – the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016-2030 – and focused on:

• The importance of tackling RHD to improving adolescent health
• The need for RHD control programmes and registers
• Exposure of adolescents to CVD and NCD risk factors
• Upcoming discussions on RHD at the next Executive Board meeting in May

We joined Joanna for a short Q&A on rheumatic heart disease, and its connection to the Global Strategy.

What is the Global Strategy, and how is the World Heart Federation involved?

The Strategy’s full name is the Global Strategy on Women’s, Children’s and Adolescents’ Health 2016-2030. It’s an ambitious plan to help all women, children and adolescents fulfil their right to health and wellbeing.
 
The World Heart Federation was asked by WHO to give recommendations and advice during the Global Strategy’s drafting process. We advocated for specific language on NCDs– as a result, the final document is very strong on risk factors and specifically mentions the ‘big four’ CVD risks (unhealthy diet, physical inactivity, tobacco use and alcohol abuse) several times.
 
As the global community prepares to put the Global Strategy into action, WHF will continue to monitor progress and offer expert CVD advice when needed. We are particularly keen to make sure that people living with neglected conditions – such as rheumatic heart disease – are not overlooked by the Strategy.

What is rheumatic heart disease (RHD), and how does it affect women, children and adolescents?

RHD is a preventable disease that mainly affects people living in conditions of poverty and overcrowding. It can be found in every WHO Region and affects more than 33 million people around the world.
RHD can have a devastating impact on adolescents: it’s the most commonly acquired heart disease in people under the age of 25. RHD needs to be caught early, otherwise it can lead to long periods in hospital or heart surgery, preventing adolescents from receiving an education or maintaining a healthy social life.

RHD also affects women and children. Pregnancy puts an extra strain on the heart, and can be fatal to mothers with RHD. Problems during pregnancy and labour can also affect the health of the baby, so it’s vital that health systems can catch RHD early in women, children and adolescents.
 
How can WHO and other stakeholders address RHD within the Global Strategy? What does the World Heart Federation recommend?

Establishing control programmes for RHD is an important first step – this involves giving regular injections of penicillin to people with existing rheumatic fever and rheumatic heart disease. We also need more data on the burden of RHD (especially among adolescents) so we are calling for the creation of national RHD registers to help provide this information.

We’re aware that countries can’t afford to set up separate programmes for every disease, so we need to take opportunities to integrate RHD into existing health services where possible. One way to do this would be to include diagnosis and management of RHD during antenatal sessions at the primary care level for pregnant women.
 
Having shared these recommendations on behalf of RHD Action, the global movement to tackle RHD, we are excited to see how WHO takes our advice forward in their implementation of the Global Strategy.
 
What are the next steps for tackling RHD?

Political momentum around RHD is growing. The Executive Board recently announced that RHD will be debated by Member States at the next EB meeting, which will take place in May 2017. This came after a sustained push by a number of stakeholders, led by the New Zealand Ministry of Health and supported by WHF on behalf of RHD Action. This is a vital step forward: eliminating RHD will require a cohesive and coordinated global response.

In the coming months, we will be calling on Member States to support and prioritize global policy on RHD. If you would like to support this initiative, please get in touch directly with Joanna Markbreiter.