1. Bongani M Mayosi University of Cape Town South Africa
Policy and Implementation on RHD Control – What Can We Learn from other Countries?
Bongani M Mayosi
University of Cape Town
South Africa

2. Acute Rheumatic Fever and Rheumatic Heart Disease Are Preventable
2018/08/26
up to two thirds of ARF patients do not get sore throat
C-E RHD progress report Sept

3. A History of Rheumatic Fever
Kaplan EL. Circulation 88, 1993

5. Costa Rica

6. Primary Prevention: A success story? At what cost?
Costa Rica
Courtesy: E Kaplan, 2007

7. Martinique and Guadeloupe

8. Bach JF et al. Lancet 1996;347:644

9. Cuba

10. THE CUBAN EXAMPLE – A COMPREHENSIVE STRATEGY WORKS
Nordet P et al. Cardiovasc J Afr 2008;19:

11. New Zealand

13. Robertson, Volmink & Mayosi. S Afr Med J 2006;96:241-5
A.S.A.P. Programme for the Control of RHD in Africa: Focus areas for action
Awareness raising: public, healthcare workers
Surveillance: incidence, prevalence, temporal trends
Advocacy: appropriate funding of the treatment and prevention programmes
Prevention: application of existing knowledge in primary & secondary prevention
Robertson, Volmink & Mayosi. S Afr Med J 2006;96:241-5

15. Implement the 7 Key Actions of Addis Ababa
Establish prospective RHD registers at sentinel sites to measure 25x25.
Ensure adequate supplies of high-quality benzathine penicillin.
Guarantee universal access to reproductive health services for women with RHD and other NCDs.
Decentralize appropriate technical expertise, diagnostic and care facilities at primary care.
Established centres of excellence for cardiac surgery.
Foster multi-sectoral and integrated national RHD control programmes.
Cultivate partnership through AUC, WHO-AFRO, WHO-EMRO, MoHs and relevant stakeholders to ensure implementation of these key actions.

17. WHO Resolution on RHD: The End Game?
On 01 June 2017, the Executive Board of the WHO recommended a Resolution on ‘Rheumatic Fever and Rheumatic Heart Disease’ for adoption at the World Health Assembly in May 2018.
The Resolution will become the first global policy on RHD endorsed by all governments.
Global policy instrument to eliminate ARF and RHD in our own lifetime

18. Figure 11
Total development assistance for health by disease area in sub-Saharan Africa
Data are based on calculations using the Institute for Health Metrics and Evaluation Development Assistance for Health Database 1990–
The Lancet DOI: ( /S (17)31509-X)
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