FOCUS ON THE PREVENTION OF HEART DISEASE AND STROKE DURING THE CLINTON GLOBAL INITIATIVE
FOCUS ON THE PREVENTION OF HEART DISEASE AND STROKE DURING THE CLINTON GLOBAL INITIATIVE
Geneva, 19 September 2006 - The World Heart Federation, a nongovernmental organisation
dedicated to the prevention and control of heart disease and stroke, with a focus on low- and
middle-income countries, is taking an active part in the second annual meeting of the Clinton
Global Initiative (CGI). The event, taking place in New York between 20 - 22 September will
bring together over 1,000 global leaders from business, politics, academia, science, religion,
and non-governmental organizations, including numerous Heads of State and CEOs from
major international corporations. CGI is a forum for participants to discuss and develop
workable solutions to some of the world's most pressing challenges, including the prevention
of heart disease and stroke which claims 17.5 million lives a year, 80% of these in low and
middle income countries.
The World Heart Federation will announce two major new commitments for which partial
funding has already been committed but needs to be met by pledges of additional support by
the global leaders during or after the CGI.
Prevention of Rheumatic Fever / Rheumatic Heart Disease in Africa
The World Heart Federation will set up four demonstration projects, one in each of Egypt,
Ethiopia, Ghana and South Africa, that will grow into sustainable, long-term, government-run
national rheumatic heart disease-control programmes. The projects will raise awareness
through public and professional education, establish surveillance systems, advocate
improving health services, and promote effective prevention measures.
Rheumatic fever (RF) can develop after an infection by the group A streptococcus bacterium.
The resulting inflammatory illness can damage heart valves; this is called rheumatic heart
disease (RHD) and can lead to disability or death. RF and RHD affects 15.6 million people
worldwide, including 2.4 million children, and is the most common cardiovascular disease of
children and young adults. There are nearly half a million new cases every year, 300,000 of
them in Africa. Hundreds of thousands of people are disabled by RHD and some 350,000 die
from it each year. 233,000 of those deaths are in Africa.
The tragedy is that almost all of these deaths are easily preventable using regular injection of
penicillin. Despite the wide availability and the proven effectiveness of penicillin for the
prevention of RF and RHD, developing countries continue to face unacceptably high rates of
RF and RHD, making RHD the most common cardiovascular disease affecting children and
young adults in the world 1.
“Our aim is to significantly reduce mortality, morbidity and disability from rheumatic
fever/rheumatic heart disease among African children and young adults,” said Dr Jonathan
Carapetis, chairman of the World Heart Federation’s Scientific Council on Rheumatic Fever
and Rheumatic Heart Disease. “Rheumatic heart disease shortens people’s lives and
aggravates human misery. We will train health workers in how to identify and treat patients,
and public health officials in how to establish and maintain prevention programmes. But this
is not enough. We will also advocate for guaranteed supplies of high-quality antibiotics and
for rheumatic heart disease to be recognized as an international clinical, public health and
political priority.”
The World Heart Federation is presently leading the global effort in RHD control. Its RHD
control project in the South Pacific, which began in 2005, has a regional training programme
and demonstration projects in Fiji and Samoa. So far, the project has screened 3,000 children
and its first regional training workshop will be held this October. The WHO supports the
programme and is co-sponsoring the workshop. Tools developed and experiences gained in
the Pacific are being made available to the world through the World Heart Federation
website, and will be adapted for the project in Africa.
Development, Production and Delivery of the Polypill
The World Heart Federation also intends to advocate for the development, production and
delivery of the polypill for the secondary prevention of cardiovascular disease in post
myocardial infarction patients by 2009/10. The initiative conducted in partnership with
CNIC, the Spanish National Centre for Cardiovascular Research.
The aim is to save the lives of those severely affected by cardiovascular disease by
successfully completing the development of a polypill or fixed dose combination of ace
inhibitor, statin and aspirin therapies.
The aim is also to build knowledge and commitment among practicing physicians particularly
in low- and middle-income countries to facilitate distribution as of 2010. Pilot countries are
being identified but will probably include Spain and China.
The World Heart Federation’s primary contribution would be in the area of advocacy and
education. The World Heart Federation would advocate for the polypill with the relevant
authorities including the FDA and EMEA, and through its national member societies,
journals and congresses encourage its inclusion in national guidelines and use by
cardiologists in post myocardial infarction patients.
With chronic diseases including cardiovascular disease and diabetes accounting for 60% of
global mortality, and 80% of that burden in low and middle-income countries, it is time to
advance the prevention agenda as well as patient care. It is proven that appropriate standalone
medications ranging from statins to aspirin have had very beneficial effects on
premature mortality in Western populations. Many of these medications are now off patent
and as such are available at lower generic prices. However, the complexity of three or more
medications would strain developing country health systems both financially and logistically.
Patient compliance would be another complicating factor.
A polypill is estimated to cost one-fifth of currently available therapies and save the lives of
post-myocardial infarction patients as well as high risk individuals in low- and middleincome
countries as well as low income patients in more developed economies who would
otherwise have limited treatment options. The production of the polypill has been
recommended in recent reports by the World Health Organization.
- Ends -
About the World Heart Federation
The World Heart Federation, a nongovernmental organization based in Geneva, Switzerland, is
committed to helping the global population achieve a longer and better life through prevention
and control of heart disease and stroke, with a particular focus on low- and middle-income
countries. It is comprised of 189 member societies of cardiology and heart foundations from
over 100 countries covering the regions of Asia-Pacific, Europe, the Americas and Africa. For
further information visit: www.worldheart.org
Press contact:
Karen Smadja, Cohn & Wolfe Public Relations
Tel: +41 22 908 4077 or E-mail: Karen_smadja(at)ch.cohnwolfe.com
Or visit: http://www.cwnewsroom.ch
1 Carapetis JR, McDonald M, Wilson NJ. Acute rheumatic fever. Lancet. 2005a;366:155-168.