CLINTON PANEL REVEALS NEGLECT OF CARDIOVASCULAR DISEASEThe world health community’s strategy of addressing infectious diseases to the near exclusion of cardiovascular and other chronic diseases is self-defeating. That’s because it fails to address the principal causes of mortality, panelists told the Clinton Global Initiative during its second annual meeting 20 to 22 September in New York. To Nizal Sarraf Zadegan, Director of the Cardiovascular Research Center in Isfahan, Iran, the flawed approach was illustrated by a photograph of an obese woman depicted as happy to be receiving life-saving drug therapies for the human immunodeficiency virus, or HIV. “She was obese,” Dr Zadegan said. “She will not get the disease (Acquired Immune Deficiency Syndrome). Yes, that’s right. But she’s obese. She will get diabetes in the future, cardiovascular disease.” Srinath Reddy, Chairman of the World Heart Federation’s Scientific Council on Epidemiology and Prevention, described the failure to address both infectious and chronic diseases as “an artificial divide” that threatened to weaken investments in human health. “If you are trying to save a child under the age of 15 from dying of a diarrheal disease, then you don’t want that same child to die prematurely at the age of 20 or 35 of a heart attack,” he said. Shaping heart-healthy behavior in the youngWorld Heart Federation President Valentin Fuster said that any effort to put cardiovascular diseases on the global health agenda should include an intense focus on the needs of children, because “this is the age where you really model the behavior of the future.” “We should tell children what is good about preserving health,” Dr Fuster said. As an example as to how to influence children’s behavior, he pointed to the World Heart Federation’s demonstration project in Colombia. It’s a partnership with the producers of the popular children’s television series “Plaza Sésamo” to teach children, about such heart-healthy activities as dancing, gardening and eating fruits and vegetables. Furthermore, he highlighted the importance of training youths 15 to 20 years old to serve as advocates for their own health and role models for younger children. In mid November, the World Heart Federation plans to join the Global Youth Meet of Hriday Shan by sending youths from four Latin American countries – Colombia, Argentina, Mexico and Uruguay – for such training in New Delhi, India. “Demonstration projects like these are where we should aim,” he said. World Heart Federation appeals for helpThe World Heart Federation announced two major commitments for which it requested pledges of support. The first is for Rheumatic Heart Disease (RHD)-control demonstration projects in Egypt, Ethiopia, Ghana and South Africa. Each would evolve into a sustainable, government-run national RHD-control programme. “Our aim is to significantly reduce mortality, morbidity and disability among African children and young adults,” said 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. We will also advocate for guaranteed supplies of high-quality antibiotics and for rheumatic heart disease to be recognized as a clinical, public health and political priority.” The other is for the development, production and delivery by 2009 or 2010 of a polypill for the secondary prevention of cardiovascular disease. The polypill would contain a fixed dose combination of an ace inhibitor, a statin and aspirin. It would cost an estimated one-fifth of currently available therapies. The polypill would be especially applicable to post-myocardial infarction patients in low- and middle-income countries and low-income patients in more developed economies who would otherwise have limited treatment options. For more information about the Clinton Global Initiative visit www.clintonglobalinitiative.org.
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