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AMA releases plan to eradicate Rheumatic Heart Disease by 2031

29 November, 2016

The AMA recently called on all Australian governments and other stakeholders to work together to eradicate Rheumatic Heart Disease (RHD).

RHD is an entirely preventable but devastating disease that kills and disables hundreds of Indigenous Australians every year – by 2031.

AMA President, Dr Michael Gannon, said on 25 November 2016 that RHD, which starts out with seemingly innocuous symptoms such as a sore throat or a skin infection, but leads to heart damage, stroke, disability, and premature death, could be eradicated in Australia within 15 years if all governments adopted the recommendations of the latest AMA Indigenous Health Report Card.

The 2016 Report Card - A call to action to prevent new cases of Rheumatic Heart Disease in Indigenous Australia by 2031 - was launched on 25 November 2016 in Darwin.

Dr Gannon said the lack of effective action on RHD to date was a national failure, and an urgent coordinated approach was needed.

"RHD once thrived in inner-city slums, but had been consigned to history for most Australians," Dr Gannon said.

"RHD is a disease of poverty, and it is preventable, yet it is still devastating lives and killing many people here in Australia – one of the world’s wealthiest countries.

"In fact, Australia has one of the highest rates of RHD in the world, almost exclusively localised to Indigenous communities.

"Indigenous Australians are 20 times more likely to die from RHD than their non-Indigenous peers – and, in some areas, such as in the Northern Territory, this rate rises to 55 times higher.

"These high rates speak volumes about the fundamental underlying causes of RHD, particularly in remote areas – poverty, housing, education, and inadequate primary health care.

"The necessary knowledge to address RHD has been around for many decades, but action to date has been totally inadequate.

"The lack of action on an appropriate scale is symptomatic of a national failure. With this Report Card, the AMA calls on all Australian governments to stop new cases of RHD from occurring."

RHD begins with infection by Group A Streptococcal (Strep A) bacteria, which is often associated with overcrowded and unhygienic housing.

It often shows up as a sore throat or impetigo (school sores). But as the immune system responds to the Strep A infection, people develop Acute Rheumatic Fever (ARF), which can result in damage to the heart valves – RHD – particularly when a person is reinfected multiple times.

RHD causes strokes in teenagers, and leads to children needing open heart surgery, and lifelong medication.

In 2015, almost 6,000 Australians – the vast majority Indigenous – were known to have experienced ARF or have RHD.

From 2010-2013, there were 743 new or recurrent cases of RHD nationwide, of which 94 per cent were in Indigenous Australians. More than half (52 per cent) were in Indigenous children aged 5-14 years, and 27 per cent were among those aged 15-24 years.

"We know the conditions that give rise to RHD, and we know how to address it," Dr Gannon said.

"What we need now is the political will to prevent it – to improve the overcrowded and unhygienic conditions in which Strep A thrives and spreads; to educate Indigenous communities about these bacterial infections; to train doctors to rapidly and accurately detect Strep A, ARF, and RHD; and to provide culturally safe primary health care to communities."

The AMA Report Card on Indigenous Health 2016 calls on Australian governments to:

  • commit to a target to prevent new cases of RHD among Indigenous Australians by 2031, with a sub-target that, by 2025, no child in Australia dies of ARF or its complications; and
  • work in partnership with Indigenous health bodies, experts, and key stakeholders to develop, fully fund, and implement a strategy to end RHD as a public health problem in Australia by 2031.


"The End Rheumatic Heart Disease Centre of Research Excellence (END RHD CRC) is due to report in 2020 with the basis for a comprehensive strategy to end RHD as a public health problem in Australia," Dr Gannon said.

"We need an interim strategy in place from now until 2021, followed by a comprehensive 10-year strategy to implement the END RHD CRC’s plan from 2021 to 2031.

"We urge our political leaders at all levels of government to take note of this Report Card, and to be motivated to act to solve this problem."

The AMA Indigenous Health Report Card 2016 is available at https://ama.com.au/article/2016-ama-report-card-indigenous-health-call-action-prevent-new-cases-rheumatic-heart-disease

 

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