Rheumatic Heart Disease: Global Failure in Tackling a Common Killer

Rheumatic heart disease (RHD) remains a major cause of preventable morbidity and premature death, affecting over 40 million people worldwide and causing more than 300,000 deaths annually, predominantly in low- and middle-income countries. Children and adolescents bear a substantial burden, with 1-year mortality rates up to 17%, primarily from heart failure, especially among those with poor adherence to benzathine penicillin prophylaxis. RHD is entirely preventable through timely diagnosis and secondary prophylaxis, yet access to prevention, medical therapy, and surgical care remains inconsistent. Girls and women face delayed diagnosis, high maternal mortality, and inequitable access to gender-sensitive care. Fewer than 10 African countries have implemented national or pilot RHD programs, and despite the 2018 World Health Assembly Resolution 71.14, progress remains slow. Sustainable, African-led programs integrated into national healthcare systems are urgently needed to reduce RHD-related mortality and achieve its long-term elimination.