Addressing Rheumatic Heart Disease in the Pacific ^†

Background/Purpose: Pacific leaders have articulated addressing rheumatic heart disease (RHD) as a Pacific health priority. The Pacific bears a disproportionate RHD prevalence relative to its population size (1–3%), affecting young women and socio-economically marginalized groups. RHD begins as a communicable Streptococcal A infection driven by environmental conditions and ends as a non-communicable disease. Approach: The Pacific RHD Program takes a dual approach to achieve the end-of-program outcomes of improving the capacity of Pacific countries to control RHD. Firstly, the development of a Fiji-based RHD Knowledge Hub will provide a sustainable center point for RHD control programs across the region, acting as a hub for resources, technical expertise, knowledge sharing, and meaningful linkages. Secondly, Vanuatu and Solomon Islands will be supported to develop locally led RHD control programs overseeing strengthened awareness, early detection and management of RHD beginning centrally, using local learnings to systematically inform the expansion of the program. Significance: This program will address three key development issues. Firstly, the breadth of RHD necessitates a system-wide response. Consequently, addressing RHD will have direct benefits, such as articulating the burden and disease management, and indirect system benefits like improved laboratory/diagnostic capacity. Secondly, sustainable action toward RHD requires a shift in control from internationally led programs to sustainable, embedded, Pacific leadership with data sovereignty. Thirdly, people living with RHD and affected communities are under-represented in efforts to address RHD. Consciously engaging lived perspectives in decisions addressing RHD and creating linkages with First Nations’ lived experiences are key factors in the success of the Pacific RHD Program.