The Cape Town Declaration on Access to Cardiac Surgery in the Developing World

Area of Science:

• Cardiology
• Global Health
• Public Health

Background:

• Rheumatic heart disease (RHD) continues to be a major cause of cardiovascular disease in children and young adults in low- and middle-income countries.
• Despite global declarations and prevention efforts, RHD affects 33 million people worldwide, with a prevalence equal to HIV infection.
• Access to essential treatments like open heart surgery is severely limited in many regions where RHD is endemic.

Purpose of the Study:

• To address the persistent global health challenge of rheumatic heart disease (RHD) twelve years after the Drakensberg Declaration.
• To propose a framework for a coordinated international alliance to tackle RHD.
• To highlight the inequality in access to life-saving cardiac surgery for symptomatic RHD patients.

Main Methods:

• Review of the current status of rheumatic heart disease (RHD) control efforts globally.
• Analysis of the persistent challenges in RHD prevention and treatment.
• Proposal of a structural framework for an international alliance.

Main Results:

• RHD remains a significant cause of cardiovascular disease in young populations in low- and middle-income countries.
• Existing prevention strategies have not eradicated the disease.
• A critical gap exists in the availability of surgical treatment for symptomatic RHD.

Conclusions:

• An international alliance is proposed to create a coordinated and transparent approach to combat RHD.
• Addressing the inequality in access to cardiac surgery is crucial for RHD management.
• Improving living conditions and implementing pilot programs remain important strategies for RHD control.