title: Seven key actions to eradicate rheumatic heart disease in Africa: the Addis Ababa communiqué.
abstract: Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) remain major causes of heart failure, stroke and death among African women and children, despite being preventable and imminently treatable. From 21 to 22 February 2015, the Social Cluster of the Africa Union Commission (AUC) hosted a consultation with RHD experts convened by the Pan-African Society of Cardiology (PASCAR) in Addis Ababa, Ethiopia, to develop a 'roadmap' of key actions that need to be taken by governments to eliminate ARF and eradicate RHD in Africa. Seven priority areas for action were adopted: (1) create prospective disease registers at sentinel sites in affected countries to measure disease burden and track progress towards the reduction of mortality by 25% by the year 2025, (2) ensure an adequate supply of high-quality benzathine penicillin for the primary and secondary prevention of ARF/RHD, (3) improve access to reproductive health services for women with RHD and other non-communicable diseases (NCD), (4) decentralise technical expertise and technology for diagnosing and managing ARF and RHD (including ultrasound of the heart), (5) establish national and regional centres of excellence for essential cardiac surgery for the treatment of affected patients and training of cardiovascular practitioners of the future, (6) initiate national multi-sectoral RHD programmes within NCD control programmes of affected countries, and (7) foster international partnerships with multinational organisations for resource mobilisation, monitoring and evaluation of the programme to end RHD in Africa. This Addis Ababa communiqué has since been endorsed by African Union heads of state, and plans are underway to implement the roadmap in order to end ARF and RHD in Africa in our lifetime.
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa; University of Washington, USA.
authors.forename: David
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authors.lastname: Watkins
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Liesl
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authors.lastname: Zuhlke
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Mark
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authors.lastname: Engel
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Rezeen
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authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Veronica
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authors.lastname: Francis
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa.
authors.forename: Gasnat
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authors.lastname: Shaboodien
authors.affiliation: African Union Commission, Ethiopia.
authors.forename: Mabvuto
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authors.lastname: Kango
authors.affiliation: Association Friends of Children with RHD, Egypt.
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authors.affiliation: University College Hospital, Ibadan, Nigeria.
authors.forename: Abiodun
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authors.lastname: Adeoye
authors.affiliation: University of Khartoum and Sudan Heart Centre, Sudan.
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authors.affiliation: University of Sana'a, Yemen.
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authors.lastname: Al-Kebsi
authors.affiliation: University of Jos, Nigeria.
authors.forename: Fidelia
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authors.affiliation: Harvard Medical School/Partners in Health, USA.
authors.forename: Gene
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authors.lastname: Bukhman
authors.affiliation: Mozambican Heart Association (AMOCOR), Mozambique.
authors.forename: Albertino
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authors.lastname: Damasceno
authors.affiliation: Addis Ababa University, Ethiopia.
authors.forename: Dejuma Yadeta
authors.initials: DY
authors.lastname: Goshu
authors.affiliation: Ministry of Health, Rheumatic Heart Disease Programme, NCDs, Egypt.
authors.forename: Alaa
authors.initials: A
authors.lastname: Elghamrawy
authors.affiliation: Kenyatta National Hospital, Kenya.
authors.forename: Bernard
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authors.lastname: Gitura
authors.affiliation: Jimma University, Ethiopia.
authors.forename: Abraham
authors.initials: A
authors.lastname: Haileamlak
authors.affiliation: Mekelle University, Ethiopia.
authors.forename: Abraha
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authors.lastname: Hailu
authors.affiliation: Ministry of Health and Social Services, Namibia.
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authors.lastname: Hugo-Hamman
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authors.lastname: Justus
authors.affiliation: All India Institute of Medical Sciences, India.
authors.forename: Ganesan
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authors.lastname: Karthikeyan
authors.affiliation: College of Medicine, University of Malawi, Malawi.
authors.forename: Neil
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authors.lastname: Kennedy
authors.affiliation: Uganda Heart Institute, Uganda.
authors.forename: Peter
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authors.lastname: Lwabi
authors.affiliation: Technical Adviser, NCD directorate, Federal Ministry of Health of Ethiopia, Ethiopia.
authors.forename: Yoseph
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authors.affiliation: Sefako Makgatho Health Sciences University, South Africa.
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authors.affiliation: Sefako Makgatho Health Sciences University, South Africa.
authors.forename: Chris
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authors.lastname: Sutton
authors.affiliation: Instituto Nacional de Saúde, Mozambique and PASCAR Vice President South.
authors.forename: Ana Olga
authors.initials: AO
authors.lastname: Mocumbi
authors.affiliation: Mulago Hospital, Uganda.
authors.forename: Charles
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authors.affiliation: University Teaching Hospital, Zambia.
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authors.affiliation: Rwanda Heart Foundation, Rwanda.
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authors.lastname: Mucumbitsi
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authors.lastname: Murango
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authors.forename: George
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authors.lastname: Nel
authors.affiliation: University of Nairobi, Kenya.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ogendo
authors.affiliation: University of Nairobi, Kenya.
authors.forename: Elijah
authors.initials: E
authors.lastname: Ogola
authors.affiliation: University of Abuja Teaching Hospital, Nigeria.
authors.forename: Dike
authors.initials: D
authors.lastname: Ojji
authors.affiliation: Federal Medical Centre, Abeokuta, Nigeria.
authors.forename: Taiwo Olabisi
authors.initials: TO
authors.lastname: Olunuga
authors.affiliation: Common Market for Eastern and Southern Africa, Ethiopia.
authors.forename: Mekia Mohammed
authors.initials: MM
authors.lastname: Redi
authors.affiliation: University of Rwanda, Rwanda.
authors.forename: Kamanzi Emmanuel
authors.initials: KE
authors.lastname: Rusingiza
authors.affiliation: Bayero University Kano and Aminu Kano Teaching Hospital, Nigeria.
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authors.lastname: Sani
authors.affiliation: Cairo University Children Hospital, Faculty of Medicine, Egypt.
authors.forename: Sahar
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authors.lastname: Sheta
authors.affiliation: WHO Regional Office in Africa, Congo.
authors.forename: Steven
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authors.lastname: Shongwe
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authors.forename: Joris
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authors.lastname: van Dam
authors.affiliation: African Heart Network, Tunisia.
authors.forename: Habib
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authors.lastname: Gamra
authors.affiliation: Telethon Kids Institute, University of Western Australia, Princess Margaret Hospital for Children, Australia.
authors.forename: Jonathan
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authors.lastname: Carapetis
authors.affiliation: University of Auckland, New Zealand.
authors.forename: Diana
authors.initials: D
authors.lastname: Lennon
authors.affiliation: Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa; PASCAR Secretariat, South Africa. bongani.mayosi@uct.ac.za.
authors.forename: Bongani M
authors.initials: BM
authors.lastname: Mayosi
mesh_terms: D000349:Africa / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000600:supply & distribution; D006348:Cardiac Surgical Procedures; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D006292:Health Priorities / Q000458:organization & administration*; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006801:Humans; D007391:International Cooperation; D020380:Needs Assessment / Q000458:organization & administration*; D010401:Penicillin G Benzathine / Q000600:supply & distribution; D011322:Primary Prevention / Q000458:organization & administration*; D012042:Registries; D012213:Rheumatic Fever / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D012214:Rheumatic Heart Disease / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D055502:Secondary Prevention / Q000458:organization & administration*
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine
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