An infectious disease due to Group A streptococcus affecting the heart, joints, skin and brain – a notifiable disease

A “third world disease” related to poverty and overcrowded housing

An indicator of child health and how we value our children

“Rheumatic fever casts a long shadow”

Rheumatic Fever: Definitions

Causal Pathway“Te Awa Pohewa”

Group A streptococcal infection

Acute rheumatic fever

Rheumatic heart disease

StrokeEndocarditis

Heartfailure

Early death

“Primordial” prevention Housing quality Respiratory hygiene Cigarette smoke Crowding NutritionPrimary prevention Awareness “sore throats matter” Access to primary care Sore throat managementSecondary prevention Early identification of ARF RF register, penicillin injections

Tertiary prevention Detection RHD Medications Surgery

Effective long-run advocacy & the journey to rheumatic fever eradication

• RF Guidelines 2006, RF Summit Meeting 2009, RF Steering Group 2010, engagement with Minister & Ministry

• National Prevention Programme $24M 2012

• RF a health target as part of Child Health Action Plan

• Better Public Services Plan – whole of government

• Budget allocation $21M 2013

• Research fund $3.2M HRC Partnership Programme

• RF Guidelines revision 2013

•

RFPP Programme approaches

Raising awareness of

the disease, its consequences

and how to prevent it

Reduced structural and

functional household crowding

Access to free, rapid, effective

sore throat management in

high risk communities

Current programme initiatives• Pacific engagement strategy

– Wider Auckland and Wellington regions• Communications campaign in high risk areas• School-based programme

– More than 230 schools (50,000 children)– Less than half of at risk children and young people

• Rapid response services• 55 free, drop in sore throat management clinics in

Auckland and Porirua • Auckland-wide healthy homes initiative • SAS Fast track scheme• RFP plans in all North Island DHBs

Health equityWhat prospects?Norman Sharpe