Rheumatic Heart Disease Control Programs, Registers, and Access to Care

Abstract Rheumatic heart disease (RHD) control programs have been recommended by the World Health Organization as the mainstay of reducing the burden of RHD for nearly half a century. Programs should be structured around a disease register of people living with RHD and to support delivery of secondary prophylaxis. Delivery of register-based RHD control programs is a reality in New Zealand, Australia, and some Pacific Island nations, while structured register-based programs are rare in Africa, South America, and India, where the largest number of people with RHD live. This chapter outlines the evidence and evolution of RHD control programs and draws conclusions about priorities following the 2018 World Health Organization Global Resolution on rheumatic fever and RHD. Conceptual, technical, and ethical issues relevant to RHD registers are addressed. Opportunities to improve access to healthcare for people at risk of, and living with, RHD are outlined with particular focus on contemporary universal health coverage.