Government focus on rheumatic heart disease

Rheumatic heart disease is receiving serious political attention, as the Federal Government makes inroads into addressing and improving the health of Aboriginal Australians.

Indigenous Health Minister Ken Wyatt has convened a roundtable in Darwin to look at charting a comprehensive roadmap to end rheumatic heart disease (RHD).

The roundtable brought together RHD and infectious diseases specialists, health professionals, Indigenous health advocates, philanthropists, service providers and government agencies.

“RHD and acute rheumatic fever take about 100 Aboriginal and Torres Strait Islander lives each year and many of these are young people,” Mr Wyatt said.

“The tragedy is compounded by the fact that RHD is almost entirely preventable, with many organisations, including governments, grappling strongly with pieces of the RHD elimination puzzle.

“Now, through this roadmap we are determined to tackle the whole challenge and eliminate this disease as a significant Indigenous public health problem.”

RHD is a long-term outcome of a condition called acute rheumatic fever (ARF), which typically occurs in childhood. As a result of ARF the affected person develops inflammation of the heart valves with resulting damage and malfunction. ARF typically precedes the RHD by decades.

RHD can be usually resolved if it is detected early, but people are being treated for the condition when it is too late. RHD is most accurately diagnosed using ultrasound.

Indigenous children and young adults in the Northern Territory are estimated to suffer from RHD at more than 100 times the rate of their non-Indigenous counterparts. The Kimberley is also an RHD hotspot, with two-thirds of all Western Australian Indigenous people suffering from RHD living in the region.

The Government has allocated $23.6 million under the Rheumatic Fever Strategy over the next four years. It is also working to address the underlying social and cultural determinants that contribute to RHD, including providing $5.4 billion to States and Territories to help them to provide remote housing, under a national agreement. While the Agreement is due to end on 30 June 2018, the Commonwealth has begun discussions with State and Territory Governments on future funding arrangements.

“While RHD affects children and young adults around the world, in Australia it is a sad reflection of the health gap between Indigenous and non-Indigenous children,” Mr Wyatt said.

“We know this is a disease of poverty, of overcrowding, of difficulty with access to health services.

“The roadmap will acknowledge there is no single silver bullet to eliminate RHD. We are now looking to tackle all the determinants – including environmental health, housing and education – as we work together to help strengthen these communities against this devastating disease.”

AMA President Dr Michael Gannon has repeatedly described the lack of effective action on RHD to date as a national failure; calling for an urgent coordinated approach.

At the launch of the AMA’s 2017 AMA Report Card on Indigenous Health, Dr Gannon said: “Governments must fund health care on the basis of need. There is no doubt whatsoever that funding and resourcing of Indigenous health does not meet the overall burden of illness.”

A copy of the AMA’s 2016 Indigenous Report Card, which focused specifically on RHD, can be found at: article/2016-ama-report-card-indigenous-health-call-action-prevent-new-cases-rheumatic-heart-disease

MEREDITH HORNE

[Comment] Amending the EU Withdrawal Bill: a safeguard for health

Detailed analyses of the health consequences of Brexit have focused on its negative effects on the UK’s National Health Service, food security, international cooperation to combat threats to health, medicines regulation, and medical research.1 Faced with this depressing picture, it is natural to seek any glimmer of hope. Could there be any opportunities to improve health? The answer, invariably, is that leaving the European Union (EU) could allow the UK to go beyond existing European policies to strengthen protection in public health—eg, by introducing traffic light labelling on food or implementing stricter environmental standards.

[The Lancet Commissions] The Lancet Commission on pollution and health

Pollution is the largest environmental cause of disease and premature death in the world today. Diseases caused by pollution were responsible for an estimated 9 million premature deaths in 2015—16% of all deaths worldwide—three times more deaths than from AIDS, tuberculosis, and malaria combined and 15 times more than from all wars and other forms of violence. In the most severely affected countries, pollution-related disease is responsible for more than one death in four.

[Correspondence] Can the scientific world positively influence decision makers on planetary health?

The 2017 G7 Health Ministerial Meeting was on Nov 5–6, in Milan, Italy, and for the first time the effect of climate and environmental factors on health was addressed in the agenda of the meeting. As reported in the final Health Ministers communiquè after the meeting (signed by all seven countries),1 the delegation agreed to identify and promote some fundamental adaptation actions. In addition to the novelty of these subjects being in the agenda and in the final meeting documents, we believe the process that led to these outcomes is innovative and interesting.

[Perspectives] Mathuros Ruchirawat: leading light in pollution control

By the time she was in high school, Mathuros Ruchirawat had already figured out her professional calling. “I’m a scientist at heart”, says Ruchirawat, now Professor of Pharmacology and Toxicology at Mahidol University in Thailand and Vice President of Research and Academic Affairs at the Chulabhorn Research Institute (CRI) where she oversees nine research laboratories. Somehow she also finds time to direct a major research and educational enterprise at Thailand’s Center of Excellence on Environmental Health and Toxicology (EHT).

[Comment] Pollution, health, and the planet: time for decisive action

For decades, pollution and its harmful effects on people’s health, the environment, and the planet have been neglected both by governments and the international development community. Pollution is the largest environmental cause of disease and death in the world today, responsible for an estimated 9 million premature deaths in 2015.1 92% of all pollution-related mortality is seen in low-income and middle-income countries.1 A new Lancet Commission on pollution and health aims to confront and overturn this urgent predicament.

[Comment] Towards a healthier and safer environment

The Lancet Commission on pollution and health by Philip Landrigan and colleagues1 is an immensely important piece of work highlighting the impact that environmental pollution has on death and disease and the related need to scale up political will if we are to effectively confront this issue.

[Seminar] Coeliac disease

Coeliac disease occurs in about 1% of people in most populations. Diagnosis rates are increasing, and this seems to be due to a true rise in incidence rather than increased awareness and detection. Coeliac disease develops in genetically susceptible individuals who, in response to unknown environmental factors, develop an immune response that is subsequently triggered by the ingestion of gluten. The disease has many clinical manifestations, ranging from severe malabsorption to minimally symptomatic or non-symptomatic presentations.

[The Lancet Commissions] The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

Sub-Saharan Africa’s health challenges are numerous and wide-ranging. Most sub-Saharan countries face a double burden of traditional, persisting health challenges, such as infectious diseases, malnutrition, and child and maternal mortality, and emerging challenges from an increasing prevalence of chronic conditions, mental health disorders, injuries, and health problems related to climate change and environmental degradation. Although there has been real progress on many health indicators, life expectancy and most population health indicators remain behind most low-income and middle-income countries in other parts of the world.

Helsinki for holidays if you are safety conscious

The newly released 2018 Travel Risk Map reveals threat levels across the globe in three categories – medical, security and road safety.

Produced by security specialists International SOS, the charted risks across the three categories shows that Finland is the safest place on the planet.

Also listed as ‘low’ threats for medical concern are Norway, Sweden as well as much of western Europe, the US, Canada and Australia.

International SOS say that their Medical Risk Ratings are determined by their assessment of a range of health risks and mitigating factors including: infectious diseases, environmental factors, medical evacuation data, the standard of available local emergency medical and dental care, access to quality pharmaceutical supplies, and cultural, language or administrative barriers.

Group Medical Director of Health Intelligence for International SOS Dr Doug Quarry said that there is an increased understanding of preventative agendas in medical and travel risk mitigation, however organisations need to do more to strategically support their travelling staff.

“A staggering 91 per cent of organisations have potentially not included their travel risk program in their overall business sustainability program and 90 per cent are seemingly ignoring the impact a wellbeing policy could have on their travelling workforce,” Dr Quarry said.

The Scandinavian countries also perform well for road safety, possessing a ‘very low’ risk of a road traffic accident. Countries that Australians visit in significant numbers that have a ‘high’ road risk include Thailand and South Africa.

Unfortunately the number of Australians who died while travelling overseas rose past 1600 last financial year according to the Australian Government’s Department of Foreign Affairs and Trade (DFAT).

DFAT updates their travel advice to countries continuously and urges any Australian travelling overseas to register on the DFAT’s Smart Traveller website. This will allow the government to immediately alert Australians of any changes to the situation and know where Australians were if an evacuation was necessary.

Travel insurance remains an area of concern for Australian consular officials. Travellers without travel insurance are personally liable for covering any medical and associated costs they incur. The Australian Government won’t pay for your medical treatment overseas or medical evacuation to Australia or a third country.

The latest survey results undertaken by DFAT that looks at how Australians use travel insurance reveals Australians are not adequately using travel insurance, especially when it came to cruises. Half (48 per cent) of recent cruise goers who took out insurance were exposed to the risk of being unknowingly uninsured. This was a combination of those (38 per cent) who took out a general travel insurance policy that may not have adequately covered them for a cruise, and / or those (30 per cent) who were not certain that their travel insurance covered them for all countries their cruise liner visited.

The Australian Government provides regularly updated travel advice to all Australians at http://smartraveller.gov.au/Pages/default.aspx.

MEREDITH HORNE