Global Response to Strep A and Rheumatic Heart Disease: A Sustainable Development Perspective

Introduction to Strep A and Its Health Impact

Strep A is a bacterial infection affecting individuals of all ages, predominantly children. It commonly causes sore throat and skin infections. In developed countries, these infections are typically treated effectively with antibiotics, aligning with SDG 3: Good Health and Well-being.

Challenges in Underserved Populations

In populations lacking adequate housing, healthcare access, and appropriate antibiotics, untreated Strep A infections can lead to severe immune reactions. This condition, known as rheumatic fever, causes inflammation and scarring of heart valves, resulting in rheumatic heart disease (RHD), a chronic and incurable heart condition. Addressing these social determinants of health is critical to achieving SDG 1: No Poverty and SDG 10: Reduced Inequalities.

Global Health Prioritization and Disease Burden

1. In 2018, the World Health Assembly mandated the World Health Organization to coordinate a global response to rheumatic fever and RHD.
2. By 2024, Strep A was recognized as one of the top four global disease control priorities.

RHD is the leading acquired heart disease in individuals under 25 years old, affecting approximately 55 million people worldwide and causing around 360,000 deaths annually. It is a major cardiovascular disease contributor in African countries, where many patients do not survive beyond 30 years of age. These statistics highlight the urgent need to advance SDG 3 and SDG 17: Partnerships for the Goals.

Disproportionate Impact on Indigenous Populations

• First Nations people in Australia experience RHD rates up to 61 times higher than the general population.
• The mortality risk from RHD for Australian First Nations is 20 times greater, increasing to 50 times in the Northern Territory.
• Between 2012 and 2021, RHD rates in Australia increased by 50%.

These disparities emphasize the importance of addressing health equity and social justice as part of SDG 10 and SDG 3.

Research and Vaccine Development Efforts

While improving social determinants remains essential, developing an effective Strep A vaccine is a high priority for disease prevention and control.

Supported by international organizations such as the Leducq Foundation and Open Philanthropy, Professor Mark Walker and his research team have made significant advances over the past two years toward creating a safe and effective vaccine.

Key Milestones in Vaccine Research

• Late 2022: Leducq Foundation investment established a global network of researchers focused on mRNA vaccines for Strep A.
• 2023: Open Philanthropy funding accelerated research using purified proteins combined with novel adjuvants.

This philanthropic support has transformed research capacity, enabling the team to enhance vaccine safety and efficacy testing in preparation for clinical trials anticipated within two years.

Collaborative Efforts and Future Outlook

The creation of global knowledge networks by Leducq Foundation and Open Philanthropy has revitalized a previously underfunded research field, fostering new collaborations and strengthening the community of practice. This collaborative approach exemplifies SDG 17 by promoting partnerships that accelerate progress against neglected diseases.

Conclusion

Addressing the burden of Strep A and RHD requires integrated efforts targeting social determinants, healthcare access, and innovative vaccine development. The progress achieved through international collaboration and philanthropic investment demonstrates the potential to overcome significant health challenges, advancing multiple Sustainable Development Goals and improving health outcomes globally.

1. Sustainable Development Goals (SDGs) Addressed or Connected

1. SDG 3: Good Health and Well-being
   • The article focuses on infectious diseases (Strep A), their complications (rheumatic fever and rheumatic heart disease), and the development of vaccines, directly relating to ensuring healthy lives and promoting well-being for all ages.
2. SDG 10: Reduced Inequalities
   • The article highlights disparities in disease burden and mortality rates among First Nations people in Australia compared to the general population, pointing to health inequalities.
3. SDG 9: Industry, Innovation and Infrastructure
   • The development of new vaccines using mRNA technology and novel adjuvants reflects innovation in health infrastructure and research.
4. SDG 17: Partnerships for the Goals
   • The article mentions international collaborations and philanthropic support, emphasizing global partnerships to tackle health challenges.

2. Specific Targets Under Those SDGs Identified

1. SDG 3: Good Health and Well-being
   • Target 3.3: End the epidemics of communicable diseases by 2030, including neglected tropical diseases and other infectious diseases.
   • Target 3.8: Achieve universal health coverage, including access to quality essential health-care services and access to safe, effective, quality, and affordable essential medicines and vaccines for all.
   • Target 3.b: Support the research and development of vaccines and medicines for communicable and non-communicable diseases.
2. SDG 10: Reduced Inequalities
   • Target 10.2: Empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
3. SDG 9: Industry, Innovation and Infrastructure
   • Target 9.5: Enhance scientific research, upgrade the technological capabilities of industrial sectors, and encourage innovation.
4. SDG 17: Partnerships for the Goals
   • Target 17.6: Enhance North-South, South-South and triangular regional and international cooperation on and access to science, technology and innovation.
   • Target 17.7: Promote the development, transfer, dissemination and diffusion of environmentally sound technologies to developing countries.

3. Indicators Mentioned or Implied to Measure Progress

1. Incidence and Prevalence Rates of RHD and ARF
   • The article provides data on the number of people affected worldwide (55 million), annual deaths (360,000), and specific increases in rates (50% rise in Australia between 2012-2021), which can serve as indicators to measure disease burden and progress in control.
2. Mortality Rates
   • Mortality risk comparisons between First Nations people and the general population (20 to 50 times higher) can be used as indicators of health inequality and effectiveness of interventions.
3. Vaccine Development Progress
   • Progress towards clinical trials (estimated in 2 years) and advancements in vaccine safety and efficacy testing serve as indicators of research and innovation success.
4. Access to Healthcare and Antibiotics
   • Implied indicators include availability and accessibility of adequate housing, healthcare services, and antibiotics, which influence disease outcomes.
5. Global Collaboration and Funding
   • Indicators related to the extent of international partnerships and philanthropic investments in research can measure progress towards SDG 17 targets.

4. Table of SDGs, Targets, and Indicators

Source: imb.uq.edu.au