Global partners come together to combat heart disease in East Africa

Ebola. Zika. HIV. Malaria. Tuberculosis. These diseases dominate headlines and present serious public health issues in developing countries. Yet heart disease, once thought to affect only wealthy countries, is a rapidly growing epidemic in low- and middle-income countries (LMIC). Cardiovascular disease (CVD) remains the No. 1 cause of death globally, and three-quarters of all cardiovascular-related deaths occur within LMICs, translating to 13 million deaths each year.

Global collaboration is vital if experts are to address the challenges presented by non-communicable diseases like CVD. To that end, an international group of cardiologists and nearly 200 global and regional health care experts, biomedical engineers, and industry partners came together for the East African Cardiology Conference. Representatives from the U.S., Europe, China, and several East African nations met in Tanzania to discuss the rising epidemic of CVD and possible strategies to strengthen the capacity to care for cardiac disease in East Africa.

The conference was driven by MUSC cardiologists Peter Zwerner, M.D., and Eric Powers, M.D, in partnership with Centra Health in Virginia and the non-profit Madaktari Africa, and funded through the generous support of GE Healthcare. Opening the conference, speakers Jakaya Kiwete, former president of the United Republic of Tanzania, Ummy Mwalimu, the country’s Minister of Health, and Michael Valentine, M.D., vice president of the American College of Cardiology, gratefully acknowledged the significant work the partners had contributed to the advancement of health care in Tanzania.

Zwerner and Powers are part of a team of U.S. cardiologists who have traveled to Tanzania for many years as part of an ongoing program to train local physicians to build capacity in caring for patients with CVD. Cardiology teams from MUSC and Centra Health work closely with staff at Madaktari to rotate training teams on the ground throughout the year. When the government of Tanzania planned to open its first advanced cardiac institute, the U.S. team advised them on equipment, techniques and evaluations methods. In 2014, the Jakaya Kikwete Cardiac Institute opened, and doctors performed the first heart catheterization and coronary stenting in partnership with MUSC physicians and U.S. partners. Previously, Tanzanian doctors had to send patients to India for heart procedures, which was costly and inaccessible for the majority of residents. With training and tools finally in place, Tanzanian doctors have performed more than 350 heart procedures at the new facility.

During the conference, the team consulted on a six-year-old patient from Arusha, who suffered from a congenital heart problem, not demons as her family first believed, due to her constant fragile, weak state. U.S. physicians were able to help their Tanzanian counterparts correctly diagnose her and perform the first-ever pediatric pacemaker implant in the country. The child now has another chance at life, due to the expertise of the team and the new cardiac facility.

CEO of GE Africa, Farid Fezoua, discussed during his address the importance of innovation in technology, in terms of how it impacts health care in low- and middle-income countries. GE Healthcare continues to evaluate how appropriate ultrasound technology coupled with training provided to front-line health care workers can help overcome diagnostic challenges. For example, GE introduced the Vscan Access, a compact hand-held and battery-powered ultrasound, which can be used in rural community clinics, helps to optimize the diagnosis, treatment, and monitoring of patients, most notably mothers-to-be during pregnancy. Clemson University’s bioengineering team led by Delphine Dean, Ph.D., and John DesJardins, Ph.D., showcased their innovative programs aimed at developing low-cost, high-impact technologies for low-resource settings. Other members of the MUSC team who presented at the conference included cardiologist Adrian Van Bakel, M.D., anesthesiologist Eric Nelson, M.D., and Scott Reeves, M.D., chair of the Department of Anesthesia and Perioperative Medicine.

Associated facts:

• According to the World Health Organization, noncommunicable diseases (NCDs) are the leading cause of death worldwide, and among these, cardiovascular disease is the leading cause of morbidity and mortality, accounting for 46 percent or 17.5 million deaths of all NCD deaths.
• By 2030, cardiovascular diseases are expected to surpass infectious diseases like malaria and HIV/AIDS as a leading cause of death in the region.
• The World Health Organization set a global goal of reducing premature deaths from NCDs, including cardiovascular diseases, by 25 percent by 2025.
• The World Economic Forum projects that the NCD epidemic will inflict $21.3 trillion in economic losses in developing countries over the next two decades.
• NCDs that are preventable or treatable in developed countries are often death sentences in developing countries.