The economic burden of rheumatic heart disease in the Eastern Mediterranean Region

Introduction Acute rheumatic fever (ARF) is an immune response triggered by group A Streptococcus (GAS) infections, predominantly affecting children aged 5–15 years. Untreated ARF can progress to rheumatic heart disease (RHD), causing complications such as valve stenosis, heart failure and stroke. Despite preventability using antibiotics, RHD persists as a major health concern in many Eastern Mediterranean Region (EMR) countries. Beyond its health implications, RHD poses a significant economic burden on societies, emphasising the need for comprehensive solutions. Methods An economic analysis was conducted to estimate the burden of RHD in 22 countries of the EMR using data from secondary databases and existing research. The analysis modelled the future disease burden, using a scenario of inaction and considering population growth and changes in population structure. Economic losses associated with RHD were explored through five pathways, including the (a) direct healthcare costs of preventing and treating RHD and its complications, (b) cost of premature deaths, (c) cost of absenteeism in adult patients, (d) cost of absenteeism in caregivers and (e) future productivity losses due to unfulfilled potential in children. Results The estimated economic burden of ARF, RHD and its related complications in the EMR was US$5.8billion in 2020, amounting to 0.20% of the combined gross domestic product. Indirect costs accounted for 78% of the burden. 192million prevalent cases and 1.5million deaths were expected by 2050. The burden is projected to increase to US$166billion between 2020 and 2050. Conclusion The disease burden of RHD is rising in the EMR, widening health inequalities and straining resources. Careful planning and resource allocation based on economic evaluations are crucial to mitigate this issue. Regional governments must implement measures to address social determinants, enhance community awareness, improve surveillance and provide accessible healthcare services to effectively tackle this challenge.