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# Australia's rheumatic heart disease plan lacks full funding
- URL: https://www.bushletter.com/australias-rheumatic-heart-disease-plan-lacks-full-funding/
- Published: 2026-11-14T23:30:00.000Z
- Updated: 2026-11-14T23:29:59.000Z
- Description: Health leaders meeting in Perth have set a 2040 elimination target for a preventable illness that falls overwhelmingly on Aboriginal and Torres Strait Islander people.
- Author: Bushletter Newsroom
- Tags: Health, Science, Australia

TLDR

Global health leaders adopted the Perth Declaration on 14 November 2026, committing to eliminate rheumatic fever and rheumatic heart disease as public-health problems by 2040\. Aboriginal and Torres Strait Islander people carry 81 per cent of Australia's recorded disease burden, while the country's own elimination roadmap has never received full national funding.

## Declaration adopted in Perth at global congress

Global health leaders launched the Perth Declaration at the closing ceremony of the Second World Congress on Rheumatic Heart Disease on 14 November 2026, setting a collective target to eliminate rheumatic fever and rheumatic heart disease as public-health problems by 2040.[\[1\]](https://world-heart-federation.org/news/perth-declaration-sets-2040-global-target-to-eliminate-rheumatic-heart-disease/?ref=bushletter.com) The congress brought together researchers, clinicians, advocates and people with lived experience of the disease.

Professor Jagat Narula, President of the World Heart Federation, said the Perth Declaration marked "the most significant global effort to date to eliminate rheumatic heart disease and save hundreds of thousands of lives each year."[\[1\]](https://world-heart-federation.org/news/perth-declaration-sets-2040-global-target-to-eliminate-rheumatic-heart-disease/?ref=bushletter.com) Professor Derek Chew, Chief Scientific and Medical Officer of the National Heart Foundation of Australia, said: "This is a disease that shouldn't exist: we know the causes, we know the solutions, we just need commitment and action from world leaders to make it happen."[\[1\]](https://world-heart-federation.org/news/perth-declaration-sets-2040-global-target-to-eliminate-rheumatic-heart-disease/?ref=bushletter.com)

The declaration sets an interim goal of halving rheumatic fever and RHD deaths among people younger than 25 by 2035 in countries with established surveillance, and calls for a regulatory pathway for a Strep A vaccine by 2028 and financing for phase-three vaccine trials to begin by 2031.[\[1\]](https://world-heart-federation.org/news/perth-declaration-sets-2040-global-target-to-eliminate-rheumatic-heart-disease/?ref=bushletter.com)

## A disease that starts with a sore throat

Rheumatic heart disease begins with a Strep A throat or skin infection. In some people the immune response develops into acute rheumatic fever, which can permanently scar the heart valves and require lifelong care or surgery.[\[2\]](https://www.health.gov.au/topics/aboriginal-and-torres-strait-islander-health/chronic-disease-support?ref=bushletter.com)

Prevention is well understood: prompt treatment of Strep A infections, followed by regular benzathine penicillin G injections for anyone who has experienced acute rheumatic fever or RHD.[\[2\]](https://www.health.gov.au/topics/aboriginal-and-torres-strait-islander-health/chronic-disease-support?ref=bushletter.com) The Australian Government says the disease mostly affects Aboriginal and Torres Strait Islander children, particularly those in rural and remote areas.

At 31 December 2024, 11,794 people were recorded with RHD or a history of acute rheumatic fever in participating Australian jurisdictional registers, with Aboriginal and Torres Strait Islander people accounting for 9,496 of those, 81 per cent of the total.[\[3\]](https://www.aihw.gov.au/reports/indigenous-australians/arf-rhd/contents/summary?ref=bushletter.com) In 2024 alone, 506 acute rheumatic fever diagnoses were recorded across five jurisdictions, with First Nations people making up 93 per cent of cases and the highest diagnosis rate falling among First Nations children aged 5 to 14.

In the four main jurisdictions, Queensland, Western Australia, South Australia and the Northern Territory, only 32.4 per cent of First Nations people on regular penicillin prophylaxis received at least 80 per cent of their scheduled doses in 2024.[\[3\]](https://www.aihw.gov.au/reports/indigenous-australians/arf-rhd/contents/summary?ref=bushletter.com) The Australian Institute of Health and Welfare says the gap between prescription and delivery reflects the structural barriers facing remote communities.

## Roadmap without a price tag

Australia's RHD Roadmap was commissioned in 2018, written through END RHD and NACCHO, and presented to the COAG Health Council in March 2019 as a plan to eliminate the disease by 2031.[\[4\]](https://endrhd.telethonkids.org.au/siteassets/media-docs---end-rhd/endgame/endgame-report-digital.pdf?ref=bushletter.com) The END RHD Endgame report recorded that, at the time it was written, the most recent national policy commitments had no funding attached.

Commonwealth funding has since flowed through separate streams rather than a unified program. The 2025-26 federal budget papers recorded $15.4 million over three years from 2025-26 to detect, treat and prevent RHD in high-risk communities, alongside $9.2 million over 2025-26 to 2027-28 for the Rheumatic Fever Strategy's register and control programs.[\[5\]](https://budget.gov.au/content/bp3/download/bp3%5F04%5Fpart%5F2%5Fhealth.pdf?ref=bushletter.com) An earlier commitment of $35 million for Strep A vaccine development was made across 2019-20 and 2020-21.

The 2025-26 budget allocations of $15.4 million and $9.2 million across the two RHD streams are discrete program and research commitments, not a published, fully costed appropriation for the 2031 Roadmap.[\[5\]](https://budget.gov.au/content/bp3/download/bp3%5F04%5Fpart%5F2%5Fhealth.pdf?ref=bushletter.com) The Department of Health, Disability and Ageing says the Australian Government is committed to ending RHD as a public-health issue by 2030, one year earlier than the Roadmap's benchmark, through the Rheumatic Fever Strategy and vaccine development.[\[2\]](https://www.health.gov.au/topics/aboriginal-and-torres-strait-islander-health/chronic-disease-support?ref=bushletter.com)

Federal Health Minister Mark Butler said in June 2024 that rheumatic heart disease was "a preventable disease" and "a shared challenge in Australia and Pacific island countries".[\[6\]](https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/addressing-rheumatic-heart-disease-in-the-pacific?ref=bushletter.com) The Perth Declaration's 2040 global target sits a decade beyond the domestic deadline the government has set itself.

KEY TAKEAWAYS

01The Perth Declaration targets elimination of rheumatic fever and RHD as public-health problems by 2040.

02Aboriginal and Torres Strait Islander people account for 81 per cent of Australia's 11,794 recorded RHD cases.

03Only 32 per cent of First Nations patients received at least 80 per cent of scheduled penicillin doses in 2024.

04Australia's 2031 RHD Roadmap was presented to COAG in 2019 with no funding attached, per the END RHD Endgame report.

05The 2025-26 federal budget allocated $24.6 million across two separate RHD streams, not a unified national program.

SOURCES & CITATIONS

1. [Perth Declaration, World Heart Federation](https://world-heart-federation.org/news/perth-declaration-sets-2040-global-target-to-eliminate-rheumatic-heart-disease/?ref=bushletter.com)
2. [Aboriginal and Torres Strait Islander chronic disease support, Australian Government](https://www.health.gov.au/topics/aboriginal-and-torres-strait-islander-health/chronic-disease-support?ref=bushletter.com)
3. [Acute rheumatic fever and rheumatic heart disease, AIHW](https://www.aihw.gov.au/reports/indigenous-australians/arf-rhd/contents/summary?ref=bushletter.com)
4. [END RHD Endgame report, Telethon Kids Institute](https://endrhd.telethonkids.org.au/siteassets/media-docs---end-rhd/endgame/endgame-report-digital.pdf?ref=bushletter.com)
5. [2025-26 Federal Budget, Health portfolio, budget.gov.au](https://budget.gov.au/content/bp3/download/bp3%5F04%5Fpart%5F2%5Fhealth.pdf?ref=bushletter.com)
6. [Minister Butler on RHD in the Pacific, Australian Government](https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/addressing-rheumatic-heart-disease-in-the-pacific?ref=bushletter.com)

FREQUENTLY ASKED QUESTIONS

What is the Perth Declaration?

The Perth Declaration is a global commitment adopted on 14 November 2026 at the Second World Congress on Rheumatic Heart Disease. It calls for the elimination of rheumatic fever and rheumatic heart disease as public-health problems by 2040, with an interim goal of halving deaths among under-25s by 2035 in countries with surveillance systems in place.

Who is most affected by rheumatic heart disease in Australia?

Aboriginal and Torres Strait Islander people carry 81 per cent of Australia's recorded RHD burden, according to AIHW data to December 2024\. The disease is concentrated among children in rural and remote communities, with First Nations children aged 5 to 14 showing the highest acute rheumatic fever diagnosis rates.

How is rheumatic heart disease prevented?

Prevention starts with prompt treatment of Strep A throat and skin infections. People who have experienced acute rheumatic fever or RHD are offered regular benzathine penicillin G injections to prevent repeat Strep A infections and further heart damage. A Strep A vaccine is in development, with the Perth Declaration calling for a regulatory pathway by 2028.

Has Australia funded its RHD elimination plan?

Australia's RHD Roadmap was presented to the COAG Health Council in 2019 without funding attached, according to the END RHD Endgame report. Since then, the Commonwealth has committed funding through separate streams, including $24.6 million across two RHD budget lines in 2025-26, but no single fully costed national elimination program has been published.