Rheumatic Heart Disease in Pakistan: Challenges and Opportunities

Rheumatic heart disease (RHD), a preventable complication of acute rheumatic fever, remains a leading cause of acquired heart disease in people under 25 years of age, particularly in low- and middle-income countries. The incidence of RHD is strongly linked to overcrowded living conditions, inadequate sanitation and poor health literacy. While countries with high socio-demographic indices have successfully reduced the prevalence of RHD through improved healthcare infrastructure and disease control programmes, low- and middle-income countries, such as Pakistan, continue to struggle with its rising burden. Here we highlight the epidemiological trends of RHD in Pakistan, explore contributing factors and underscore the need for targeted public health interventions. A review of recent literature and epidemiological data was conducted to assess the prevalence, incidence and sex disparities in RHD cases across Pakistan. The global burden of RHD exceeds 40.5 million cases annually, with Pakistan exhibiting one of the highest prevalence rates in South Asia. Despite the availability of effective preventive strategies, Pakistan’s limited healthcare resources and lack of standardised disease control programmes contribute to its persistent RHD burden, with RHD continuing to pose a significant public health challenge in the country. Addressing the issue requires strengthening healthcare infrastructure, increasing access to preventive measures such as penicillin prophylaxis and implementing national disease control programmes. Urgent policy action is needed to curb the rising incidence of RHD and improve health outcomes.