29 Sep 2022
World Heart Day 2022: Sub-Saharan Africa - the underserved continent when it comes to cardiovascular disease care
SHARE (Sustain Health development in Africa through Responsible Education)
The humble and noble ambition of SHARE (Sustain Health development in Africa through Responsible Education) is to identify a favorable environment in sub-Saharan countries where catheter labs can be established.
As a result of progressive urbanization and westernization of lifestyle in sub-Saharan Africa, the spectrum and pattern of cardiovascular diseases, along with their risk factors, are changing in urban areas. Non-communicable diseases, such as systemic hypertension, diabetes, and coronary heart disease, are increasing, while the burden of infectious diseases remains important.
Cardiovascular diseases are the main non-communicable conditions, and are a major public health concern worldwide; they account for 9.2 % of total deaths in the African region, where they are the leading cause of death in those over the age of 45.
In 2019, more than 1 million deaths were attributable to CVD in sub-Saharan Africa, which constituted 5.4 % of all global CVD-related deaths, and 13 % of all deaths in Africa.
54 countries make Africa, and 20 only have a catheter lab. If we exclude the North African countries and South Africa, the void in sub-Saharan countries becomes even more obvious.
The humble and noble ambition of SHARE is precisely to address this void by identifying a favorable environment in sub-Saharan countries where catheter labs can be established.
Two conditions need to be fulfilled:
- Local healthcare authorities (possibly private investors) understand the burden of CVD on their population, and see value in investing long-term in a structured offer of diagnostic & therapeutic services (catheter lab) for the benefit of the local population;
- Committed local cardiologists and allied professionals ready to embark on a long journey to training and continuous medical education in the field of interventional cardiology.
SHARE: a non-profit organization established in 2009 in Monaco, under the leadership of interventional cardiologists Dr François Bourlon & Pr Jean Marco (PCR). Solely focused on training and education for those local champions (cardiologists, catheter lab teams, echocardiographers, etc.), so that the catheter labs in sub-Saharan countries can offer proper diagnosis and treatment in their home countries.
What has been achieved so far
Mauritania: creation, in 2009, of the Centre National de Cardiologie (CNC) in Nouakchott, under the auspices of the MoH.
SHARE has supported - and continues to do so - more than 15 healthcare professionals (cardiologists and interventional cardiologists, echocardiographers, technicians, nurses, and others) in their training journey through residencies in Europe/Asia/North Africa, or during onsite missions by European cardiologists at CNC.
More than 1,000 patients p.a. undergo coronary angiography, and close to 500 patients benefit from coronary angioplasty at their home country.
This emulated into:
- additional cardiovascular care offering, both within CNC (e.g. cardiovascular surgery) and outside of CNC, through the development of private practice in Nouakchott for echocardiography & interventional cardiology.
- opportunity for CNC to host trainees in interventional cardiology from other African countries, with the benefit of dwelling on the specificity of the patients in sub-Saharan countries and the constraints of the environment (social, economic, etc.)
Mali: in 2016, in collaboration with the Malian health authorities, within an existing public institution (Hôpital Mère Enfant Le Luxembourg in Bamako): decision to build a cathlab facility.
SHARE supported residency in Europe for 5 Malian HCPs over the past 5 years, the majority of them being back in Bamako.
Despite some current political challenges (2022) affecting patient care, the catheter lab team in Bamako is active and committed.
What is still in crucial need
For Mauritania and Mali: training and medical education are not a one-time thing, but rather a life-long journey. Hence, the more centers in Europe, North Africa and Asia can offer residencies (short to long term) to local HCPs, the better.
Goodwill welcome!!!
Other sub-Saharan countries: if you have an interest in other countries, please don’t hesitate to contact us.
Article written by Patrick Jolly, Director, Europa Group
AfricaPCR 2022
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