Heart disease is the leading global killer. It has claimed more lives than COVID-19, strokes, lung cancer, respiratory infections and any other disease you could name. World-wide, there were over 20 million deaths attributed to cardiovascular diseases in 2021, which is over six times the number of people killed by the Black Death. A lot of heart disease is preventable and treatable, but outcomes differ drastically based on geography and income.
Vitalina Chaona grew up in the small village of Gochi 2 in Ntcheu District in Malawi, and in her 40s began experiencing symptoms like
shortness of breath, discomfort in her chest and overall feeling extremely weak. In 2021 she was diagnosed with rheumatic heart
disease, a condition that begins with a bacterial infection and leads to complications that affect heart valves.
In wealthier countries like the UK, access to antibiotics and routine primary care could have prevented Vitalina’s illness entirely. Additionally, if detected early, echocardiographic screening and valve surgery could have preserved her heart function. Instead, delayed
diagnosis and limited healthcare resources meant years of avoidable suffering. It was only through a non-governmental organization’s
intervention that she was eventually referred to Tanzania for life-saving cardiac surgery.
Vitalina’s story is not unique. The World Heart Federation estimates that over 80% of deaths from cardiovascular diseases now occur in
low- and middle-income countries. Environmental changes, such as air pollution and exposure to metals like arsenic and lead, have been particularly detrimental to the deterioration of cardiovascular health in low-income countries. Moreover, poorer countries lack the medical resources that we take for granted, like ECGs, statins, stents, and even just the infrastructure to carry out adequate treatment.
The burden of heart disease is not distributed equally, and millions in low and middle income nations still die from treatable cardiovascular conditions. This inequality reflects the deep gaps in healthcare access within our world. Initiatives such as the World Health Organization’s Global Hearts programme aim to strengthen prevention and improve access to essential medicines. Local programs, like community screening and affordable generic drug distribution, have shown promising results in nations such as Rwanda and Nepal.
Heart disease is not merely a biological condition; it is a reflection of global inequality. In the future it is vital that medical professionals understand and address these disparities is essential to making global cardiovascular care truly universal.