The challenge of global inequalities in cardiovascular care
Principal Director Professor Stephen MacMahon focussed on the disparity between the distribution of burden and the distribution of expenditure on cardiovascular health care when he gave the 2007 Paul Dudley White International Lecture to the American Heart Association in Orlando, Florida.
Low and middle income countries suffer more than 80% of the global burden of cardiovascular disease, but more than 80% of global expenditure on cardiovascular health care occurs in high income countries, according to Professor MacMahon. In low and middle income countries, more than half of all cardiovascular disease affects people in middle age - during their most economically productive years - and as a result cardiovascular disease is now an important cause of poverty in many regions.
However, most individuals in low and middle income countries who are at high risk of a fatal or disabling cardiovascular event receive no treatment whatsoever. Even aspirin is not routinely provided to patients who have suffered a myocardial infarction.
To address these disparities, Professor MacMahon called for a broad approach to the WHO, the World Bank, governments and pharma to promote an increase in healthcare workers and capacity, preventive programs of guidelines and education, and availability of reasonably priced generic medications.
The Paul Dudley White International Lecture is presented by a distinguished researcher in the health arena who has played a pivotal role in the advancement of cardiology throughout the world. The lecture is held in memory of Paul Dudley White who, aside from being a founder and one time President of the American Heart Association, was US President Eisenhower's personal physician. Dr White guided Eisenhower's recovery from a heart attack in 1955.
Professor MacMahon’s lecture can be accessed through the American Heart Association website.