Morocco's Ministry of Health and Social Protection, in collaboration with the World Health Organization (WHO), has developed a National Strategic Plan for the Prevention and Control of Acute Rheumatic Fever (ARF) and Rheumatic Heart Disease (RHD) for 2026-2030. The plan, with a budget of over 30 million Moroccan Dirham (DH), aims to position Morocco among countries with low risk of rheumatic heart disease by 2030. This initiative aligns with the country's efforts to achieve Sustainable Development Goal 3.4, which focuses on reducing premature mortality from non-communicable diseases.
The plan seeks to reduce the burden of morbidity, premature deaths, and disabilities associated with ARF and RHD by coordinating efforts among various stakeholders. Morocco has been tackling rheumatic heart disease since 1995 through a national prevention and control program. An evaluation of this program in 2021 highlighted the need to revise the national strategy, taking into account scientific progress in diagnosis and treatment, as well as evaluation recommendations. Consequently, the Ministry, with WHO support, developed the new strategic plan.
According to the Ministry, the national incidence of ARF in 2024 was estimated at 14.41 cases per 100,000 inhabitants, categorizing Morocco as having a moderate to high prevalence. In 2024, 5,306 new cases of ARF and 1,754 new cases of rheumatic heart disease were reported. The number of new ARF cases in Morocco has fluctuated between 2018 and 2024, with a notable decrease between 2019 and 2021, followed by a significant increase from 2022. The proportion of rheumatic heart disease cases has also seen a significant rise since 2022.
The economic impact of rheumatic heart disease in Morocco is substantial. The direct cost of managing a patient with mild to severe rheumatic heart disease is estimated at around 27,000 DH per year. The cost of heart valve surgery is approximately 100,000 DH. The disease's impact on pregnant women and their families can be devastating, both socially and economically.
The National Strategic Plan has three specific objectives: to reduce the incidence of ARF to less than 2 per 100,000 school-age children (5-15 years) by 2030; to decrease the incidence of relapses to less than 0.5% per patient year; and to reduce the prevalence of rheumatic heart disease to less than 1 per 1,000 inhabitants. The plan's budget is allocated across six strategic areas, including prevention, early detection, and management of complications.
The plan's six strategic domains include prevention of ARF, secondary prevention, and tertiary prevention. The first domain focuses on preventing the initial onset of the disease through awareness, community engagement, and improved diagnostic and therapeutic capabilities. Secondary prevention aims to detect cases early to limit progression to severe cardiac complications. Tertiary prevention seeks to reduce complications, disabilities, and mortality associated with rheumatic heart disease.
The successful implementation of this strategic plan will require coordination among various stakeholders, including healthcare professionals, communities, and government agencies. The plan's progress will be monitored through a national evaluation system, with annual assessments and impact studies. By achieving its objectives, Morocco aims to significantly reduce the burden of rheumatic heart disease and improve the health and well-being of its population.
Key points
- The plan aims to reduce the incidence of ARF to less than 2 per 100,000 school-age children by 2030.
- The budget for the plan is estimated at over 30 million DH.
- The plan seeks to position Morocco among countries with low risk of rheumatic heart disease by 2030.
