Healthy Heart Africa

Partnership objectives

The partnership aims to ensure that 10 million patients in Africa with hypertension are on treatments which control their condition by 2025, supporting the World Health Organization’s (WHO’s) ‘25 by 25’ global monitoring framework for preventing and controlling non-communicable diseases.

If achieved, this would address a quarter of the WHO’s hypertension target in Africa. Healthy Heart Africa aims to do this by determining the most effective methods of integrating hypertension care into existing health platforms.

Healthy Heart Africa is designed to raise awareness of the symptoms of hypertension Healthy Heart Africa is designed to raise awareness of the symptoms of hypertension Copyright AstraZeneca

What are the health needs and challenges?

Hypertension, or high blood pressure, is an often-overlooked non-communicable disease that puts patients at high risk of developing more serious cardiovascular conditions such as coronary heart disease and stroke. Africa has the highest prevalence of adults with hypertension at 46%, and a quarter of all premature deaths in Africa are attributable to the condition. Hypertension causes 7.5 million deaths annually (12.8% of all deaths) and the risk of dying from hypertension in low and middle-income countries is more than double that in high-income countries. Hypertension is a major risk factor for CVD and indicates an increased risk of heart attack, heart failure, stroke and other complications. In Africa alone, CVD accounts for one in ten deaths across the continent.

Description of partnership activities and how they address needs and challenges

Healthy Heart Africa is designed in consultation and collaboration with non-governmental and community based organizations, international organizations, health experts and governments to support local health systems by increasing awareness of the symptoms and risks of hypertension and by offering education, screening, treatment and control.

The program has three components:

  • Education and awareness – increasing awareness of the risk factors associated with hypertension and how to prevent it, as well as prompting patients to access screening services.
  • Providing training and treatment guidelines – supporting training for health and community care workers and developing guidelines with professional societies and the Kenyan Ministry of Health to ensure consistency in the level and quality of care.
  • Access and affordability – improving access to hypertension treatment and ensuring a consistent supply of low priced, affordable medicines including calcium-channel blockers, angiotensin-converting enzyme (ACE) inhibitors and hydrochlorothiazide diuretics.

Given the novel nature of HHA, and the reality that few cost-effective models for NCD care have been proven and scaled in Africa, AstraZeneca launched five different demonstration projects– HHA tested different models across a relatively fragmented healthcare system in order to identify what works and at what cost to inform future scale-up both within Kenya and across the region more broadly. HHA implementing partners have included Ampath, AMREF, Christian Health Association of Kenya (CHAK), Population Services Kenya (PSK), Jhpiego, and Kenya Conference of Catholic Bishops (KCCB). AstraZeneca also collaborates with Kenya’s Mission for Essential Drugs and Supplies (MEDS), to establish secure supply chains for antihypertensive medicines, and with Abt Associates, to evaluate baseline and endline program data.

The partner program models have explored a number of approaches for improving access to hypertension care, including:

  • Integrating hypertension and infectious disease programming
  • Providing hypertension programming across public, social franchise, and faith-based facility networks
  • Testing uptake of hypertension care in community settings.

This has generated key learnings, described in additional detail below, that have supported the expansion of HHA programming, both in Kenya and Ethiopia.

After 18 months in Kenya, Healthy Heart Africa has already: 

  • Conducted  over 2 million hypertension screenings in the community and in health facilitites
  • Activated over 400 health facilities
  • Trained over 3,000 healthcare workers across 31 counties including doctors, nurses, community health volunteers, and pharmacists to provide education and awareness, screening and treatment services for hypertension
  • Identified more than 300,000 hypertensive patients
  • Treated over 80,000 patients

In September 2016, AstraZeneca and PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) launched a partnership to expand access to HIV and hypertension services across Africa. The partnership will receive $10 million in funds for a five-year global public-private partnership. It will expand access to HIV/AIDS and hypertension services by offering them in an integrated manner at existing PEPFAR-supported HIV/AIDS sites, beginning in Kenya. The new partnership supports the achievement of the UN Sustainable Development Goal 3 on good health and well-being. 

It is optimizing existing HIV/AIDS service delivery infrastructure and more specifically enhancing services for men aged 25-50. Data show that men often access HIV/AIDS testing and treatment at far lower rates than women. For example, according to the most recent Kenya AIDS Indicator Survey, 79.8 percent of women surveyed had received an HIV test, whereas only 62.5 percent of men had received one. This significant gender disparity leads to HIV-infected men entering care with more advanced disease, being less likely to receive lifesaving antiretroviral therapy (ART), and having higher mortality than HIV-infected women. Late diagnosis also results in missed opportunities for HIV prevention, including early ART initiation, resulting in ongoing transmission to previously uninfected partners.

Launching in October 2016 with a one-year pilot program in Western Kenya, the partnership, in collaboration with the Kenyan Ministry of Health, will leverage PEPFAR’s existing HIV/AIDS infrastructure in Homa Bay and Kisumu. These areas were identified not only due to the high burden for all patients, but particularly working-age males who have not yet been reached by current HIV/AIDS programming. Longer term, the partnership aims to extend to other areas where the burdens of both HIV/AIDS and hypertension are particularly high.

After the success of the HHA program in Kenya, AstraZeneca developed a partnership with the Federal Ministry of Health in Ethiopia to integrate HHA programming into the Ethiopian healthcare system in support of the Government of Ethiopia’s National Strategic Action Plan for Non-Communicable Diseases. The HHA partnership in Ethiopia is designed to provide the same programmatic elements that have been successful in Kenya while ensuring their appropriate adoption to meet the needs of the Ethiopian healthcare system by utilizing the Government’s extensive Health Extension Program to bring care closer to the community.

The goal for Ethiopia HHA partnership is to decentralize and scale up high-quality hypertension care and treatment across health facilities in and around Addis Ababa, with eventual expansion to twelve hospitals and thirty-six health centres across seven regions. Program implementation is being adapted in partnership with the Ethiopian Ministry of Health for integration into public facilities.


Videos

AstraZeneca launches Healthy Heart Africa

Why is it important to tackle hypertension in Africa?

Partnership information

Company(ies) AstraZeneca

Partner(s) Abt Associates, Academic Model Providing Access to Healthcare (AMPATH), African Medical and Research Foundation (AMREF), Christian Health Association of Kenya, Mission for Essential Drugs and Supplies, Population Services International (PSI), Tanzania Ministry of Health, Touch Foundation, US President´s Emergency Plan for AIDS Relief (PEPFAR)

Type of Partner(s) Academia / Hospitals, Government, NGOs

Therapeutic Focus Non-Communicable Diseases

Disease(s) Cardiovascular Diseases, Hypertension

Program Type(s) Availability of Treatment - Differential Pricing, Health System Infrastructure - Training, Prevention Programs - Awareness & Outreach

Targeted Population(s) General population, Health professionals, Men, Patients in needs of treatment, Women

Region(s) Sub-Saharan Africa

Number of Countries 3

Country(ies) Ethiopia, Kenya, Tanzania

Start Date 2014

More information Press Release

Anticipated completion date Ongoing

« We welcome AstraZeneca’s Healthy Heart Africa program, which has the potential to have a significant impact on the burden of cardiovascular disease across this continent. »

Prof. Elijah Ogola, Kenya Vice-President (East), Pan African Society of Cardiology