Healthy Heart Africa

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What is the Healthy Heart Africa programme?

Launched in 2014, our Healthy Heart Africa (HHA) programme is committed to tackling hypertension and the increasing burden of cardiovascular disease, with the ambition to reach 10 million people with elevated blood pressure across Africa by 2025.

HHA supports local health systems by:

  • Increasing awareness of the symptoms and risks of hypertension
  • Training providers and driving care to the lower levels of the healthcare system
  • Offering health education, screening, and reduced-cost treatment and control, as applicable

 

Healthy Heart Africa is central to our commitment to sustainability and improving access to healthcare, as we put patients first – today and in the future.

Pascal Soriot Chief Executive Officer, AstraZeneca


Healthy Heart Africa Milestones

Since launching in Kenya in 2014, Ethiopia in 2016, Tanzania in 2018, Ghana in 2019, Uganda in 2020 and Côte d'Ivoire, Senegal and Rwanda in 2021, and Nigeria and Zanzibar in 2022. HHA has already:

  • Conducted more than 47.9 million blood pressure screenings in the community and in healthcare facilities1
  • Trained more than 11,300 healthcare workers, including doctors, nurses, community health volunteers and pharmacists to provide education and awareness, screening and treatment services for hypertension1
  • Activated 1,516 healthcare facilities in Africa to provide hypertension services, and facilitate access to low cost, high-quality branded antihypertensive medicines1, where applicable

There were approximately 130 million adults with high blood pressure in sub-Saharan Africa in 2010 and this figure is expected to rise to 216.8 million by 2030.2

Healthy Heart Africa’s public/private partnership model

The nature of non-communicable diseases (NCDs) and their risk factors call for multi-sector involvement in prevention and control measures. We therefore work with local stakeholders to align on our shared objectives and develop interventions that are optimised to address local challenges on a sustainable basis, while leveraging our experience in health programming.3 This not only enhances local ownership, but it also enables sustainability of the programme’s activities.

We have learned that our approach to fighting hypertension works best when integrated into existing health platforms. Our partnerships with public, private and faith-based facilities, supported by our joint global and local knowledge and expertise, are now helping to integrate blood pressure screening and hypertension treatment into routine care in the countries where we operate.

Additionally, our demonstration phase proved the potential of using hypertension as a new entry point for treatment of other disease areas, including HIV/AIDS. 

Through our partnerships, we establish mechanisms for collaboration through, for example, joint coordination, planning and agreement of a set of core indicators for monitoring and evaluation.4

Healthy Heart Africa in Kenya

HHA was launched in Kenya in October 2014 in collaboration with the Ministry of Health (MOH) and in support of its commitment to combat NCDs in line with the Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases, 2015-20205. The initiative began with an 18-month demonstration phase to understand how to integrate hypertension services into the existing healthcare service infrastructure.

Given the novel nature of HHA, and the reality that there was a lack of evidence of successful implementation of NCD interventions within the primary care setting in African countries,6 AstraZeneca launched five different demonstration projects. In collaboration with a range of partners, HHA tested different models across a relatively fragmented healthcare system7 to identify what worked and at what cost, to inform future scale-up both within Kenya and across the region more broadly.

Since launch, we have continued to refine the model, applying resources where they have most impact and identifying learnings that we have built into our ongoing operation of the programme in Kenya and beyond. The Kenya Conference of Catholic Bishops (KCCB) is the HHA implementing partner.

Healthy Heart Africa and PEPFAR

Announced in September 2016, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and AstraZeneca embarked on an innovative global public-private partnership to tackle the burden of HIV and hypertension primarily among men in Africa. The partnership uses hypertension as a stigma-free entry point to find and reach those who need HIV services by integrating hypertension services into existing HIV platforms. It is expanding access to HIV/AIDS and hypertension services by offering them in an integrated manner at existing PEPFAR-supported HIV/AIDS sites, beginning in Kenya.8

At the foundation of the partnership is a shared commitment to reaching those outside of the traditional entry points to care, with a particular emphasis on men. The collaboration is designed to leverage PEPFAR’s sizable patient reach, and HHA’s access to hard-to-reach populations, to bring better care to those in need.8

HHA has identified new strategies for bringing hard-to-reach populations into hypertension care, including men from 25 – 50 years of age who are also a difficult population to engage for HIV care,8,9 and HHA’s model presents a natural opportunity for partnership with PEPFAR to improve HIV care in the same population.

Initial pilot projects ran in Homabay and Kisumu Counties8, and the most recent PEPFAR partnership project was implemented in Bungoma County, Western by the Academic Model Providing Access to Healthcare (AMPATH) Kenya. As the Government of Kenya is also a key partner for both AstraZeneca and PEPFAR through existing initiatives, we worked closely together to contribute to both the HIV and NCD programming priorities of the country.8

Healthy Heart Africa in Ethiopia

After the success of the HHA programme in Kenya, AstraZeneca developed a partnership with the Federal Ministry of Health in Ethiopia in February 2016 to integrate HHA programming into the Ethiopian healthcare system in support of the Government of Ethiopia’s National Strategic Action Plan for Non-Communicable Diseases10. The HHA partnership in Ethiopia is designed to provide the same elements that have been successful in Kenya while ensuring their appropriate adaptation to meet the needs of the Ethiopian healthcare system by utilising the Government’s extensive Health Extension Programme to bring care closer to the community.

The goal for the Ethiopia-HHA partnership is to address the growing burden of hypertension, through decentralising and scaling up high-quality hypertension care and treatment in health facilities across Ethiopia. Population Services International (PSI) in Ethiopia is the HHA implementing partner. 

Healthy Heart Africa in Tanzania

In June 2018, AstraZeneca unveiled a partnership with the Ministry of Health Community Development, Gender, Elderly and Children and the Touch Foundation to spearhead implementation of the HHA programme in Tanzania, in support of the Government of Tanzania's Strategic Action Plan for the Prevention and Control of Non-Communicable Diseases.

Between 2018 and 2021, the Healthy Heart Africa programme in Tanzania:

  • Trained 437 healthcare workers on hypertension management, and screened11 931 healthcare workers for hypertension
  • Screened over 76,000 pregnant and postpartum women for hypertension
  • Diagnosed and/or referred for treatment 1,631 women with hypertension

AstraZeneca's partnership with the Ministry of Health in Tanzania has continued, working with PATH on the second phase of the Healthy Heart Africa programme, to contribute towards efforts to prevent and control cardiovascular diseases in the country, by focusing on hypertension.

In October 2022, AstraZeneca expanded the HHA programme into Zanzibar, in partnership with the Zanzibar Ministry of Health. Health Improvement Project Zanzibar (HIPZ) is the implementing partner.

Healthy Heart Africa in Ghana

In July 2019, AstraZeneca expanded the HHA programme into Ghana in partnership with the Ghana Health Service. The partnership seeks to contribute to the prevention and control of cardiovascular diseases (CVD) in Ghana with emphasis on hypertension. Although hypertension is a rising problem in Ghana, knowledge of the prevalence, awareness, treatment and control at the national level is limited12. PATH in Ghana is the HHA implementing partner.

Healthy Heart Africa in Uganda

In May 2020, Uganda became the fifth African country to participate in AstraZeneca’s HHA programme. In collaboration with the Ugandan Ministry of Health (MoH) and the Uganda Protestant Medical Bureau (UPMB), the partnership aims to strengthen the provision of services for managing and preventing hypertension, using MoH guidelines to standardise care and upskilling health workers through training. It will also work to increase education and awareness of high blood pressure and lifestyle risk factors for CVD. Uganda has a high burden of undiagnosed and uncontrolled blood pressure, with the prevalence of hypertension and pre-hypertension estimated to affect 24% and 37% of the population, respectively.13,14 The programme in Uganda also screens for and works to increase education of respiratory conditions, such as chronic obstructive pulmonary disease (COPD) and asthma, a significant burden on low and middle-income countries.15

Healthy Heart Africa in Côte d'Ivoire

In March 2021, HHA’s footprint in West Africa expanded with agreement to launch the programme in Côte d'Ivoire in partnership with the Ministry of Health and Public Hygiene. The programme will integrate into existing health platforms, working alongside the Ministry of Health and Public Hygiene to make a sustainable contribution to the fight against hypertension. It will support efforts towards the early detection, prevention and control of hypertension in Côte d'Ivoire. According to the World Health Organization’s (WHO) country report of 2016, non-communicable diseases (NCDs) in Côte d'Ivoire account for 37 percent of deaths. The report also showed that CVDs have a prevalence of 15 percent.16

Implementing partners are the Africa Christian Health Associations Platform (ACHAP) and Christian Initiatives for Human Promotion (ICHP).

Healthy Heart Africa in Senegal

In June 2021, AstraZeneca and the Ministry of Health and Social Action signed a Memorandum of Understanding (MoU) to launch HHA in Senegal. The aim of the programme is to contribute to the prevention and control of cardiovascular diseases (CVD) in the country with a focus on  hypertension. The programme is being implemented by PATH in Senegal, where it is estimated that  nearly 30% of the population has hypertension although mostly untreated, with a control rate of just eight percent. 23 In addition, the World Health Organization. (WHO) estimates that 42% of all deaths in Senegal are caused by non-communicable diseases (NCDs).24

Healthy Heart Africa in Rwanda

Agreement was reached to launch Healthy Heart Africa in Rwanda in 2021, with the official launch in 2022 with the Ministry of Health and the Rwandan Biomedical Centre.The partnership is in line with the principles of the country's National Strategy for NCDs25, which encourages community action and multisector collaboration, with a focus on saving the future costs of treating advanced disease and reducing NCD-related premature mortality by 25% by 2025. The implementing partner in Rwanda is PATH.

Healthy Heart Africa in Nigeria

In August 2022, AstraZeneca, the Federal Government of Nigeria, and the National Primary Health Care Development Agency (NPHCDA) marked the launch of the Healthy Heart Africa (HHA) programme to support the prevention and control of hypertension. In 2018, researchers conducted a systematic review and meta-analysis of noncommunicable diseases (NCDs) and their risk factors in the absence of a nationally representative survey. According to the study, 31.2 percent of Nigerians have hypertension.26 Other studies reveal that more than half of people with the disease in Nigeria are unaware they have it.27

The programme is implemented by Population Services International (PSI) in Nigeria.

HHA expansion through Grant Country Programme 2023-2024

In 2023, the programme launched in eight of 10 new HHA Grant Countries planned in partnership with ACHAP and PATH. These partners will implement and manage the programme expansion to five countries each over two years, with targeted interventions in hypertension care and management. The planned expansion will be to Burkina Faso, Central African Republic, The Gambia, Madagascar, Malawi, Morocco, Mozambique, Sierra Leone, Zambia, and Zimbabwe.

Our implementing partners


Hypertension – the facts

Hypertension, also referred to as high blood pressure, is a serious medical condition which can lead to other complications like heart attack, stroke and heart failure. It is a major cause of premature death worldwide22 and is an entry point for addressing the growing NCD burden across Africa.17

  • Hypertension is associated with an increased risk of cardiovascular disease (CVD).18
  • In 2015, an estimated 37% of 17 million premature deaths (under the age of 70) were due to CVDs.19
  • By 2025,150 million adults are expected to be living with high blood pressure in Sub-Saharan Africa.2
  • NCDs are projected to become the most common cause of death in Africa by 2030, exceeding the mortality burden of communicable diseases, nutritional diseases and maternal and perinatal deaths.20
  • At present a person in Africa, aged 30–70 years, has a 20.7% chance of dying from one of the major NCDs (chronic lung disease, CVD, diabetes and cancer).21

 

References

1. AstraZeneca data on file. Total Programme Numbers Since Start as at 31 December, 2023

2. Dzudie A, et al. Roadmap to achieve 25% hypertension control in Africa by 2025. Cardiovasc J Afr. 2017;28(4):262-272. http://globalheartjournal.com/articles/10.1016/j.gheart.2017.06.001

3. AstraZeneca Sustainability Report 2023. Available at: http://z3dcwi.178758.com/content/dam/az/Sustainability/2024/pdf/Sustainability-Report-2023.pdf Last accessed February 2024

4. The World Bank The Challenge of NCDs and Road Traffic Injuries in SSA an Overview Available at: http://ncdalliance.org/sites/default/files/The%20Challenge%20of%20Non-Communicable%20Diseases%20and%20Road%20Traffic%20Injuries%20in%20Sub-Saharan%20Africa%20-%20AN%20OVERVIEW.pdf Last accessed February 2024

5. Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases Available at: http://aphrc.org/publication/kenya-national-strategy-for-the-prevention-and-control-of-non-communicable-diseases-2015-2020/ Last accessed February 2024

6. F. Temu et al. Integration of non-communicable diseases in health care: tackling the double burden of disease in African settings Pan Afr Med J_ 2014; 18:202 Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237574/pdf/PAMJ-18-202.pdf Last accessed February 2024

7. Business Daily. Is Kenya sitting on ticking heart attack time bomb. November 2014 Available at: http://www.businessdailyafrica.com/bd/corporate/health/is-kenya-sitting-on-ticking-heart-attack-time-bomb--2074054 Last accessed February 2024

8. AstraZeneca PEPFAR and AstraZeneca launch partnership across HIV and hypertension services in Africa. 8 September 2016. Available at: http://z3dcwi.178758.com/media-centre/press-releases/2016/pepfar-and-astrazeneca-launch-partnership-across-hiv-and-hypertension-services-in-africa-080920161.html# Last accessed February 2024

9. Nglazi M, van Schaik N, Kranz er K, Lawn S, Wood R, Bekker L. An lncentivized HIV Counseling and Testing Program Targeting Hard-to-Reach Unemployed Men in Cape Town, South Africa. J Acqwr lmmun Def1c Syndr. 2012:59:e28- e34. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801093/ Last accessed February 2024

10. International Cancer Control Partnership Federal Democratic Republic of Ethiopia, Ministry of Health. National Strategic Plan (NSAP) for Prevention & Control of Non-Communicable Diseases in Ethiopia. Available at http://e-library.moh.gov.et/library/wp-content/uploads/2021/07/final-NSAP.pdf Last accessed February 2024 

11. Touch Foundation. Healthy Heart Africa in Tanzania. http://touchfoundation.org/news/#celebrating-3-years-of-healthy-heart-africa-in-tanzania Last accessed February 2024

12. Sanuade OA. Boatemaa S, Kushitor MK (2018) Hypertension prevalence, awareness, treatment and control in Ghanaian population Evidence from the Ghana demographic and health survey. http://pubmed.ncbi.nlm.nih.gov/30403686/ Last accessed February 2024

13. WHO. Uganda STEPwise Report Available at: http://www.who.int/teams/noncommunicable-diseases/surveillance/data/uganda Last accessed February 2024

14. Plos One Journal The Epidemiology of Hypertension in Uganda, Findings from the National Non-Communicable Diseases Risk Factor Survey. Available at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138991 Last accessed February 2024

15. Van Gernert, F , van der Molen, T , Jones, R et al The impact of asthma and COPO in sub-Saharan Africa Prim Care Respir J 20, 240-248 (2011). Available at: http://pubmed.ncbi.nlm.nih.gov/21509418/ Last accessed February 2024

16. World Health Organization. Cote d'Ivoire. Available at: http://www.afro.who.int/fr/countries/cote-divoire Last accessed February 2024

17. Musinguzi G, Bastiaens H, Wanyen2e R, et al. Capacity of health facilities to manage hypertension in Mukono and Buikwe districts in Uganda challenges and recommendations PLoS One 2015; 10 e0142312   Available at: http://pubmed.ncbi.nlm.nih.gov/26560131/ Last accessed February 2024

18. World Heart Federation. Risk Factors Cardiovascular Risk Factors. Available at: http://world-heart-federation.org/what-is-cvd/ Last accessed February 2024

19. World Health Organization Cardiovascular Diseases. Available at: http://www.afro.who.int/health-topics/cardiovascular-diseases Last accessed February 2024

20. World Health Organisation. Global status report on non-communicable diseases 2010. Available at: http://apps.who.int/iris/handle/10665/4457 Last accessed February 2024

21. World Health Organization. The State of Health in the WHO African Region. Available at: http://www.afro.who.int/sites/default/files/2018-08/State%20of%20health%20in%20the%20African%20Region.pdf Last accessed February 2024

22. World Health Organization_ Hypertension factsheet. Available at: http://www.who.int/news-room/fact-sheets/detail/hypertension Last accessed February 2024

23. CDC How Senegal is tracking the silent killer. Available at: http://www.cdc.gov/globalhealth/healthprotection/fieldupdates/fall-2018/senegal-track-hypertension.html Last accessed February 2024

24. WHO. Senegal Available at: http://www.who.int/publications/m/item/noncommunicable-diseases-sen-country-profile-2018 Last accessed February 2024

25. Ministry of Health Rwanda. National Strategy and Costed Action Plan for the Prevention and Control of Non-Communicable Diseases in Rwanda. http://moh.prod.risa.rw/index.php?eID=dumpFile&t=f&f=26357&token=8caa516ee82d42d1d0a48567f943d4a893342ee6 Last accessed February 2024

26. WHO Africa. Nigeria collaborates with WHO to curb hypertension, introduces control initiative. Available at:http://www.afro.who.int/news/nigeria-collaborates-who-curb-hypertension-introduces-control-initiative Last accessed February 2024

27. The Journal of Clinical Hypertension: Prevalence, awareness, treatment, and control of hypertension in Nigeria in 1995 and 2020: A systematic analysis of current evidence. Available at: http://onlinelibrary.wiley.com/doi/full/10.1111/jch.14220 Last accessed February 2024

Veeva ID: XS-3639
Date of preparation: February 2024

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