Although there is an immediate need in sub-Saharan Africa to treat individual children in heart failure from rheumatic heart valve disease (RHVD), a bigger solution to this problem is necessary. RHVD is a curable problem. This has been demonstrated over and over again in many countries that have become developed.

The challenge is to diagnose and treat cases of strep throat before the repeated attacks transform into rheumatic fever and then RHVD. The treatment is simple: oral penicillin. The challenge to treat episodes of strep throat all across sub-Saharan Africa is colossal. After all, parents know that a sore throat will eventually recover and travelling miles by foot to a medical clinic for every sore throat that recovers on its own anyway seems silly to them. Education, therefore, is crucial, so that it becomes understood that the potential consequences of leaving strep throat untreated may be life-threatening a few years later.

For reasons still unknown, RHVD is more aggressive in Africa and advances much more rapidly such that heart failure often occurs in the teenage years. Nevertheless, eradicating strep throat by widespread education, simple but careful diagnosis, and straightforward cheap treatment could almost eliminate the early need for expensive open heart surgery for millions of children in Africa.