Healthy Heart Africa
Strengthening health systems
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.
Healthy Heart Africa Milestones
Since launching in Kenya in 2014, Ethiopia in 2016, Tanzania in 2018, Ghana in 2019, Uganda in 2020 and and Côte d'Ivoire, Senegal and Rwanda in 2021, HHA has already:
- Conducted over 25 million blood pressure screenings in the community and in healthcare facilities1
- Trained over 9,100 healthcare workers, including doctors, nurses, community health volunteers and pharmacists to provide education and awareness, screening and treatment services for hypertension1
- Activated over 950 healthcare facilities in Africa to provide hypertension services, and facilitate access to low cost, high-quality branded antihypertensive medicines1 , where applicable
There were approximately 80 million adults with high blood pressure in sub-Saharan Africa in 2000 and this figure is expected to rise to 150 million by 2025.2
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.
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 will also screen for 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 NCDs.24
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
1. AstraZeneca data on file. Total Programme Numbers Since Start as of 28th February 2022
2. Van de Vijver S, Akinyi H, Oti S, et al Status report on hypertension in Africa· Consultative review for the 6th Session of the African Union Conference of Ministers of Health on NCDs. Pan Afncan Med J_ 2013; 16:38. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3932118/pdf/PAMJ-16-38.pdf Last accessed April 2022
3. AstraZeneca Sustainability Report 2021. Available at: https://www.astrazeneca.com/content/dam/az/Sustainability/2022/pdf/Sustainability_Report_2021.pdf Last accessed April 2022
4. The World Bank The Challenge of NCDs and Road Traffic Injuries in SSA an Overview Available at: https://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 April 2022
5. Kenya National Strategy for the Prevention and Control of Non-Communicable Diseases Available at: https://aphrc.org/publication/kenya-national-strategy-for-the-prevention-and-control-of-non-communicable-diseases-2015-2020/ Last accessed April 2022
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: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237574/pdf/PAMJ-18-202.pdf Last accessed April 2022
7. Business Daily. Is Kenya sitting on ticking heart attack time bomb. November 2014 Available at: https://www.businessdailyafrica.com/bd/corporate/health/is-kenya-sitting-on-ticking-heart-attack-time-bomb--2074054 Last accessed April 2022
8. AstraZeneca PEPFAR and AstraZeneca launch partnership across HIV and hypertension services in Africa. 8 September 2016. Available at: https://www.astrazeneca.com/media-centre/press-releases/2016/pepfar-and-astrazeneca-launch-partnership-across-hiv-and-hypertension-services-in-africa-080920161.html# Last accessed April 2022
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: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3801093/ Last accessed April 2022
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 https://e-library.moh.gov.et/library/wp-content/uploads/2021/07/final-NSAP.pdf Last accessed April 2022
11. Touch Foundation. Healthy Heart Africa in Tanzania. https://touchfoundation.org/news/#celebrating-3-years-of-healthy-heart-africa-in-tanzania Last accessed April 2022
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. https://pubmed.ncbi.nlm.nih.gov/30403686/ Last accessed April 2022
13. WHO. Uganda STEPwise Report Available at: https://www.who.int/teams/noncommunicable-diseases/surveillance/data/uganda Last accessed April 2022
14. Plos One Journal The Epidemiology of Hypertension in Uganda, Findings from the National Non-Communicable Diseases Risk Factor Survey. Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0138991 Last accessed April 2022
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: https://pubmed.ncbi.nlm.nih.gov/21509418/ Last accessed April 2022
16. World Health Organization. Cote d'Ivoire. Available at: https://www.afro.who.int/fr/countries/cote-divoire Last accessed April 2022
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: https://pubmed.ncbi.nlm.nih.gov/26560131/ Last accessed April 2022
18. World Heart Federation. Risk Factors Cardiovascular Risk Factors. Available at: https://world-heart-federation.org/what-is-cvd/ Last accessed April 2022
19. World Health Organization Cardiovascular Diseases. Available at: https://www.afro.who.int/health-topics/cardiovascular-diseases Last accessed April 2022
20. World Health Organisation. Global status report on non-communicable diseases 2010. Available at: https://apps.who.int/iris/handle/10665/4457 Last accessed April 2022
21. World Health Organization. The State of Health in the WHO African Region. Available at: https://www.afro.who.int/sites/default/files/2018-08/State%20of%20health%20in%20the%20African%20Region.pdf Last accessed April 2022
22. World Health Organization_ Hypertension factsheet. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension Last accessed April 2022
23. CDC How Senegal is tracking the silent killer. Available at: https://www.cdc.gov/globalhealth/healthprotection/fieldupdates/fall-2018/senegal-track-hypertension.html Last accessed April 2022
24. WHO. Senegal Available at: https://www.who.int/publications/m/item/noncommunicable-diseases-sen-country-profile-2018 Last accessed April 2022
Veeva ID: Z4-35905
Date of preparation: April 2022
Date of expiry: April 2024