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19 février 2026
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Article
Revolutionizing Rheumatic Heart Disease Prevention: Dr. Asha Bowen’s Vision for Equitable Diagnostics
Rheumatic heart disease (RHD) is a preventable yet devastating condition, especially among children in low-resource settings. In Australia, it disproportionately affects Aboriginal and Torres Strait Islander communities.(1)
Dr. Asha Bowen, former President of the World Society of Pediatric Infectious Diseases, is leading an initiative to bring advanced diagnostics to remote primary care clinics.
Central to Dr. Bowen's initiative to bring advanced diagnostics to remote primary care clinics is Cepheid’s GeneXpert® system, which enables fast molecular testing for Group A Streptococcus (GAS)—a key trigger for rheumatic fever. Delivering results quickly allows timely treatment and helps prevent RHD.
“This test could revolutionize prevention,” said Dr. Bowen, comparing it to the impact of molecular diagnostics in tuberculosis and HIV. Unlike the U.S., where antigen-based strep tests are common, Dr. Bowen notes that Australia lacks widespread primary care diagnostics due to Medicare reimbursement gaps. “Remote clinics often rely on slow, costly lab cultures,” she added.
Teaming up with Cepheid, Dr. Bowen’s team is deploying the test in 30 remote clinics across northern Australia—eight are currently active. Children aged 3 to 15 are screened using a culturally validated checklist. If symptoms are present, they receive a rapid test.
Members of Dr. Bowen’s team with the GeneXpert system.
This study is designed to drive change, not just collect data. “We’re showing this tool is effective and cost-effective,” said Dr. Bowen, who is aiming to secure national reimbursement and scale the program.
Rheumatic fever stems from the social determinants of health, from under-investment in housing and healthcare, resulting in overcrowding and poor sanitation. Untreated GAS infections can trigger immune responses that damage the heart. In many countries, a lack of diagnostics means the disease is only recognized after severe complications. “By then, prevention is no longer possible,” Dr. Bowen noted.
These maps of Australia represent the overall prevalence of RHD in Australia, with the blue map showing the overall population and the red indicating the prevalence in Aboriginal and Torres Strait Islander people, demonstrating that the majority of cases are in Aboriginal and Torres Strait Islander children. Source : https://pubmed.ncbi.nlm.nih.gov/32924748/
Dr. Bowen credits collaboration as essential. Key partners to the program include Cepheid, the Kirby Institute (UNSW), led by Professor Rebecca Guy, pioneering in point-of-care diagnostics for STIs and COVID-19, Flinders Medical Centre, where Professor Susan Matthews’ team trains non-lab staff to administer tests, the National Aboriginal Community Controlled Health Organization (NACCHO), the Kids Research Institute Australia, and the Australian Government.
GeneXpert system operation training.
Dr. Bowen urges diagnostic companies to make tools more affordable and accessible. “They can achieve commercial success while improving global health,” she noted. She also advocates for investment in implementation science to ensure research leads to real-world impact.
As the study progresses, the team remains focused on proving the effectiveness and cost-efficiency of molecular testing. If successful, the model could be scaled nationally and globally. “We’re not just testing a tool—we’re testing a pathway to health equity,” said Dr. Bowen.
Références :
- Jones B, Celermajer DS. (2025) Rheumatic heart disease 2025 – current status and future challenges. Australian Health Review 49, AH24343. https://doi.org/10.1071/AH24343
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