If the heart becomes affected, repeated episodes may result in rheumatic heart disease, a preventable condition that remains one of the leading causes of acquired heart disease among young people in many low- and middle-income countries. ‘Acute rheumatic fever and rheumatic heart disease disproportionately affect communities experiencing poverty, overcrowding and barriers to healthcare. For people who have previously had rheumatic fever or who are living with rheumatic heart disease, continued treatment is equally important. ‘Rheumatic heart disease can turn a treatable childhood infection into lifelong heart-valve disease. The organisations are also calling for stronger disease surveillance, improved referral pathways, reliable medicine supplies and better patient registries to help health authorities understand the true burden of rheumatic fever and rheumatic heart disease in South Africa.