In 2017, a survey revealed that 18% of the 33 participating African countries had no registered cardiologists.^9,10 Across Africa, there are approximately 2000 registered cardiologists for a population of 1.2 billion inhabitants.¹¹ There is a scarcity of cardiac surgery and interventional cardiology services, with around 22 cardiothoracic centers in Africa, and 30% of African countries lack artificial cardiac stimulation therapies and cardiac electrophysiology.^11–13 The lack of qualified human resources is a critical obstacle. The region faces a shortage of health professionals equipped to handle CVD. The specialized training process is lengthy and inadequate, contributing to this gap.^9,11 Compared to Africa, Latin America has a great number of estimated cardiologists: 25000 to 30000. According to the 2023 Brazilian Medical Demographics study, the cardiology field has 20324 licensed professionals.¹⁴ Angola, an African low- to middle-income country with an estimated population of 34.0 million inhabitants, has made notable efforts in training specialists in cardiology and cardiac surgery.¹⁵ There are currently around 100 registered cardiologists, including 4 interventional cardiologists and 5 cardiologists who autonomously implant cardiac stimulation devices. There are also 10 cardiac surgeons, all of whom were trained abroad.

Reducing the burden of CVD in Latin America and Africa requires a multi-faceted approach that addresses various factors. For instance, collaboration with middle- and high-income countries plays a crucial role in establishing specialized centers and training professionals. However, the sustainability of these centers is challenged by economic fluctuations and political instabilities, affecting the continuity of these services.^9,11 Inclusive health policies are crucial to ensure equitable access to medical services and medications for CVD. Expanding health insurance coverage and providing accessible therapies are fundamental steps in this direction. Partnerships between countries, both North-South and South-South, are essential to strengthen specialized workforces and improve cardiovascular care.^9,12,16

Meanwhile, Africa and Latin America are seeking to expand their cardiology resources. Intensive training programs and cooperation agreements with more developed countries have been fundamental. However, the journey is long and challenging, especially with the post-pandemic economic constraints, making the maintenance of these high-complexity services a daunting task.

Investing in research on the causes and prevention of CVD in Latin America and Africa is critical to change this landscape, as is research on genetic, environmental, and social determinants of CVD. The development and testing of new interventions and technologies for CVD prevention and treatment are also important.

The challenge lies not only in training specialists, but also in establishing adequate medical infrastructure. The unequal distribution of diagnostic and therapeutic services in cardiology highlights the gap between urban and rural areas, exacerbating health disparities. International partnerships have played a crucial role in establishing specialized centers. However, maintaining these high-cost structures is challenging amid economic volatility.¹⁷

In conclusion, the collaboration between Latin American and African countries to reduce the burden of CVD is of paramount importance in fostering global health equity. Both regions face common challenges, such as rapidly changing lifestyles, limited healthcare infrastructure, and socioeconomic disparities, that contribute to the rising prevalence of CVD. By pooling their resources, sharing best practices, and engaging in joint research initiatives, these regions can develop targeted and culturally sensitive interventions (Figure 2).

Collaborative efforts will not only enhance the understanding of region-specific factors influencing CVD, but also facilitate the implementation of effective preventive measures and treatment strategies. Moreover, shared experiences in addressing CVD can strengthen the overall resilience of health systems and contribute to a more equitable distribution of healthcare resources. Recognizing the interconnectedness of health challenges, a unified approach will empower Latin American and African countries to navigate the complexities of cardiovascular health, ultimately promoting a healthier future for their populations and fostering a global environment where the benefits of progress in cardiovascular health are shared by all.