Clinical Innovators: Addressing Cardiovascular Disease on a Global Scale, An Interview with Johanna Ralston, MBA, MPH | Interview by Katlyn Nemani, MD

CardioSource WorldNews | Johanna Ralston took on the post of chief executive officer (CEO) of the World Heart Federation on Feb. 1, 2011. Prior to becoming CEO of the WHF, Johanna served as Vice President of Global Strategies at the American Cancer Society (ACS). While working at ACS, Johanna used her strong leadership skills to build up their Global Health department, launching ACS University (a program aimed at strengthening civil society’s role in cancer control in low and middle income countries) and the international roll-out of Relay for Life. She also led the global tobacco and cancer control projects in more than 30 countries. Johanna is an alumna of Harvard and the Harvard Business School Advanced Management Program and studied public health at Harvard and Johns Hopkins Bloomberg School of Public Health.

How did you become interested in global health and development?

My first job in global health was with International Planned Parenthood Federation of Latin America, about 20 years ago. However, my interest probably started with my grandmother, who was a midwife in rural Sweden and from whom I inherited a sense of the association between access and health. I also lived in India for a while as a young child and I think my love for that country started then; it has been a privilege to work with leaders from India, including Salim Yusuf, MD, DPhil, FACC, and Srinath Reddy, MD, as well as other pioneers in global health and NCDs, from Pekka Puska in Finland to Deborah Chen’s work to fight the tobacco industry in Jamaica. 

What is the mission of the World Heart Federation?

The WHF unites its members and leads the global fight against heart disease and stroke, with a focus on low and middle income countries.   

In 2011 the UN launched a global action plan: A “Decade of Action Against Non-Communicable Diseases (NCDs).” Last year NCDs were included in the Sustainable Development goals 2016–2030 for the first time. How did this affect the WHF?

Both of these milestones have been influenced by and have an influence on the WHF.  In 2009, we formed the NCD Alliance along with our sister associations representing cancer and diabetes, and our collective advocacy helped to drive the 2011 meeting, along with the leadership of governments in key regions where the NCD burden has been greatest.  Through NCD Alliance and the power of our members we also advocated for an NCD target in the sustainable development goals.  This enables a more coordinated response and we hope will also lead to prioritization of CVD on donor agendas. 

What kind of progress have you seen in addressing cardiovascular disease on a global scale since you became CEO 5 years ago?

Progress has been remarkable, and much credit is due the CVD organizations across the globe that have advocated for and support global goals.  The American College of Cardiology and AHA were early supporters of the WHF work to launch the NCD Alliance and to help advocate for the UN meeting and the SDGs.  Our members in the African Heart Network and Interamerican Heart Foundation advocated at the country level to support a strong UN political declaration, and we were fortunate that our board member Nooshin Bazargani, MD, of the Emirates Cardiac Society was placed on a high level panel leading up to the UN meeting.  The World Health Organization (WHO) has carved out a position as the CVD “go to” organization in the global health space, and our close partnership with the WHO allows us to link our members to important policies that are being developed around best buys for CV health. We have a seat at entirely new and different tables. 

What have some of the barriers been to placing cardiovascular disease on the global political agenda?

I think it boils down to three things: the myth that CVD only affects older people in high income countries, the absence of CVD in the original Millennium Development Goals which drove donor priorities for the early part of this century, and the need for a stronger patient voice to tell the story of CVD—including how much of the death and suffering associated with CVD is preventable—to communicate to policymakers and the public. A coordinated response from the CVD community is an important first step in overcoming these challenges, and we have recently launched the Mexico Declaration for Circulatory Health. 

Could you tell us about the Mexico Declaration for Circulatory Health?

The Mexico Declaration for Circulatory Health brings together global health organizations committed to improving circulatory health and reducing deaths and disability from heart disease and stroke around the world. To achieve this we must work together to support implementation of the WHO Global Action Plan 2013–2020 for NCD reduction, advocate to politicians and poly makers for funding and implementation of national action plans, and communicate our shared vision and strategy to politicians, policy makers, professionals, and the public through all of our organizations. By uniting the whole cardiovascular community around the “25 by 25” agenda (25% premature mortality from NCDs by 2025) and bringing in other stakeholders—the public sector, non-governmental organizations, the private sector and the general public—we aim to strengthen our already powerful global voice for circulatory health.

What are you goals for the World Heart Federation in the coming years?

In 2014 the Board approved a new 3-year strategy to focus the efforts of the WHF on working with our members to achieve the WHO 25 by 25 target and to align closely with WHO through roadmaps on priority targets and a program to train emerging leaders.  We are also focused on ensuring that CVD is in the global health agenda, including within universal health coverage (UHC) and the sustainable development goals, and that World Heart Day and our leadership role as a convener through the Summit and Congress continue to profile the CVD agenda.  Finally, we are committed to an accelerated response to addressing rheumatic heart disease with a WHO resolution planned for 2017.  We’re also committed to amplifying the voices of our members and welcome new organizations to come join us! 

Read the full August issue of CardioSource WorldNews at

Keywords: CardioSource WorldNews, American Cancer Society, Global Health, Neoplasms, Organizations, Public Health

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