Acute Rheumatic Fever (ARF) can develop after infections with Group A Streptococcal (GAS) bacteria. If untreated, this can lead to Rheumatic Heart Disease (RHD). New Zealand children, especially Māori and Pacific Peoples, have a much higher rate of GAS infections and subsequent ARF and RHD than other first world countries. The current best practise to reduce the risk of ARF and RHD after a confirmed GAS infection is prophylactic BPG delivered once every 4 weeks to maintain a protective level of Penicillin. This project will engage with Pacific communities and review published studies from around the world to investigate the Immunogenetics of ARF and RHD. A research report on current state of knowledge around the Immunogenetics of ARF and RHD will be prepared, highlighting gaps to be investigated and potential areas of focus.