A child health expert says Auckland has the most rheumatic disease in the country, but will not be getting its share of funding to combat it.
The warning coincides with a new study in the New Zealand Medical Journal on Friday on the heart damage caused by the disease in children.
Rheumatic fever is the leading cause of acquired heart disease, with Maori and Pacific people most affected.
A $12 million government programme to tackle rheumatic fever is under way in which throat-swabbing is carried out to detect the cause, strep A.
Auckland University professor Diana Lennon says while the Auckland region has up to 60% of acute cases, it is to get just 30% of the funding, which she says could jeopardise the programme's success.
The Health Ministry says it has not made final decisions yet on what funding it will give district health boards to tackle rheumatic fever.
Deputy director of public health Darren Hunt says $8.2 million is to be allocated to eight priority areas in the North Island, while another $4 million will go into rheumatic fever services that will be coordinated nationally for all regions.
Dr Hunt says the ministry expects DHBs to contibute from their own funding.
The Labour Party says the Government's rheumatic fever programme is under funded and bound to fail.
The New Zealand Medical Journal study shows 36 children, almost all Maori or Pacific, were admitted to Starship Hospital over two years with serious heart problems caused by the disease.
Of those, 25 had serious heart operations, often to replace or repair a heart valve, heart specialist Nigel Wilson says.
Dr Wilson says mild rheumatic disease can be detected by echocardiogram scans, and treated with penicillin, but until more of that is done there will continue to be children and young adults with the preventable disease.