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R heumatic fever and rheumatic heart disease were very common in the United States in the years before and during World War II. Because of the public health significance of acute rheumatic fever and crippling rheumatic heart disease, in 1944 T. Duckett Jones published the initial version of what we know as the Jones criteria, assisting clinicians in accurately making the diagnosis of acute rheumatic fever.1 The clinical importance of these criteria worldwide is documented by the modification of these important clinical adjuncts by the World Health Organization in 19882 and, more recently, by a special American Heart Association writing group.3 The first lecture honoring T. Duckett Jones' important contributions and his memory was given at the 35th annual Scientific Sessions of the AHA in Cleveland, Ohio, in 1962. That lecture, entitled "Rheumatism Then and Now," was delivered by Dr Paul Dudley White. Not only is this the 30th anniversary of the T. Duckett Jones Memorial Lecture but, of special personal significance, this is also the 20th anniversary of the 1972 Jones Lecture, entitled "The Chain That Binds the Heart to the Throat,"4 delivered by my mentor and friend, Dr Lewis W. Wannamaker, then a Career Investigator of the AHA. Among those individuals selected for this honor by the AHA are several others I would like to acknowledge who have had an important personal influence on me. Included are names familiar to clinicians and laboratory investigators with an interest in streptococcal infections and rheumatic fever: Drs Rebecca Lancefield, Milton Markowitz, Gene Stollerman, Angelo Taranta, Richard Krause, Elia Ayoub, Leon Gordis, and Floyd Denny. While considering the tradition of this lecture, I recalled that Dr White, the first Jones Lecturer, was a founder of the AHA's international program. This very successful effort has proved important by allowing colleagues from around the world to exchange ideas and collaborate in mutually beneficial clinical and research

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T. Duckett Jones Memorial Lecture. Global assessment of rheumatic fever and rheumatic heart disease at the close of the century. Influences and dynamics of populations and pathogens: a failure to realize prevention?