Prof Valery Feigin, Global Policy Committee, World Stroke Organization

Prof Valery Feigin, Global Policy Committee, World Stroke Organization highlights the importance of action on stroke prevention to secure health for all.

Stroke is the major contributor to deaths from neurological disorders globally.

Based on current data 1 in 4 individuals over the age of 25 will have a stroke in their lifetime and the number of people living with impairments and complex disabilities caused by stroke is set to rise, at a significant personal and macro-economic cost.

Stroke is also a risk factor for other neurological diseases, including dementia and epilepsy – which, in turn, also significantly contribute to the increasing global prevalence of disorders of the brain and central nervous system.

Therefore, there are sound reasons for neurology advocates to come together and call for implementation of policies that will advance stroke prevention; which will lead to a reduction in the overall global burden of disease.

We know that around 90% of strokes are linked to a small number of modifiable risk factors, and yet we are seeing a two-fold increase in stroke in many countries. In a context where the impact of COVID-19 is creating significant immediate and long-term challenges to healthcare capacity, particularly in countries where individual and healthcare resources are most scarce, the imperative to implement solutions that are smart, cost effective and that support effective healthcare provision are critical to delivering health for all.

The World Stroke Organization [WSO] has made a commitment to focus our advocacy efforts on primary prevention of stroke, not only because this offers a practical solution when (and where) these are most needed, but also because trend data suggests that clear opportunities to implement these relatively low-cost interventions are being missed.

At political level, implementation of tobacco control policies supported by access to smoking cessation, interventions to improve access to nutrition and to reduce alcohol consumption through taxation could all offer significant opportunities to reduce the global burden of neurological disease, without requiring relatively expensive healthcare interventions.

Supporting individuals to understand their risks, such as high-blood pressure and to take appropriate action either through diet and exercise or with access to low-cost medication, can be supported through the training and deployment of community health workers. Community health workers and individuals, can in turn be supported by information and motivational tools that can be accessed from a mobile phone, such as the StrokeRiskometer app.

Given that stroke shares risk factors with other non-communicable diseases and is a significant contributor to the overall impact of neurological disease, our position at WSO is that addressing stroke must be part of other prevention and disease advocacy initiatives. That is why we work in collaborations with other global NGOs, such as OneNeurology partnership, NCD Alliance and the Global Coalition for Circulatory Health.

If we work together to prevent the preventable when it comes to neurological disease, we can reduce the number of people living with the impact of stroke, including people with dementia and epilepsy. And by focusing our shared efforts on primary-prevention, we have the potential to create change for people in low and middle income countries who experience the greatest burden of disease.

In reducing the incidence and prevalence we have an opportunity to free up resources to those areas of neurological care where prevention isn’t yet possible, but where access to treatment and support could make all the difference to individual health and well-being.