Preventing the preventable to improve life for all

05 Jul 2021

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 contributor to other neurological diseases, including dementia and epilepsy that are also significant contributors to the increased global prevalence of diseases of the brain and central nervous system. There are therefore sounds reasons for those of us advocating for increased focus on neurological disease to come together to call for the implementation of policies that will advance stroke prevention efforts as part of the effort to reduce the 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 impacts of COVID-19 are 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 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, the 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, preventative initiatives for stroke and other neurological disorders, our position at WSO is that addressing stroke must be part of other prevention and disease advocacy initiatives. That’s why we work in collaborations with other global NGOs, such as One Neurology 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.

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