We are pleased to see the Future Stroke Leaders Group Project Publication on ‘’Regional and national differences in stroke thrombolysis use and disparities in pricing, treatment availability, and coverage’’ was published in International Journal of Stroke in 2022. The group documented significant variability in rtPA availability and price among countries. Relative costs are higher in lower income countries, exceeding the available HE. Concerted efforts to improve rtPA affordability in low income settings are necessary.