World Stroke Organization Launches Strategy to Cut Stroke in Half

NEWS RELEASE

On World Stroke Day Oct 29th, the World Stroke Organization has announced the launch of an ambitious global strategic framework that has the potential to cut global stroke incidence by half.  

The framework, developed by an international network of leading stroke clinicians and researchers, builds on strong evidence of impact in the prevention of stroke and circulatory disease. It provides a roadmap for governments and health systems that points prevention focus towards low and medium risk populations with an approach that combines improved access to stroke preventive treatment, development of a stroke trained community health workforce, improved public awareness and mobile technologies that support the identification of risk factors and individual behavior change. A study trial that aims to prove the efficacy of the WSO strategy and the feasibility of implementation in other locations is scheduled to start in Brazil, through a partnership of the Ministry of Health and the Hospital Moinhos de Vento.

‘The latest data analysis shows that 1 in 4 of us will have a stroke in our lifetime, just 10 years ago that risk was 1 in 6. Stroke is a devastating disease and is a leading cause of disability and death worldwide. It is essential that we act urgently and focus our efforts on where we can have greatest impact on prevention’ said WSO President Prof Michael Brainin. ‘We need action at every level, from governments we need policies to address the drivers of stroke such as taxation of diet, alcohol and tobacco. We also need them to invest to ensure access to screening and preventive treatments. For individuals we need everyone to understand their risk and to commit to taking the steps they can to prevent a stroke.’

This year’s World Stroke Day #DontBeTheOne campaign aims to raise public awareness of stroke with a high profile social media campaign a patient information website complemented by on the ground activities by WSO members urging people to get informed about stroke risk.

For more information contact campaign@world-stroke.org 

Alteplase (rtPA) now included on the WHO’s List of Essential Medicines (EML) for acute ischemic stroke

Alteplase (rtPA) has made it on to the WHO’s List of Essential Medicines (EML) for acute ischemic stroke

 In the last 25 years, several studies have shown the efficacy of alteplase for acute ischemic stroke. If given within three hours, about one in four patients will have a reduced long-term handicap. This important effect of alteplase already includes its haemorrhage risk of 3-4%.

Despite this important reduction of brain damage, alteplase is only available in two thirds of countries and remains much underused in low and middle income countries. In order to increase access and use of thrombolysis around the globe, the World Stroke Organization (WSO) assembled 13 stroke experts from five continents under the leadership of Patrik Michel (Switzerland) and Michael Brainin (Austria). In 2018, this group submitted a 30 page application to the World Health Organization (WHO) for alteplase to be included in the EML (https://apps.who.int/iris/handle/10665/325771) describing all the pros, cons, conditions, and costs of alteplase.

This week, the WHO informed the WSO that the application was successful: alteplase is now included in the 21st EML, to be used in specialized diagnostic or monitoring facilities and with specialist medical care, as described for example in the WSO's Road Map for Quality Stroke Care.

This new inclusion of alteplase in the EML marks a major step forward for better stroke treatment worldwide, in particular in less affluent countries. All UN-member states are now encouraged to offer thrombolysis for a reasonable cost or for free, such as through Universal Health Coverage (UHC).

And in other good news for the stroke community, the new EML also increases the options for stroke prevention: it now lists fixed-dose dual combinations of antihypertensives, and four direct oral anticoagulants (dabigatran, apixaban, edoxaban and rivaroxaban) as essential medicines. Furthermore, a WSO expert group is currently working with WHO on a list of Priority Medical Devices for stroke prevention and treatment.

These new treatment options are likely to have an important impact on stroke incidence and long-term outcome worldwide, especially in combination with health policy, organized stroke care systems and lifestyle changes. 

Sharing all of our stories to raise awareness of stroke

At the World Stroke Organization, our work with patient stroke support organizations (SSOs) promotes the voice of people affected by stroke in our activities, including the World Stroke Congress and the World Stroke Campaign.

We recognise that people affected by stroke have unique insights into the experience of having a stroke, the effects, the care received and long term needs. These insights can and should inform stroke policy development and service provision. We also know that the voice of stroke survivors adds legitimacy to our advocacy work.

We work closely with our SSO members to capture and share stories from stroke survivors, carers and family members. These stories detail the lived experience of having a stroke, the effects and the impact on peoples’ lives. Often these stories include reflections on individual behaviour and making changes to reduce stroke risk. All the stories are deeply personal, and can describe feelings of pain, fear, confusion and also hope; a new normal and strength.

Credit: Stroke Foundation Australia

Recently to mark World Hypertension Day, Sharon McGowan, CEO of the Stroke Foundation Australia and also Co-chair of the SSO Committee at the World Stroke Organization, shared her own story.  ‘I thought long and hard about sharing my own health story. I was encouraged by the many stroke survivors who generously share their stories to encourage, educate and support our community. If just one person reads this and takes action to get their blood pressure checked then sharing my shamefully unhealthy past will be worth it’.

As a champion for the voice of people affected by stroke, by sharing her own personal story, Sharon is a great role model to others, and has added a deeper appreciation at the World Stroke Organization of the courage it takes for people affected by stroke to share their personal experiences so openly.

If you would like to add your voice and experience to the World Stroke Organization’s work to raise awareness of stroke, please contact the International Development Manager, Sarah Belson sarah.belson@stroke.org.uk

In the Company of Angels

WSO Announces Launch of WSO Angels Awards

The World Stroke Organization is proud and happy to strengthen the partnership with the ANGELS Initiative with the launch of a WSO Angels Award. This will see the extension of the Boehringer Ingelheim founded initiative, to include institutions providing stroke care worldwide and will help to extend and provide WSO with real time, quality data that will help to shape the resources and the support we provide to our members.

The partnership builds on WSO’s and the Angels Initiative’s ongoing work to drive improvement of stroke treatment and care across the world. The programme consolidates our respective efforts to improve stroke outcomes worldwide, complements the WSO roadmap to delivering quality stroke care stroke care and will provide key data to inform the development and delivery of WSO educational activities.

WSO Angels Awards will be given to hospitals who provide data and evidence of delivery of care and treatment against a set of seven criteria. In this way Angels Awards encourage continuous data capturing, enabling analysis of that data to identify and act to address areas for improvement.  

Hospitals submitting data in either the RES-Q or SITS QR Registry using the WSO Awards Protocol, will be eligible for an award. Based on their performance against various measures, participating hospitals can be recognised with either Gold, Platinum or Diamond level award. 

In addition to the Award, participating professionals and institutions in the Angels community will be supported to convene and connect, to identify good practices and to share learning that will help them to implement and accelerate improvements for patients. The Awards will also provide another platform for WSO to acknowledge excellent stroke care and honour the teams and organizations who go above and beyond in the care for their patients.

The first deadline for WSO Angels Award applications will be June 30, 2019. More information about the requirements and the application process will be posted on the WSO website in due course. 

Report from the 21st Conference of the Iberoamerican Stroke Organization and the 1st Latin American Ministerial Meeting on CVA. Gramado, Brazil, August 2nd - 4th, 2018.

Discussions at the Ministerial Meeting

In this congress experts on cerebrovascular diseases from the Ibero-American countries (Portugal, Spain and the Americas) and other areas of the world met in Gramado to present the greatest innovations in this field.  

WSO Faculty Members at the conference

The ministerial meeting gathered healthcare administrators and practitioners from Latin America, in addition to experts from other continents. They discussed the impact of stroke on the region, the organization of services and healthcare networks, successful models, challenges and potential solutions. We finished it with the expectation that this meeting will have a great impact on regional public healthcare policies, making them a reference for the world.

Professor Michael Brainin presents the WSO Social Commitment and Bill of Rights at a meeting for the general public

The 21^st Congress of the IASO joined some of the leaders in stroke neurology from the continent; we had lecturers from Argentina, Australia, Austria, Brazil, Bolivia, Chile, Canada, Colombia, Costa Rica, Ecuador, Germany, Italy, Mexico, New Zealand, Panama, Paraguay, Peru, Spain, USA. 

Dr Sheila Martins and a stroke survivor present his testimonial

Lectures, Seminars, Workshops, Challenges, a spectacular location and interesting social activities contributed to the celebration of a very successful meeting, with 810 participants from 20 countries. Professors Werner Hacke, Michael Brainin, Patrice Lindsay, Valery Feigin from the WSO and Valeria Caso from the ESO joined us to enrich one of the most important international meetings for stroke in Latin America.

Next year we will meet in Costa Rica; another wonderful chance to learn, to share and to enjoy.

Discussion at the interactive ‘Stroke Challenge’ workshop

Presentation of the First Prize in the World Stroke Campaign awards