As part of the World Stroke Organization (WSO) ‘Minutes save lives’ awareness campaign, they have issued an urgent call to action after a survey conducted in partnership with the World Health Organization found that, while patients in 91% of high-income countries could expect access to specialist care, only 18% of low-income countries could offer an essential level of stroke care.

The finding is reflected in the recent analysis of the Global Burden of Disease, which shows that people in low-income countries experience four times the rate of stroke-related death and disability compared to those living in higher income countries. Stroke remains the second biggest killer in the world. 14 million people worldwide will have a stroke this year and 5.5 million will die as a result. Stroke occurs when the blood supply to part of the brain is stopped, due to a clot or a ruptured blood vessel.  For the most common types of strokes, treatment with clot busting medication (tPA) or interventions to mechanically remove clots (thrombectomy), can save lives and significantly improve outcomes for patients, but access to these is a distant dream for many patients.

And it’s not just in the delivery of state-of-the-art treatments that stroke units can make a difference. The specialist care that these units provide is proven to lead to improved outcomes, even in the most resource constrained settings. Training on low-cost protocols such as glucose, fever and swallowing tests for acute stroke patients is a low-cost intervention that can significantly reduce complications for stroke patients, while the multi-disciplinary approach improves access to rehabilitation, which is vital to recovery, and improves independence and quality of life. 

“Stroke units are an essential foundation for improved outcomes for patients worldwide” said WSO President-elect and Campaign Chair Sheila Martins. “We need these foundations in place if we are to deliver better patient care today, and game-changing stroke treatments tomorrow. We know that tPA is a cost-effective medication, paying for itself within 2 years of treatment. People treated with tPA have a 31% higher recovery rate and can go on to lead fully independent lives. We campaigned for many years for it to become an essential medicine and it is shocking that in 2021, 65% hospitals are still unable to provide it to their patients. We are calling for urgent action from industry, donors and governments to make tPA widely available. The first step has to be a commitment to improving stroke care through the implementation of stroke units. Every second is precious when it comes to stroke, we don’t have time to waste.”

WSO has developed tools and resources including training courses for non-specialist doctors and nurses, and an online “Roadmap to Quality Stroke Care” platform, which supports healthcare institutions to assess and identify priority areas for improvement and make a commitment to developing quality stroke units. The roadmap can be used in all resource settings in order to improve services, regardless of funding constraints.

For more information, please visit the World Stroke Day website. You can join the conversation online by registering for the World Stroke Day Live panel event at 3pm CET with Olympic gold medal winner and stroke survivor Michael Johnson or by using the social media hashtag #Precioustime.

About the author

Anita Wiseman is the Campaign and Partnership Manager for the World Stroke Organization.