Global Declaration on Stroke Commitments for Facing Stroke: New Delhi, India – September 8th, 2023

15 Sep 2023

We, Ministers Representatives, Representatives of the Countries, World Stroke Organization and World Health Organization together in New Delhi, India, on September 8^nd, 2023, for the Global Stroke Alliance Meeting:

Acknowledging that cerebrovascular diseases, including stroke, are among the main causes of death globally, and that stroke is preventable and treatable, through evidence-based and cost-effective strategies;

Highlighting that the cooperation among countries joining health managers, specialists, stroke support organizations, societies and public-private partnerships for facing stroke is inserted in the implementation framework of the Sustainable Development Goals of the United Nations’ 2030 Agenda, that proposes collaboration for reducing, until 2030, premature death by noncommunicable diseases by means of prevention and treatment, and for promoting mental health and well-being;

Reiterating the World Health Organization's Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013-2020, which aims to reduce in 25% the premature deaths due to chronic diseases until 2025;

Decided to unite our efforts to promote the development and implementation of effective, integrated, sustainable and evidence-based public policies, for the prevention and treatment of stroke and its risk factors, and resolve:

1. To provide education to the population on the symptoms of stroke, treatment urgency, risk factors and their control;

2. To promote safe and healthy environments for the practice of physical activity;

3. To implement policies to control smoking, to stimulate healthy food intake and physical activity, to reduce sodium intake, alcohol abuse, and to control weight, with the aim of reducing the incidence of cerebrovascular and cardiovascular diseases;

4. To implement strategies for the detection and treatment of the main cardiovascular risk factors, which are hypertension, diabetes, hyperlipidemia and atrial fibrillation;

5. To organize the pre-hospital care to prioritize the patient with stroke;

6. To prioritize the structuring of Stroke Centers:

To organize Stroke Units with a defined physical space and a trained multidisciplinary teams;
To implement evidence-based acute treatments (thrombolysis and thrombectomy);
To provide access to exams for minimal etiological investigation (neuroimaging and cardiac diagnostic tools);
To promote the prescription of secondary prevention treatments at the hospital discharge and also continuous availability of these drugs;
To promote smooth and coordinated transition between hospital and post-hospital care, covering clinical, social and rehabilitation needs
To stimulate the use of telemedicine in hospitals without specialist stroke clinicians, 24 hours a day, 7 days a week, to advise on acute treatment.

7. To increase access to rehabilitation (in-hospital and post-discharge);

8. To train all professionals engaged in stroke care;

9. To monitor national prevalence of the main risk factors, and quality indicators of acute stroke care;

10. To standardize stroke care with implementation of national or regional evidence-based practice guidelines, that are frequently updated;

11. To prioritize the structuring of Integrated Networks for Continuous Care of patients with stroke or stroke risk factors, that encompass all levels of healthcare, creating a defined care pathway;

12. To assign human and financial resources for the development of a stroke continuum of care;

13. To implement national stroke care action plans / policies;

14. To promote exchange of experiences among countries for the improvement of stroke care;

15. To implement research in stroke, based on the priorities and realities of each country.

We sign the Global Declaration on Stroke, and we manifest our commitment to these recommendations!

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