Global Stroke Alliance Meeting Report

27 Mar 2020

The Global Stroke Alliance Meeting, held in Rio de Janeiro, Brazil from March 11 to 14 was an innovative meeting that aimed to stimulate a global alliance to improve stroke care worldwide and to discuss the best strategies to implement evidence-based interventions access the continuum of care

The Global Stroke Alliance Meeting brought together leaders from 20 countries around the world with extensive experience in the organization of stroke systems of care, alongside researchers, health professionals, health managers, scientific societies, private hospitals, industry and patients associations. There were 570 in person participants and several by teleconference, with live transmission from the main sessions. The meeting reached its goal of disseminating knowledge, exchanging experiences and creating action plans tailored to each region. All actors working together, joining initiatives and adding efforts in the same direction.

In addition to representatives of international stroke societies, several representatives of Ministry of Health of Brazil and Ministry of Latin American countries, Health Secretaries from States and Cities of Brazil, the meeting included a strong participation of Dr. Anselm Hennis, Director of Non-Communicable Diseases of Pan American Health Organization from Washington – that represents World Health Organization in Americas.

The dynamics of the event included a series of forums on the most diverse themes, in an attempt to cover all fronts related to the disease -research, political, logistical and educational.

Policy forums

1A. II Latin American Stroke Ministerial Meeting: In 2018, the first edition took place in Gramado, in Rio Grande do Sul, where goals to the region were established. Now, the meeting discussed what has been implemented, what has been accomplished and what is pending, all with a view to drawing up an action plan to combat stroke in the region. The discussions showed that the efforts in the first meeting helped to develop the region based on the best experiences, pushing the other countries to start the development. In 2018 we had 13 countries represented, in the Global Stroke 11 represented. The majority of countries improved a lot in 2 years, in a few countries anything was modified (mainly that countries without Ministry representatives in 2018). Several Ministries of Health are very committed to work together to improve stroke care.
1B. Forum of Brazilian Health Managers: the forum had health managers from 13 Brazilian cities / states and 3 representatives of Brazilian Ministry of Health discussing the implementation of stroke programs in different regions of Brazil.

Organizational and logistics forums

2A. Angels Global Forum
2B. Medtronic Acute Ischemic Stroke Forum

Technical / educational forums

3A.Teaching course for primary attention – a huge success, free for health professionals of Primary Attention of State and city of Rio de Janeiro, teaching about prevention with local resources and local policies (200 participants)
3B.Teaching course for acute care
3C.Teaching course on how to organize a stroke unit

3D. Practical activity in neurointervention (hands on)
3E.Neurocritical Care in Stroke: 2020 Frontiers
3F.Stroke in 2020 - where are we? - Update in Stroke in all levels with experts from several countries

Research Fora

4A. Early Career Research Workshop - GAINS (Global Alliance of Independent Networks focused on Stroke Trials) – led by Andrew Demchuk and Julie Bernhard in local with virtual participation of Joseph Broderick and Carlos Molina
4B. Forum of Brazilian National Research Network (pre-congress) discussing important local and international trials.
4C. Research without frontiers: research contributing to improve stroke care regionally

Meeting Highlights

Cut Stroke in Health Project: Worldwide launch of the project Cut the stroke in half, a World Stroke Organization strategy to act in primary attention to prevent stroke and cognitive impairment using stroke riskometer + health community workers (to stimulate life style changes) and a polypill with antihypertensive and statin. It was launched in March 13 during the Global Stroke Alliance meeting. Brazil will be the first to implement with a large clinical trial starting in 2020, to prove the benefit of the strategy, a partnership among WSO, Ministry of Health of Brazil, Hospital Moinhos de Vento and Secretary of Health of Porto Alegre.
HEARTS Initiative: a strategy of WHO to control hypertension and to stimulate lifestyle modification in primary attention, in implementation in few countries in Latin America by Pan American Health Organization (PAHO) - accorded during the meeting to be implemented in Brazil together with Cut Stroke in Health with support of neurologists and Ministry of Health.
RESILIENT Trial -a thrombectomy trial performed in Brazil sponsored by the Ministry of Health of Brazil showed that the treatment is feasible, effective and cost- effective in public health system in developing countries (the first study to show the benefit of this treatment in a developing country). Including the presentation by the Ministry of Health of the cost-effectivenes study.

Ana Claudia de Souza e Jamary Oliveira Filho gave a beautiful and emotional performance to open the meeting.

Conclusions and Key Gaps

1. Acute stroke care has improved a lot in the last years in several countries but still is not enough to cover the whole population

2. There is a huge gap of implementation of primary prevention strategies and rehabilitation in several countries (mainly after discharge)

3. The implementation of Cut stroke in Half Project + HEARTS Project can help in reducing the incidence of stroke

4. Working together unifying isolated strategies increases the power of actions and can decrease the burden of stroke accross the globe.

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