World Stroke Day: One world voice for stroke


The worldwide challenge of stroke is massive with 16 million new cases each year, about six million of which result in death [1, 2]. The greatest burden is in the developing world with 60% of the global burden, where the incidence is rising and compounded by the increased challenge of advances in life expectancy [2, 3]. The annual World Stroke Day (WSD) promotes stroke awareness to the international community. It is part of our World Stroke Campaign (WSC), which provides education, support and advocacy for stroke survivors, families and healthcare professionals involved in all aspects of stroke treatment and rehabilitation.

The mission statement of the World Stroke Organization (WSO) is to reduce the global burden of stroke through prevention, treatment and long-term care. We have numerous strategies in place aimed at achieving this vision, by fostering best practice worldwide. These involve increasing stroke awareness amongst health professionals, influencing policies for stroke prevention and improved health services, providing education in collaboration with private and public organizations, facilitating stroke research and advocacy for people with stroke and fostering the development of systems and organizations for the long-term support of stroke survivors and their families. The structure of the WSO is inclusive, represents all world regions and involves doctors, nurses, allied health professionals, scientists, representatives of professional stroke organizations and stroke support organizations.

The WSD was launched at the instigation of Vladimir Hachinski, as part of a call to action [4]. It is held on October 29 each year and provides a focus for the many global and regional projects of the World Stroke Campaign. Activities have increased exponentially in the last few years. It currently has a ‘1 in 6’ theme, representing the one in six people in the world who will have a stroke in their lifetime and uses the slogan ‘Because I care’. It is aimed at educating people about the best ways to minimize their risk of stroke, facilitate access to the best possible treatment, care and support along the pathway to recovery.

The WSO has a universal symbol representing the connectivity between clinicians, patients and carers, the stroke solidarity string, which is prominently featured on our WSD. This indigo-colored string, worn around the wrist, is an international symbol of global solidarity, analogous to the pink ribbon for breast cancer. WSD awards are also a highlight. Recent awards in 2012 to centers of excellence in Mexico, Brazil and Mongolia recognized statewide campaigns to raise stroke awareness, evaluation of the role of primary care physicians, promotion of the ‘1 in 6’ message in sporting events, and other public educational and advocacy activities.

Stroke support organizations play a key role in the WSO, but are lacking in many developing regions. We have developed a WSO toolkit, which teaches people how to set up stroke support organizations in any setting. This helps to address the concerns of stroke survivors and their care givers, represents their views, facilitates the organization of services and support in the community, raises awareness and allows stroke survivors to share stories. The toolkit also supports regional government initiatives. The WSO is developing a global Bill of Rights for stroke patients and carers, who will lead in writing this document and determine their priorities. It will consider survivor rights across the continuum from prevention, to acute care, rehabilitation and long-term support, in line with the WSO mission. It will be launched at the World Stroke Congress in Istanbul in October 2014.

Stroke prevention is the most cost-effective way of reducing the global burden of stroke and the WSO is closely affiliated with the non-communicable disease (NCD) alliance, partnering with other organizations including those representing heart disease, cancer and diabetes. The target is to reduce the world burden of NCDs by 25% by 2025. Many strategies are common to all NCDs. We have recently formed an alliance with the World Hypertension League and are also involved in promotion of salt and tobacco reduction. We strongly advocate organized care in stroke units. These are cost-effective, proven to be effective in developing regions in low-income countries, as well as in resource rich settings [5].

Post-stroke care is another plank of the WSO. The many millions of stroke survivors in the world are at risk of recurrent stroke and the majority of them have some degree of disability. We have therefore assisted in the development of the post-stroke checklist, which identifies 11 complications that can occur after stroke and should be considered by healthcare professionals looking after stroke patients [6]. These domains include secondary stroke prevention, activities of daily living, mobility, mood, spasticity, cognition, pain, incontinence, communication, life after stroke, and relationships with family.

Finally, the WSO has a major focus on global policy, working in our official partnership with the World Health Organization. This partnership will also be prominently featured on WSD, underpinning our efforts to reduce the global burden of stroke. We encourage all those involved in stroke, both individual and member societies of the WSO, to be involved and contribute to the success of WSD. Together we can make a change.