New urban health 'accelerator' aims to transform cardiovascular population health globally

• The CARDIO4Cities Accelerator by Novartis Foundation and IntraHealth International aims to replicate the successful CARDIO4Cities approach in 30 major cities within three years to transform cardiovascular population health and equity globally.
• Results of initial programs in São Paulo, Dakar and Ulaanbaatar show the cost-effective approach averted up to 13% of strokes and 12% of heart attacks during implementation.
• Experts say public-private partnerships are key to address the growing burden of cardiovascular disease, the world’s leading cause of death, according to the World Health Organization (WHO)¹.

Geneva, May 22, 2023 — Today, at the sides of the 76th World Health Assembly, the Novartis Foundation and IntraHealth International launch the CARDIO4Cities Accelerator. The accelerator aims to replicate CARDIO4Cities, the cardiovascular (CV) population health approach pioneered and validated by the Novartis Foundation, in 30 major cities within the next three years.

As a neutral broker between city governments, health experts, industry, implementing partners, funders and investors, the accelerator pledges the global community to direct action and funding toward transforming CV population health and equity.

Projections based on initial CARDIO4Cities programs in São Paulo (Brazil), Dakar (Senegal) and Ulaanbaatar (Mongolia), published in PLOS Global Public Health², revealed that CARDIO4Cities was highly cost-effective, increased blood pressure controls by three times or more, and averted up to 13% of strokes and 12% of heart attacks within one to two years of implementation.

Based on global hypertension estimates, replicating this impactful CV population health approach in 30 large cities within the next three years could save and improve millions of lives around the world.

Public-private partnerships like CARDIO4Cities, leveraging real-time health outcomes data, can guide city authorities in designing and targeting public health interventions more effectively, and help them achieve the largest health impact on the greatest number of people.

In São Paulo, for example, where limited data existed on hypertension, which is the prime risk factor for CV disease, authorities offered blood pressure measurement opportunities outside the health facilities, in football stadia, metro stations and samba clubs. Interventions like these made for an effective way to detect this silent risk factor in the local male population, who often go undiagnosed for many years until presenting with an acute event such as a stroke or heart attack.

In Dakar, several companies introduced blood pressure measurement at the workplace, to accelerate detection and prompt management of hypertension in their workforce. And in Ulaanbaatar, information about healthy nutrition and other ways to limit CV risk was included in national school curricula.

CV disease is the world’s leading cause of death, claiming almost 18 million lives every year. 80% of these deaths occur in low- and middle-income countries, often prematurely. Through CARDIO4Cities and the data it collected to monitor progress, local authorities were able to better target interventions and resources to where they were most needed.

"The launch of the CARDIO4Cities Accelerator is a logical next step to enable large scale replication of the CV population health approach the Novartis Foundation successfully pioneered," says Dr Ann Aerts, Head of the Novartis Foundation. "While this simple, innovative approach is scientifically validated and highly cost effective, it proves above all to rapidly improve CV health outcomes. The key success factors of CARDIO4Cities are strong ownership by the local authorities and intervention design based on real time data."

"As CV disease and health inequity are the burning issues of our time, it is urgent to ensure that many more people benefit from this simple yet impactful approach,” Aerts adds. “Today, I call upon the global community to join us in our pledge to roll out CARDIO4Cities in 30 cities within the next three years."

Philippe Guinot, chief technical officer and interim chief operating officer at IntraHealth International, says: "Health is a human right, but for too many, it remains a dream. The CARDIO4Cities Accelerator offers a concrete path toward making that dream a reality, empowering cities to use collaboration across sectors, innovative financing, proven strategies, and real-time data to improve cardiovascular health. Cardiovascular disease is the top cause of premature death. But with the CARDIO4Cities Accelerator, acting together, we can create a more equitable world where everyone has access to the health care they need to thrive."

Further information on the CARDIO4Cities Accelerator can be found online at www.cardio4citiesaccelerator.org.

About the CARDIO4cities approach

CARDIO4Cities applied a simple comprehensive strategy based on six CARDIO pillars – shorthand for quality of Care, early Access, policy Reform, Data and digital technology, Intersectoral collaboration, and local Ownership. CARDIO4Cities are programs developed in conjunction with local authorities, the health sector and private sector partners. These stakeholders work together to explore unmet needs in response to hypertension and other cardiovascular risks. The intervention design was informed by a combination of best practices for hypertension and heart disease management, such as the WHO HEARTS package, the Measure Accurately, Act Rapidly, and Partner With Patients Protocol (M.A.P.) and the World Heart Federation roadmap to reduce high blood pressure, as well as local policies, guidelines and data. A key intervention was standardizing hypertension diagnosis and management for primary health providers. This was rolled out, through clinical decision support systems and online continuous medical education. The program engaged non-traditional health players such as sports clubs, dance clubs, schools and workplaces. This maximized opportunities for hypertension detection and increased opportunities for understanding of cardiovascular risk. In some instances, it even included increasing opportunities for physical exercise or healthy food options in the city.

About the Novartis Foundation

The Novartis Foundation is a non-profit organization based in Switzerland. For over 40 years, we have helped improve the health of low-income populations, initially supporting disease elimination in areas such as leprosy and malaria. Today, we tackle the burning issues of our time, cardiovascular disease and health inequity. We take a population health approach, which means widening the lens from a narrow focus on healthcare delivery to a panoramic vision of improving health in the population at large, ensuring access to healthy lives for all. Our population health approach brings together existing but disconnected data to help authorities understand the root causes of unequal health outcomes and find the best ways and best partners to remediate those. This empowers governments to transform their health systems from being reactive to proactive, predictive, and preventative, and achieve health equity among the populations they serve.

www.novartisfoundation.org

The Novartis Foundation is on LinkedIn at @Novartis Foundation and on Twitter at @NovartisFDN.

About IntraHealth International

IntraHealth International is a global health nonprofit that has worked in over 100 countries since 1979. We partner with governments and local collaborators to improve the performance of health workers and strengthen the systems in which they work so that everyone everywhere has the health care they need to thrive. IntraHealth works in a variety of health areas including maternal and child health, family planning and reproductive health, community health, HIV/AIDS, global health security and noncommunicable diseases. Since 2017, IntraHealth has been a key implementation partner of the Ministry of Health in Senegal to support early diagnosis, treatment and management of hypertension and other cardiovascular risk factors among the population in Dakar. Under the CARDIO4Dakar program, IntraHealth tests evidence-based approaches by leveraging the power of data and digital solutions to accelerate reach and impact throughout Senegal and beyond.

References

1. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
2. Reiker T and Des Rosiers S et al. Population health impact and economic evaluation of the CARDIO4Cities approach to improve urban hypertension management. PLOS Global Public Health (2023)