Stroke Prevention in Poor Countries

See related article, pages 3063–3069. Stroke is a cause of poverty and is caused by poverty. Stroke prevention, along with the prevention of other chronic (noncommunicable) diseases, is a grossly neglected feature of the global development agenda,1 despite the huge economic and health burdens due to stroke. The reasons for this neglect are complex. They include a series of myths which have perpetuated the mistaken notion that stroke and chronic diseases in general are primarily problems of wealthy countries and which do not require serious government intervention. Nothing is further from the truth. A serious and balanced global health development agenda should include all key health issues, not just those which have a historical precedence.2Stroke is the third leading cause of death, responsible for ≈5.7 million deaths each year, the vast majority of which occur in low-income and middle-income countries.3 Stroke rates in middle-aged people (30 to 69 years) are 5 to 10 times higher in large countries such as Russia, India, China, Pakistan and Brazil, compared with the United Kingdom or the United States.3 Projections suggest that, without …