Access to Health
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CARDIO4Cities: Strengthening public health systems to save more lives
In a nutshell
| Location | Brazil, Colombia |
|---|---|
| Sustainable Development Goal | Good health and well-being |
Project timeline
"Project is 37.9164142944% completed "
The challenge
Cardiovascular diseases (CVDs) are the leading cause of death by noncommunicable diseases (NCDs) worldwide, now accounting for more than 80% of deaths in low- and middle-income countries. Rapid urbanisation, air pollution and the spread of unhealthy behaviours such as smoking and physical inactivity all contribute to the growing CVD burden, as do widening health inequities and a shortage of health infrastructure and professionals.
The main risk factor for CVDs such as heart disease and stroke is hypertension, or high blood pressure. Of the 1 billion people with hypertension in low- and middle-income countries, half don’t know they have the condition and less than 10% have it under control. Since many lack access to primary healthcare for early detection and treatment, the disease is often diagnosed late, killing people in the prime of their lives.
The approach
A multisector initiative pioneered by the Novartis Foundation, CARDIO4Cities aims to reduce the hypertension burden and improve cardiovascular population health in low- and middle-income countries by offering a comprehensive portfolio of health intervention options tailored to local circumstances. Its evidence-based approach to improving the early detection and management of hypertension in urban settings involves strengthening public health systems in six ways:
- Improve quality of care
- Provide early access to health and care
- Reform policies with proven health benefit
- Leverage data and digital technology
- Create intersectoral collaboration
- Ensure local ownership
The CARDIO4Cities toolkit of insights, strategies and best practices was successfully piloted in Ulaanbaatar (Mongolia), Dakar (Senegal) and São Paulo (Brazil) in 2018. Now – in collaboration with the Novartis Foundation – Beneficência Portuguesa is working with municipal health authorities to roll out this locally owned, data-driven approach in more cities in Brazil.
Goals and expected impact
In the first phase of this Swiss Re Foundation-focused project (2023–2024), CARDIO4Cities was implemented in 49 public healthcare units in the cities of Patos and Aracaju. With nearly 2 000 health professionals trained and over 370 000 people reached, the initiative achieved a fivefold faster rollout at one-quarter of the cost of the São Paulo pilot. Early results showed a doubling of hypertension control in Patos and a 15% increase in hypertension diagnoses in Aracaju. A post-implementation survey found that 90% of participating healthcare units reported improvements in noncommunicable disease management, screening and diagnosis.
In the second project phase (2025–2028), Beneficência Portuguesa is scaling CARDIO4Cities to 80 more healthcare units in Patos, Aracaju, João Pessoa and Fortaleza, with plans to reach at least 438 000 new individuals and improve the health resilience of over 48 000 people. The approach will also be adapted and implemented in Bogotá, Colombia. In both countries, the project will track over 30 health indicators, aiming to nearly triple hypertension control rates and reduce cardiovascular mortality.
Relevant links
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