Joint statement of the WSO, ESO, EAN and WFN on stroke on the occasion of the 68th WHO-Europe meeting 2018, Rome

What a fucking pile of lazy shit. NOTHING to address these many problems in stroke. 
And these are our stroke 'leaders'? They all need to be keelhauled.  Awareness, knowledge and 'care'  are useless to stroke survivors. Have you ever talked to a survivor? They all want to get back to their old life, 100% recovery. Get the fuck out of the way and let survivors run things.

1. Only 10% of patients get to full recovery.
2. tPA only fully works to reverse the stroke 12% of the time. Known since 1996.
3. No protocols to prevent your 33% dementia chance post-stroke from an Australian study.
4. Nothing to alleviate your fatigue.
5. Nothing that will cure your spasticity.
6. Nothing on cognitive training unless you find this yourself.
7. No published stroke protocols.
8. No way to compare your stroke hospital results vs. other stroke hospitals.

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This statement was jointly prepared by the World and European Stroke Organizations (WSO and ESO), the World Federation and the European Academy of Neurology (WFN and EAN) all of which are specialty societies for neurology and brain health.

Statement

NCDs continue to increase worldwide. Cardiovascular diseases, stroke and dementia are a major concern. Stroke is now ranked the 2nd greatest cause of both disability and death worldwide. Stroke threatens everyone. Stroke causes paralysis of limbs, impairs vision, gait, language and cognition. It contributes to dementia. Of particular concern is the increasing stroke burden in young adults and its effect on keeping employment, as more than 40% of working age adults with stroke fail to return to work.
The burden of stroke disproportionately affects people living in countries with limited resources, also in Europe. Most stroke survivors carry lifelong physical, cognitive, mental, and socio-economic burdens. A significant proportion of European and Global NCD burden can be attributed to stroke and stroke-related dementia. This issue of NCDs, including stroke and dementia, is highlighted at this month's UN High-Level Meeting in New York.
The importance of stroke is acknowledged by the WHO in ICD 11 where stroke is now included as a disease of the nervous system. This most important change will have dramatic impact on the promotion of brain health and the distribution of resources.
For stroke prevention, it is important to know that 90 % of strokes are linked to 10 modifiable risk factors including hypertension, smoking, obesity, physical inactivity, and unhealthy diet. The same factors apply to ischemic heart disease, the other main cause of global disability and death. The occurrence of an acute stroke has to be considered a major emergency which needs a seamless chain of interventions until recovery. Quality care needs to be provided timely by competent personnel and teams across the whole pathway in an organized and audited manner. This kind of access to adequate stroke expertise should be independent of region, time of day and socio-economic status. These stroke facts were highlighted during last year's WFN World Brain Day.
Dementia on the other hand is growing globally with ageing populations, and stroke contributes with other NCDs such as hypertension, heart disease, chronic kidney disease and diabetes mellitus to the development of dementia. Rates of dementia may be reduced by modifying these risk factors and both stroke and dementia may be prevented through coordinated action.
Developments in vascular neurology has made stroke and dementia preventable, treatable and increasingly reversible, thus reducing the burden on patients, families and societies. To ensure these developments are more evenly distributed, we will require national, regional and global efforts to increase awareness, make available quality acute stroke treatment, primary and secondary prevention and rehabilitation.
ESO and the patient organization SAFE (Stroke Action for Europe - https://www.safestroke.eu) have just finalized the Action Plan for Stroke in Europe 2018-2030, which is aligned with the UN's Sustainable Development Goals. The plan has four overarching goals:

1. to reduce the absolute number of strokes in Europe by 10%
2. to treat 90 % or more of all patients with stroke in Europe in a dedicated stroke unit as the first level of care
3. to have national plans for stroke encompassing the entire chain of care, and
4. to fully implement national strategies for multisector public health interventions

In this context WSO, ESO, EAN and WFN call upon the WHO European Regional Committee to support its member states to increase their efforts based on these three domains:

1. Awareness: WHO-Europe should help to strengthen programs that increase awareness of stroke, as risk factors, therapy and rehabilitation.
   
2. Access: We will support WHO-Europe with its efforts to remove financial barriers for patients for prevention, detection and treatment of NCDs, including European wide health coverage.
   
3. Action: The neurology specialist societies will support WHO-Europe in the development of regional and national strategies, to develop the health-related Sustainable Development Goals, with the goal to reduce premature deaths caused by NCD by one-third by 2030.
   

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About the World Stroke Organization (WSO)

The WSO promotes stroke awareness and knowledge through its annual World Stroke Day, the World Stroke Campaign, and educational programs like the World Stroke Academy. Professionals and searchers benefit from clinical exchange programs, the biannual World Stroke Congress, and the International Journal of Stroke. WSO supports patients with post-stroke checklists, its Roadmap for Quality Stroke Care, and through stroke support organizations. WSO is in official relation with the World Health Organization (WHO).
WSO website: www.world-stroke.org
Contact: mgrupper@world-stroke.org

About the European Stroke Organization (ESO)

The ESO aims to improve stroke care in Europe by promoting awareness, prevention and treatment of all aspects of stroke. Through the annual ESO conference, best practice approaches, the European Stroke Journal, teaching and research, the ESO strives to support and harmonize stroke management by professionals and the lay public. ESO works as the voice of stroke in Europe to develop and promote public policies to reduce stroke's individual and societal burden.
ESO website: www.eso-stroke.org
Contact: esoinfo@eso-stroke.org

About the World Federation of Neurology (WFN)

The World Federation of Neurology (www.wfneurology.org) is a UK charity, devoted to the interest of neurology worldwide. It has presently 120 members, and is regionally represented in the Americas, Asia-Oceania, Arab countries, Africa and Europe. The aim is to "Foster quality neurology and brain health worldwide ". The regional organization in Europe is the European Academy of Neurology (EAN). The WFN has a long tradition of good relations and close cooperation with the WHO, including projects such as WHO Atlas of Neurology, participation in ICD development, and change of stroke classification in ICD 11. At the last WHO meeting in Europe the WFN made a statement on environment and neurology (to be accessed here), and the yearly WFN World Brain Day of 2018 was devoted to environment and pollution. WFN is a non-state actor in official relations with the World Health Organization (WHO).
WFN Websit:e: www.wfneurology.org
Contact: jade@wfneurology.org

About the European Academy of Neurology (EAN) and this statement

The European Academy of Neurology (EAN) was founded to promote "Excellence in Neurology in Europe" and represents 47 European national neurological societies with about 45.000 neurologists. One of the missions of EAN is to increase the availability and standards of neurological services across Europe. Along these lines EAN full heartedly underscores this statement as a) stroke is in the lead of neurologic diseases which cause disability and death and b) inequalities of stroke incidence and care do not only exist in resource poor countries but also across Europe. This has just been recently demonstrated in a pan European survey conducted among others by ESO and EAN (D. Aguiar de Sousa et al., European Stroke Journal 2018). It is important to stress, however, that also several other neurologic diseases such as dementia, movement disorders and epilepsy are on the rise due to the aging of our population and poor recognition and management of vascular risk factors and that this development needs immediate attention because of associated disability, death and socioeconomic consequences.
EAN website: www.ean.org
Contact: Eveline Sipido: sipido@ean.org