CARDIO4Cities: An effective strategy for reducing overall cardiovascular risk in urban populations Challenge Cardiovascular (CV) risk factors (hypertension, high cholesterol and diabetes) are highly prevalent in the world’s populations and cause millions of heart attacks and strokes every year, resulting in CV disease remaining the largest burden of disease globally.26 Acute CV events are largely preventable through early detection and prompt and adequate management of CV risks. Ample evidence exists as to what needs to be done, but effective strategies to safeguard heart health are not implemented as they should be. That leads to extensive suffering and death, which is largely preventable. Solution The Novartis Foundation developed the CARDIO4Cities initiative to improve overall CV risk in urban populations, leveraging intersectoral collaboration, digital innovation and data-driven decision-making. It rests on three pillars: –Set targets for screening, diagnosing and treating people with CV risk factors –Co-design roadmaps with concrete action plans to achieve these targets –Use data, technology and intersectoral partnerships to implement these population health roadmaps The programme worked with city authorities and stakeholders in São Paulo (Brazil), Dakar (Senegal) and Ulaanbaatar (Mongolia) to pioneer and validate the approach in different geographical contexts in three continents. In São Paulo, the Novartis Foundation collaborated closely with the health authorities, health system managers, patients, the education authorities, sport and workplace sectors and other stakeholders. Design thinking was used to co-create a CV population health roadmap, with innovative interventions targeted at the gaps in this roadmap. These innovations included digitalized CV risk-screening corners for all visitors in health facilities and optimized early detection in non-traditional venues – such as sports and dance clubs or metro stations – around the city, simplified CV risk management protocols translated into digital decision support tools, as well as a local digital CV risk assessment, self-care plans for patients and school programmes to improve physical activity and nutrition. While the CARDIO4Cities approach implements existing evidence and global best practices (such as the World Health Organization Hearts package), its success was mainly driven by the use of real-time data for decision-making. Local health authorities decided with the CARDIO4Cities partners on a shared measurement system and the monthly or quarterly results coming out of that data system were reviewed in a simple dashboard, allowing decision-makers to adapt interventions accordingly. Outcome Within one to two years of implementation, control rates for hypertension, the prime risk factor for CV disease, increased threefold or more across the three cities. This translated into an estimated reduction of 13% for strokes and 12% for heart attacks. The approach proved highly cost-efficient, e.g. a cost of $784 per quality-adjusted life year (QALY) was achieved in São Paulo. Across the pioneering sites, CARDIO4Cities is now being continued by local governments, while the World Heart Federation and the Novartis Foundation are expanding the approach to 30 megacities globally over the next three years to improve the heart health of 150 million people.CASE STUDY 2 CARDIO4Cities – Novartis Foundation Better Together: Building a Global Health Network Economy through Data Collaboration 20

Better Together 2025