Cardiovascular diseases take almost 18 million lives per year, with three-quarters of these deaths occurring in low- and middle-income countries. Working with local authorities and partners from different sectors, the Novartis Foundation’s Better Hearts Better Cities initiative addressed hypertension – the leading risk factor for cardiovascular diseases – from pioneering models through to initiatives that achieved impact at scale. The pioneering models included the Community-based Hypertension Improvement Project in Ghana; Communities for Health Hearts in Vietnam; and KaziBantu (Healthy Schools for Healthy Communities) in South Africa.
The full-scale multisector Better Hearts Better Cities initiative was implemented in Ulaanbaatar, Mongolia; São Paulo Brazil; and Dakar, Senegal. In each city, it built networks of partners that reached beyond the health sector. Partners included healthcare providers but also digital and telecommunication organizations, food suppliers, employers, insurance funds, social enterprises and civil societies.
This multisector approach integrated complementary capabilities and resources to tackle hypertension from health literacy and lifestyle choices, to prevention, screening, diagnosis and patient management.
The initiative worked. For example, data at the end of 2020 indicated an eight-fold increase in blood pressure control in Dakar within two years of Better Hearts Better Cities implementation. In São Paulo, preliminary data showed that blood pressure control tripled after just 1.5 years of implementation, reaching a 60% control rate, which is higher than in many European countries. This is important given that uncontrolled high blood pressure is a leading risk factor for stroke, heart attacks and heart failure. An impact evaluation of Better Hearts Better Cities showed how by controlling blood pressure, we could reduce the number of strokes by 30% in the 1.5 years of program implementation.
The most successful tools from Better Hearts Better Cities are now part of the Novartis Foundation’s Urban Population Health Toolkit and are the basis for our next phase of work toward improving Cardiovascular Population Health.