Project background
Cardiovascular disease (CVD) is the leading cause of death worldwide, causing nearly 18 million deaths every year. Most of these deaths happen in low- and middle-income countries. The main risk factor for CVDs is high blood pressure, or hypertension. Multisector initiative CARDIO4Cities uses evidence-based approach to improving the early detection and management of hypertension in urban areas.
Project outline and goal
CARDIO4Cities is a population health program that uses data and digital tools to improve cardiovascular health in cities. Its main goal is to reduce the hypertension burden and improve cardiovascular population health. The approach is evidence-based, relying on city-specific data to guide local authorities’ decisions and investments in health interventions. First launched in Ulaanbaatar (Mongolia), Dakar (Senegal), and São Paulo (Brazil) in 2018, the initiative has since been implemented in several additional cities across Brazil and continues to scale further in collaboration with local partners.
Ecosystem players involved
CARDIO4Cities is a multisector and multi-partner initiative, designed and pioneered by the Novartis Foundation, a non-profit organization, in 2018. Since 2023, Swiss Re Foundation supports the project with funding to scale its impact and expand to new cities. Beneficência Portuguesa, one of six hospitals collaborating with the Ministry of Health in Brazil, is currently working with municipal health authorities to scale this project to more cities in Brazil.
The partnership between the Swiss Re Foundation and the Novartis Foundation was initiated following a presentation of the CARDIO4Cities during a DCCC gathering in January 2023. The Swiss Re Foundation expressed strong interest in the initiative, particularly because of its focus on noncommunicable diseases, the use of digital tools, and its efforts to strengthen the capacity of local health units. These shared priorities laid the foundation for the collaboration that followed.
Anticipated outcomes and impact
After just 1–2 years of implementation in São Paulo, Dakar, and Ulaanbaatar, the CARDIO4Cities approach improved hypertension control rates by three to six times and showed positive effects on stroke and coronary heart disease rates. This improvement in blood pressure control could translate into a reduction of up to 13% in strokes and up to 12% in heart attacks during the implementation period.
CARDIO4Cities now reaches over 40 million people. Beyond these numbers, the project strengthens local health systems, trains local healthcare professionals, and provides local authorities with data and tools to design more effective future health interventions.
A paper published in PLOS Global Public Health in April 2023 provides evidence that CARDIO4Cities is a cost-effective approach to alleviate the growing cardiovascular disease burden in cities across the world.
Project progress and next steps
Currently, Beneficência Portuguesa is scaling CARDIO4Cities to a total of 1155 healthcare units in 46 cities in Brazil, including capital cities such as São Paulo, Fortaleza, Aracaju, and João Pessoa, covering approximately 20.4 million citizens. The group is adapting the approach in Lisbon, Portugal and Bogotá, Colombia besides other global capitals managed through the Novartis Foundation.
Collaboration opportunities
CARDIO4Cities invites city governments, health authorities, investors, researchers, and technology providers to join the initiative by sharing expertise, allocating funding, testing new digital health tools, or supporting community engagement. Interested parties can learn more and connect with project team through the CARDIO4Cities Accelerator website.
