What are the health needs and challenges?

Cardiovascular disease is the world’s leading cause of death – taking almost 18 million lives per year. Although cardiovascular disease is a global challenge, three-quarters of these deaths occur in low- and middle-income countries.

Cities are facing unprecedented health challenges, from the growing burden of cardiovascular disease, to increased demands on health systems due to rapid urbanization, the constant threat of emerging diseases often hitting urban populations hardest as seen during the COVID-19 pandemic, the impact of climate change and the global shortage of skilled health workers. At the same time, data and AI are transforming the urban health landscape and providing new opportunities for driving population health and transforming health systems from reactive care systems to proactive, predictive and even preventive health systems. COVID-19 has been a wake-up call for this urgent re-engineering. And, as the pandemic hit urban populations particularly hard, cities are the best place to start.

Against this background, the Novartis Foundation is working with city authorities and other partners to co-design and implement data-driven responses to improve cardiovascular population health and narrow health inequities in urban settings.

The Novartis Foundation built and validated its cardiovascular population health approach, called CARDIO4Cities, through the Better Hearts Better Cities initiative. This initiative developed powerful proof for how cities can improve cardiovascular health in their populations – by dramatically increasing hypertension control, the prime risk factor for cardiovascular disease in cities on three continents. This was achieved by combining resources and expertise from multidisciplinary partners, and monitoring progress against measurable targets.

Partnership activities and how they address needs and challenges

In the framework of the CARDIO4Cities initiative, the Novartis Foundation is working with the city authorities of São Paulo (Brazil), Dakar (Senegal), and Ulaanbaatar (Mongolia) to extend its approach from hypertension control toward overall cardiovascular risk reduction in urban populations.

In each city, the Novartis Foundation works with local authorities to map their health systems, jointly identifying opportunities to build coordinated care pathways for patients to improve hypertension detection, treatment, and control while partnering with community players to bring health and care closer to where people live and work. Where possible, activities put a strong emphasis on the use of data to make better decisions and apply health tech innovations.

Further, as part of CARDIO4Cities, the Novartis Foundation and the Swiss Tropical and Public Health Institute work with city authorities in São Paulo to develop a population health intervention simulator. The tool captures the complexities of the health system and cardiovascular disease interventions. This data- and evidence-based tool should help decision-makers assess the impact and cost-effectiveness of interventions before they are implemented – hence select the interventions that will benefit the greatest number of people. Once validated in São Paulo, the simulator will be adapted to additional locations.