In a significant public health decision last week, the World Health Assembly (WHA) for the first time formally recognised stroke as a major global health priority, signalling growing international concern over the rapidly rising burden of brain attacks across both developed and developing countries.
The resolution, adopted on May 22, urges all member nations to strengthen stroke prevention, early diagnosis, emergency treatment, rehabilitation and long-term care systems. The move comes at a time when stroke has emerged as one of the world’s leading causes of death and disability, increasingly affecting younger populations, particularly in low- and middle-income countries such as India. The resolution calls for stronger national action on controlling major risk factors such as hypertension, diabetes, obesity, tobacco use, unhealthy diets and physical inactivity.
As per the World Health Organization (WHO), stroke is a medical emergency caused either by blockage of blood supply to the brain or bleeding within the brain. In both situations, brain cells begin dying within minutes, making immediate medical treatment critical.
Globally, stroke affects nearly 12 million people every year. More than six million die from it annually, while millions of survivors are left with permanent disabilities affecting speech, movement, memory and independence. Two out of three stroke survivors continue to live with some form of long-term disability.
Public health experts say the WHA’s decision reflects a major shift in global thinking. Stroke is no longer being viewed merely as an individual neurological disease but as a large-scale public health and development challenge affecting productivity, healthcare systems and economies.
The timing of the resolution is particularly significant for India, where stroke cases have been rising steadily over the past decade. According to available estimates, India records between 108 and 172 stroke cases annually per one lakh population, with one-month case fatality rates ranging from 18% to 42%.
Perhaps more concerning is the changing age profile of stroke patients.
New findings from the Indian Council of Medical Research (ICMR)-led National Stroke Registry Programme reveal that nearly one in seven stroke patients in India is below the age of 45 — a demographic once considered relatively low-risk for stroke. The registry analysed nearly 35,000 stroke cases reported from 30 hospitals across the country between 2020 and 2022.
The registry also exposed major gaps in emergency stroke care. Only around 20% of patients reached hospitals within the critical therapeutic window of 4.5 hours — the period during which clot-dissolving drugs or advanced procedures such as mechanical thrombectomy can significantly reduce brain damage.
Neurologists say lack of public awareness remains one of the biggest barriers to effective stroke care in India. Many people fail to recognise warning signs such as facial drooping, weakness in the arm, slurred speech or sudden confusion.
They say the resolution could help push governments towards integrating stroke prevention and treatment into universal health coverage programmes. This is especially important for India, where out-of-pocket healthcare expenditure remains high and advanced stroke care is often inaccessible for poorer families.
Stroke-related disability affects people during their most productive years, reducing workforce participation and increasing long-term caregiving burdens on families.
Dr. Rajinder Dhamija, senior neurologist and Director at Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, said the WHA recognition may encourage countries to invest more in primary prevention strategies such as blood pressure screening, diabetes control, anti-tobacco measures, healthier diets and public awareness campaigns.
Unlike in developed countries where it is in decline, many people still do not understand what uncontrolled hypertension is, and this lack of awareness is one of the reasons why stroke cases are rising in India, said Dr. Dhamija.
Along with the increase in stroke, cases of cognitive decline are also increasing. Earlier, such conditions were usually seen much later in life, but now they are appearing almost 10 years earlier in many patients.
“People may survive these degenerative brain conditions for long periods, but many become dependent on their families and society for daily care. In India, there is limited welfare support from the State for long-term neurological care. As a result, family members often have to leave their jobs or significantly alter their lives to care for stroke survivors and dementia patients."
“Brain haemorrhage cases are also relatively higher in India compared to many Western countries. Stroke is therefore a very important public health issue. As Chairperson of the National Brain Task Force, I have consistently emphasised the need to develop a structured national stroke care model."
“We have also started creating hub-and-spoke healthcare models where treatment guidance from specialised centres can reach smaller towns and cities. This is still an evolving stage for us, but strengthening stroke care remains extremely important.”
One of the major challenges is the severe shortage of neurologists in India. We have only around 4,000–5,000 neurologists for such a large population. Most patients do not reach hospitals within the treatment window. Effective clot-busting drugs can be given within four-and-a-half hours after a stroke, but transportation problems, traffic congestion and lack of awareness delay treatment. Many people fail to recognise the warning signs of stroke, said Dr. Dhamija.
Efforts are underway to establish Primary Stroke Centres and Advanced Stroke Centres across the country. “Our priority now is to strengthen district-level systems, ensure availability of CT scan facilities and create stroke-ready centres where patients can receive clot-busting drugs without delay,” he added.
Stroke is largely preventable and increasingly treatable — but only if recognised early.
Dr. NK Soni, Consultant and HOD - Internal Medicine & Diabetology, Yatharth Hospital, Omega 1, Greater Noida, too welcomed the much-needed move. “It has become necessary for the WHA to declare stroke as a public health priority for the very first time, because this is one of the major reasons for mortality and morbidity throughout the world."
“This will help in promoting awareness and prevention of this condition along with proper early diagnosis and prompt treatment. Cases of stroke are increasing rapidly owing to certain conditions like high blood pressure, diabetes, obesity, stress and smoking. It becomes imperative now to focus on prevention through a healthy way of life.”
Dr. Neha Kapoor, Associate Director and Head-Neurology, Asian Hospital, Faridabad, called the WHA move “a major global health milestone”. Stroke remains one of the leading causes of death and long-term disability worldwide, with nearly one in four adults at risk during their lifetime.
“The biggest challenge in India, where the burden is rising rapidly due to increasing NCDs, is delayed response. That is why public awareness about the ‘BEFAST’ acronym is crucial, that is, Balance, Eyes, Face, Arm, Speech and Time, which can significantly improve survival rates and recovery outcomes."
“If a person suddenly develops balance problems, vision disturbances, facial drooping, arm weakness or speech difficulties, time becomes extremely critical. Patients should immediately be referred to centres equipped with stroke treatment facilities.”
This delay can turn a treatable emergency into a life-threatening situation. The first 4.5 hours, often called the golden window, are extremely critical in saving the brain and reducing disability.
“The encouraging part is that India today has advanced stroke-ready hospitals, neuro-intervention technology and emergency care systems capable of effectively managing stroke if patients reach in time. Awareness and timely action are the strongest weapons against stroke,” she added.
