In the latest online lecture, Dr. Leonardo A. Carbonera from the WSO provided us with a valuable opportunity to learn about “The Brazilian Experience” in stroke care. Stroke is the leading cause of death and disability in Brazil, with over 400,000 new cases occurring each year. To prevent severe consequences, it is crucial to ensure appropriate care and treatment.

Dr. Leonardo explained that since the establishment of the Unified Health System (SHS) in 1988, every individual in Brazil has had access to free healthcare, from the onset of the disease to rehabilitation. However, it still took a while to start the first movement aiming to improve stroke care in the country. General stroke treatment was not performed until 2002 in private hospitals, and not until 2005 in the first few public hospitals. The real turning point came in 2007 with the launch of the Pilot Stroke Program. The project involved 35 public and private hospitals that treated over 1,000 patients, achieving results comparable to international standards. It demonstrated that the use of tPA not only improves patient outcomes but is also a cost-effective investment. The success of this pilot project laid the foundation for the National Stroke Program, which aims to establish high-quality stroke care across Brazil. The main pillars of the program include establishing and implementing a stroke “line of care,” setting up certified stroke centers with dedicated stroke units, evaluating local and national networks, providing training for healthcare personnel, and educating the population. In 2012, the National Stroke Policy was implemented, which included funding for tPA through the Ministry of Health. These significant changes in stroke care led to a 5% decrease in stroke mortality in less than 5 years. Despite these remarkable improvements, Dr. Leonardo Carbonera acknowledged that while many stroke centers and networks have been established in highly populated areas, there is still room for improvement, especially in rural areas where such facilities are limited.

Dr. Leonardo highlighted the importance of the Brazilian Way, referring to the population’s passion and commitment to their country and its people, as a crucial foundation for the development of a national stroke policy. Through numerous awareness campaigns, the population has been and continues to be informed about the dangers of stroke and the importance of prompt and high-quality treatment to prevent death and long-term disability.

The commitment of Brazil to enhancing stroke care remains ongoing. In addition to continuous efforts to establish stroke centers staffed by qualified healthcare professionals, the implementation of stroke research and clinical trials has helped highlight the economic benefits of public access to stroke care. It also allows for a critical examination of the current state of stroke care not only in Brazil but also on an international scale, identifying areas for improvement.

Thank you, Dr. Leonardo A. Carbonera for this insight into the development of stroke care in Brazil. We all can take it as a great example of what can be done. Also a big thank you to all participants for attending and engaging in the lecture and following discussion!