Angels Initiative Strengthens Stroke Care Systems Across Brazilian Cities
The Angels Initiative stroke care programme is helping improve access to timely stroke treatment in Brazil by strengthening coordination between communities, emergency services and hospitals. Its approach combines public awareness, healthcare professional training and improvements in hospital care, contributing to lower stroke mortality in participating Brazilian cities.
A key component of this effort is ensuring that people can recognise stroke symptoms early and that patients reach appropriately equipped hospitals without unnecessary delays. The initiative has reported improvements in treatment access, survival outcomes and hospital discharge times across cities participating in the programme.
Strengthening stroke care through the Angels Initiative
Stroke remains a significant global healthcare challenge, with 87% of stroke-related deaths occurring in low- and middle-income countries. Improving outcomes requires more than hospital-based treatment. Public awareness, emergency response systems and the availability of specialised hospital care must work together.
The Angels Initiative seeks to address these challenges by improving collaboration among the different stakeholders involved in stroke treatment. Its approach focuses on strengthening local stroke systems of care, supporting hospitals and building awareness within communities.
In Brazil, the programme has supported the certification of 81 hospitals, while six cities have achieved Angels City status. These efforts aim to establish more coordinated pathways for patients, from the recognition of initial symptoms to emergency treatment and recovery.
FAST Heroes brings stroke awareness into schools
Public education is an important part of the initiative. Through the FAST Heroes programme, children in public schools learn to recognise the warning signs of stroke and are encouraged to share this knowledge with their families.
The programme uses children as community awareness ambassadors, extending stroke education beyond classrooms and into households. This approach helps families understand the importance of identifying symptoms and seeking emergency medical assistance promptly.
FAST Heroes reached 100,000 students in Brazil within a single year, demonstrating the scale of the initiative’s community education efforts.
Angels Cities report improvements in stroke outcomes
The Angels Cities programme brings together community awareness, emergency services and hospital-level improvements to strengthen local stroke care systems.
According to the initiative’s reported figures, participating Brazilian cities have recorded several improvements in patient outcomes and treatment access.
Key results include:
- 10% reduction in stroke deaths: Stroke mortality was 10% lower in Angels Cities during the first year.
- 25% thrombolysis rate: The reported rate across Angels Cities reached 25%, compared with a national estimate of 7%.
- Earlier hospital discharge: Patients in Angels Cities were discharged an average of 1.5 days sooner than the relevant comparison baseline reported by the initiative.
- 81 certified hospitals: The programme supported the certification of 81 Brazilian hospitals.
- Six Angels Cities: Six Brazilian cities achieved Angels City status.
- 100,000 students reached: FAST Heroes engaged 100,000 students in Brazil in a single year.
Thrombolysis is a treatment that uses medication to dissolve blood clots obstructing blood flow. In eligible patients with ischaemic stroke, timely administration can help restore circulation and improve the chances of recovery.
The reported 25% thrombolysis rate across Angels Cities is particularly notable against the national estimate of 7%, indicating improved access to this treatment in participating locations.
Angels Initiative targets 100 Angels Cities by 2027
The initiative has set a target of transforming 100 cities or regions into Angels Cities by the end of 2027.
Achieving this objective will require sustained investment in stroke care infrastructure, adequate healthcare resources and stronger coordination among the organisations involved in patient care.
Community awareness will also remain central to the programme. By involving healthcare professionals, emergency responders, schools, families and other stakeholders, the initiative aims to establish a broader support network for stroke prevention, recognition and treatment.
The emphasis is on creating an integrated system in which patients can receive appropriate care as quickly as possible, rather than relying solely on improvements within individual hospitals.
Global reach of the Angels Initiative
The Angels Initiative describes itself as the world’s largest stroke community. As of 2025, its network encompassed approximately 227,000 healthcare professionals across more than 8,700 hospitals in 157 countries.
The initiative reports that its work has helped nearly 19 million stroke patients to date.
These figures reflect the programme’s international scale and its focus on improving stroke care through collaboration between healthcare institutions and local communities.
Broader healthcare commitments through 2030
Alongside its stroke-care objectives, the organisation has outlined broader healthcare commitments extending to 2030.
These include:
- Expanding access to healthcare for 50 million people.
- Investing €35 billion in health innovation and research to address non-communicable diseases.
- Allocating an additional €250 million to partnerships aimed at combating emerging infectious diseases.
Together, these commitments place stroke care within a wider healthcare agenda focused on improving access to treatment, advancing medical innovation and strengthening responses to major health challenges.
The Angels Initiative’s experience in Brazil highlights the importance of coordinated stroke systems of care. By combining public education, emergency response improvements and hospital-level capabilities, the programme aims to make timely stroke treatment more accessible and improve outcomes for patients.
