Submission to the 72nd Session of the WHO Regional Committee for Europe

Referring to agenda Item 5 – The WHO Europe framework for action to achieve the highest attainable standard of health for persons with disabilities 2022-2030

Additionally referring to WHO Rehabilitation 2030: a call for action [1]

STATEMENT ON THE WHO EUROPEAN FRAMEWORK FOR ACTION TO ACHIEVE THE HIGHEST ATTAINABLE STANDARD OF HEALTH FOR PERSONS WITH DISABILITIES 2022–2030

Stroke is the leading cause of disability and the second highest cause of death [2,3] in the adult population in Europe. It strikes suddenly, often with permanent consequences, in many cases irreversible even when people have access to the best standards of care in the acute phase. Without warning, it causes sudden paralysis, loss of ability to speak, blindness, memory loss, and dementia in people who were living happy and productive lives moments before. It often affects young people, impacting upon their personal, family, work and social life causing a great deal of suffering to them and their families.

Patients benefit from early, systematic and organized rehabilitation services to promote recovery, return to independence, and prevent progressive loss of ability in the years following the stroke event.
While across Europe almost all of those disabled by a stroke confirmed they had improvements from rehabilitation, about one third of the patients consider their rehabilitation experience to be limited and
insufficient. About one fourth of the patients, even after rehabilitation, finds that their overall quality of life remained poor [4].

People with stroke often have sensorimotor disability, and a multitude of cognitive, emotional and relational consequences. For those living after a stroke there are important barriers to well-being. These are visible, like lack of access for people with disability in the built environment and public transport, and invisible, like the stigma around stroke and its effects. The coronavirus pandemic has further penalized stroke patients, making it harder for them to access rehabilitation services.

The European Stroke Organisation (ESO) welcomes the WHO European Framework for action to achieve the highest attainable standard of health for persons with disabilities 2022–2030. This is fully aligned with the ESO Stroke Action Plan for Europe5, to promote the improvement of stroke healthcare and life after stroke across Europe and its neighbor countries.

We join WHO in calling for urgent actions to improve awareness, public health measures, acute health services, post-acute rehabilitation, and multi-sector measures to reduce stroke, improve outcomes, and improve life after stroke for patients with disability. We call on member states to develop coordinated National Stroke Plans, which are funded, implemented, and monitored.

These should include actions to ensure stroke patients’ access to rehabilitation, assistive technology, support services (including peer support), and community-based rehabilitation. We emphasize the importance of developing laws, policies, and plans in health and related sectors, aimed at improving prevention and an environment socially and professionally inclusive for stroke patients and their families after stroke.

References

1. WHO Rehabilitation 2030: a call for action https://www.who.int/initiatives/rehabilitation-2030

2. WHO The top 10 causes of death https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-ofdeath

3. European Cardiovascular Disease Statistics 2017 European cardiovascular disease statistics 2017.pdf

4. Sanità24, Medicina e ricerca https://www.sanita24.ilsole24ore.com/art/medicina-e-ricerca/2022-04-20/ictus-riabilitazione-insufficiente-un-italiano-tre-e-il-17percento-qualita-vita-scarsa-appello-neurologilinee-guida-121822.php?refresh_ce=1&uuid=AEl1wATB

5. Action Plan for Stroke in Europe 2018-2030
https://journals.sagepub.com/doi/full/10.1177/2396987318808719

Co-signatories: