CARDIO4Cities is a population health approach created by the Novartis Foundation to tackle the growing burden of cardiovascular disease. It rapidly improves heart health in city populations by supporting health professionals, patients and the health system to accelerate early detection of cardiovascular risk and optimizing its care and management. Enabling data-driven decision making, and unlocking the power of multi-sector partnerships, CARDIO4Cities now reaches over 40 million people and has proven to be impactful, cost-effective, and scalable in different geographies around the globe.

CARDIO4Cities consists of a six-pillar strategy that collectively accelerate and improve access to quality health and care for cardiovascular conditions and create more heart-healthy cities. CARDIO is an acronym, shorthand for quality of Care, early Access, policy Reform, Data and digital, Intersectoral collaboration, and local Ownership. The approach offers guidance and solutions on how to design and implement cardiovascular population health roadmaps that are tailored to local needs, priorities and capabilities. CARDIO4Cities is an approach built to continuously improve, and to be embedded within a city’s existing health system.

By 2050, more than 70% of our world’s population is estimated to live in cities. Compounding with global aging of our populations and more and more people living with non-communicable diseases, health systems will face ever-growing pressures, and economic growth may stifle following productivity losses.

CARDIO4Cities is designed to address the growing burden of cardiovascular disease in cities with precision and pragmatism. By implementing CARDIO4Cities, city leaders can champion greater heart health for the populations they serve.

CARDIO4Cities aims at reducing overall cardiovascular risk (hypertension, diabetes and dyslipidaemia), by accelerating early detection of and prompt adequate management of those risk factors and equipping decision makers and health authorities with the data and insights to tailor health interventions specifically to where they are needed most.

With the CARDIO4Cities Accelerator, the Novartis Foundation invites city leaders and decision makers to leverage CARDIO4Cities for improving the heart health of the populations in their jurisdiction. Leaders can familiarize themselves with the content of the CARDIO4Cities website that contains a rich catalogue of successful interventions and the CARDIO4Cities Playbook, with useful advice and tools on how to design and implement a local CARDIO4Cities roadmap and create rapid impact on cardiovascular health.

When a city expresses interest in CARDIO4Cities, a multidisciplinary steering committee led by the city stakeholders should be set up to ensure alignment of all partners behind the same goal. Based on local baseline prevalence, the steering committee sets the city’s targets for reducing overall cardiovascular risk by improving the detection and control rates of hypertension, diabetes and high LDL-cholesterol in the urban population. The Steering Committee then co-designs a cardiovascular population health roadmap, with interventions and innovations to accelerate detection and adequate management of CV risk factors, and a standard data dashboard to regularly monitor progress towards achieving the targets.

Yes. After a short implementation period of 1.5 to 2 years, CARDIO4Cities managed to increase pressure control rates in the pioneering cities of São Paulo (Brazil), Dakar (Senegal) and Ulaanbaatar (Mongolia) up to more than three times. This translated into remarkable reductions of up to 13% of strokes and 12% of acute coronary event rates.

In the first-mover cities, the Novartis Foundation has invested between 500k to 1Mio USD p.a. to develop and refine the CARDIO4Cities model.* While actual resource needs depend on how much the city already invests in CV health, new cities adopting the approach demonstrate that replicating CARDIO4Cities costs much less. Overall budget requirement depends mainly on the number of innovative interventions or tools the city decides to introduce. Costing elements include e.g. the maturity of the health system and its health information system (uniform or siloed EHRs, data science capabilities, …), human capital, and performance of the primary health system. Technology or data innovations tend to be the highest new cost drivers in the CV population health roadmaps.

CARDIO4Cities was designed and pioneered by the Novartis Foundation, a non-profit organization based in Switzerland. For over 40 years, the foundation has helped improve the health of low-income populations, initially supporting disease elimination in areas such as leprosy and malaria. Today, we tackle the burning health issues of our time: cardiovascular disease and health inequities. We take a population health approach by widening the lens from a narrow focus on healthcare delivery to a panoramic view on improving health in the population at large. The Novartis Foundation’s work brings together existing but disconnected data to help authorities understand the main determinants that predict health outcomes and disparities in these health outcomes. That understanding then allows city leaders to find the best ways and partners to remediate them; ultimately, the Novartis Foundation aim to empower local authorities to transform their health systems from being reactive to becoming proactive, predictive, and preventative, so that they can keep their populations healthy.