Patricia Dütsch
Senior Portfolio Manager, Swiss Re Foundation
Supporting cities to enhance their health resilience and reduce health risks, reflects our commitment to making the world more resilient.
Fortaleza joins CARDIO4Cities: building a healthier future in Brazil
Fortaleza, capital of the state of Ceará and Brazil’s 4th-largest city, is the newest joiner in implementing CARDIO4Cities – marking the further growth of the network of cities dedicated to addressing cardiovascular (CV) disease: shifting from reactive care to proactive, predicative and even preventive systems that keep people healthy. With 2.5 million residents and strong dedication to increase health equity, Fortaleza is poised to show how a large, complex city can improve cardiovascular risk management at population level.
Why Fortaleza, why now
Cardiovascular disease remains the leading cause of death in Brazil. In Fortaleza, many communities face accumulating vulnerabilities ranging from inadequate management and control of CV risk factors to poverty or food insecurity. Choosing Fortaleza means integrating these insights into the CARDIO4Cities approach and generating more evidence for more cities to replicate.
Earlier this year, the greater Fortaleza area launched CARDIO4Cities with support from the Brazilian Development Bank (BNDES) through the Juntos pela Saúde initiative, managed by IDIS – the Institute for the Development of Social Investment, starting in Caucaia (≈360,000 people) and ADS Maracanaú (a decentralized health area spanning eight municipalities).
With Fortaleza now on board, the cluster reaches 10 municipalities – an optimal environment for collaborative governance, seamless data integration, and peer-driven problem solving across municipal health systems. The result: faster learning cycles and stronger, more resilient care networks.
Powered by partnership
CARDIO4Cities in Fortaleza is supported by the Novartis Foundation, co-funded with the Swiss Re Foundation and Umane, and implemented by Beneficência Portuguesa de São Paulo. This partnership brings together private sector, philanthropy, public sector innovation, and delivery know-how. Policy alignment across municipal, state, and federal levels is creating the enabling environment needed to integrate CARDIO4Cities sustainably into primary healthcare.
Zurich, Switzerland
What success looks like
Because Fortaleza stands out among other cities with social vulnerability areas, Beneficência Portuguesa de São Paulo and Umane are conducting an impact evaluation to measure results while systematically incorporating insights on the social determinants of health into the local strategy. The initiative started with 50 Primary Healthcare Units (UBS) out of all 134 in the city, to validate the implementation pathway. As the initiative matures, Fortaleza will expand it to cover 100% of the city, and bring proactive health and care to the entire city population.
Ultimately, success in Fortaleza means that more people stay healthy longer – through better blood pressure control and consistent access to high-quality primary care, ultimately resulting in less heart attacks and strokes. The other aspect will be a refined CARDIOCities playbook that can be copied by other cities facing similar social and health challenges.
São Paulo, Brazil
Thais Junqueira
CEO of Umane
The partnership with CARDIO4Cities reinforces Umane’s commitment to strengthening Brazil’s public health system (SUS) and driving structural improvements capable of transforming the healthcare experience nationwide. Our purpose is to help make cardiovascular health a proactive, predictive, and integrated concern in people’s daily lives – promoting prevention, well-being, and long-term quality of life.
Rollout of CARDIO4Cities in Brazil:
3x
blood pressure control rates in São Paulo
2x
hypertension control in Patos
15%
increase in hypertension diagnoses in Aracaju
By the numbers
- 3x
blood pressure control rates in São Paulo - 2x
hypertension control in Patos - 15%
increase in hypertension diagnoses in Aracaju
About CARDIO4Cities
CARDIO4Cities helps cities transform cardiovascular health by shifting to data-driven decision making, empowering primary healthcare teams, and aligning multisector partners around the same goal of reducing overall cardiovascular risk and disease. Each city contributes new evidence to CARDIO4Cities, so that it becomes a continuously learning system that can be replicated.
Partners: Swiss Re Foundation • Umane • Novartis Foundation
Implementing partner: Beneficência Portuguesa de São Paulo
Related initiative: BNDES – Juntos pela Saúde (Caucaia and ADS Maracanaú), managed by IDIS – the Institute for the Development of Social Investment
Local partners: Municipal Health Secretariat, through Riane Azevedo, Secretary of Health of Fortaleza and Aline Gouveia, Deputy Secretary of Health of Fortaleza.