Program Profile

Better Hearts Better Cities

Improving cardiovascular health in low-income urban populations, through a multisector approach that addresses hypertension and its underlying risk factors in a sustainable way at scale.

Better Hearts Better Cities is a Novartis Foundation initiative to improve cardiovascular health in low-income urban populations. Implemented in Ulaanbaatar in Mongolia, Sao Paulo in Brazil, and Dakar in Senegal, Better Hearts Better Cities seeks to achieve its objective through a multisector approach that addresses hypertension and its underlying risk factors in a sustainable way at scale.

Through its focus on hypertension, Better Hearts Better Cities aspires to reimagine the way chronic diseases can be prevented and managed, as an example that can be applied to other noncommunicable diseases.

Over 10 million people are estimated to die from hypertension (high blood pressure) globally every year. Hypertension is the prime risk factor for cardiovascular disease. Hypertension often doesn’t show any symptoms and so is often referred to as the “silent killer.” If left unaddressed, it can lead to heart disease, stroke or kidney failure. Although the problem of hypertension is a global challenge, low- and middle-income countries are hit the hardest. Rapid urbanization seems to be a key driver of this increasing burden. Health systems in low- and middle-income countries are mainly geared toward acute care and are often not set up to provide care for chronic diseases like cardiovascular health problems. Patients also face barriers to seeking and following treatment, for example affordability and their capacity to pay for the care they need.

Today's urban health challenges are complex, involving factors as broad as lifestyle choices, diet, transport, workplace practices and air pollution. These challenges are systemic and cannot be tackled by one organization alone. We believe that by collaborating with local and global partners across a range of sectors, we can co-design and implement holistic solutions for healthier cities and communities. To achieve this, Better Hearts Better Cities is building networks of partners, reaching beyond the health sector. Partners can include healthcare providers but also digital and telecommunication organizations, food suppliers, employers, insurance funds, social enterprises and civil societies. Comprised of both public and private organizations, these networks operate globally and at the local level. This multisector approach aims to integrate complementary capabilities and resources to tackle hypertension from health literacy and lifestyle choices, to prevention, screening, diagnosis and patient management. Local ownership is crucial to the success of Better Hearts Better Cities; not only to build a network of implementation partners, but to achieve longer-term impact and sustainability by working with local governments to strengthen health systems.

Better Hearts Better Cities reached 1.3 million people in 2018. One highlight in Dakar was working with a new partner, the Syngenta Foundation, to investigate how to improve the availability of healthy food. In São Paulo, there has been exceptional community support, for example from the Samba School and Corinthans Football Club, as well as financial and strategic support from our new partner Associação Samaritano. In Ulaanbaatar, the program has shaped policy to improve affordability and access to treatments, and incentivize quality outcomes for patients.