SDG 3: Good Health and Well-being | SDG 10: Reduced Inequalities | SDG 17: Partnerships for the Goals
Ministry of Health and Family Welfare (MoHFW) | NITI Aayog | Indian Council of Medical Research (ICMR)
A new January 2026 ADB policy brief titled Turning the Tide on Stroke in Asia and the Pacific: Addressing the Rising Burden Through Prevention, Health Investment, and Human Development warns that Asia and the Pacific now account for more than half of the global stroke burden. In 2023, the region recorded the highest global mortality and disability rates from stroke, driven by a “double burden” of metabolic risks—such as hypertension and diabetes—and environmental exposures, specifically air pollution and high sodium intake. East Asia and the Pacific, followed by South Asia, currently bear the highest stroke-related mortality and disability-adjusted life years (DALYs) globally.
Institutional Gaps and Performance Despite progress in Universal Health Coverage (UHC), many low- and middle-income countries (LMICs) lag in primary prevention, early detection, and rehabilitation services. The report identifies three predominant categories of risk:
Metabolic: Hypertension and diabetes are the leading contributors to stroke mortality.
Environmental: Air pollution is a major driver of stroke deaths, particularly in East and South Asia.
Behavioral: Tobacco use and unhealthy diets (high sodium) significantly increase regional vulnerability.
Strategic Policy Recommendations To reverse these trends, the ADBI advocates for a shift from reactive care to proactive prevention:
Primary Prevention: Strengthening community-level screening for hypertension and diabetes.
UHC Expansion: Explicitly embedding stroke rehabilitation and long-term care within national UHC frameworks to prevent catastrophic out-of-pocket expenditures for families.
Fiscal Commitment: Increasing government health expenditures to build resilient health infrastructure capable of handling acute cerebrovascular events.
Countries like Thailand and Malaysia are highlighted as success stories where high health expenditure and investments in human development and education have yielded better stroke outcomes through integrated measures like salt reduction and tobacco control.
What is the “Stroke Burden” and why is it unique in the Asia-Pacific region? The stroke burden refers to the combined impact of mortality (death) and disability-adjusted life years (DALYs) lost due to stroke. In Asia and the Pacific, this burden is unique because of the rapid transition in lifestyles leading to metabolic risks, coupled with some of the world’s highest ambient air pollution levels. This creates a “synergistic risk” environment where the population is geographically and biologically more vulnerable to cerebrovascular diseases than in other global regions.
Policy Relevance
The ADBI findings provide a strategic framework for the MoHFW to refine India’s non-communicable disease (NCD) roadmap.
Beyond Insurance to Prevention: While Ayushman Bharat has improved acute treatment access, India’s rising DALY rate (1,353 per 100,000) signals that insurance alone is insufficient. Policy must shift toward sustained primary prevention to curb the sharp increase in stroke incidence.
Rehabilitation Infrastructure: India’s persistent long-term disability burden highlights a critical need for the National Health Mission to expand community-based stroke rehabilitation services, which currently remain limited.
Metabolic Risk Management: With hypertension prevalence driving stroke incidence, the MoHFW must prioritize large-scale screening and salt-reduction initiatives to mirror the success of regional peers like Thailand.
Addressing Environmental Triggers: Integrating stroke prevention into broader environmental policies—specifically air quality management—is essential to protect the health of aging populations in resource-constrained settings.
Follow the full report here: Turning the Tide on Stroke in Asia and the Pacific