Stroke remains one of Europe’s most pressing public health challenges. It is currently the second leading cause of death and a major cause of adult disability across the continent. In response to this urgent burden, the Stroke Alliance for Europe (SAFE)—a key partner in the UMBRELLA consortium representing stroke support organisations and the voice of stroke survivors across Europe—and the European Stroke Organisation (ESO) jointly developed the Stroke Action Plan for Europe (SAP-E), the largest coordinated stroke initiative ever undertaken in Europe.
First published in the European Stroke Journal in 2018 and translated into 12 languages, the SAP-E set out a shared roadmap to strengthen stroke prevention, treatment, rehabilitation and long-term support in every European country by 2030.
A plan grounded in expertise and evidence
The SAP-E draws on robust scientific research, clinical expertise and the lived experience of people affected by stroke. Its overarching goal is to reduce the burden of stroke and to ensure that every individual in Europe has access to timely, high-quality, evidence-based care, irrespective of geography or socio-economic background.
The plan identifies four major targets to achieve by 2030:
- Reduce the total number of strokes by 10 per cent.
- Ensure that at least 90 per cent of stroke patients receive care in a specialist stroke unit.
- Develop comprehensive national stroke plans covering the full pathway from prevention to life after stroke.
- Implement public health strategies that promote healthy living and address environmental, social and economic determinants that increase stroke risk.
Addressing the entire stroke pathway
To guide countries towards these goals, the SAP-E focuses on seven core domains: primary prevention, organisation of stroke services, acute stroke treatment, secondary prevention, rehabilitation, life after stroke and evaluation of quality and outcomes. Each domain includes specific 2030 targets designed to provide clear direction for system-wide improvement.
A central message of the plan is that stroke is not only an acute medical emergency. Recovery often takes months or years, and access to rehabilitation, structured follow-up and community support plays a decisive role in long-term outcomes for stroke survivors and their carers.
Monitoring progress across Europe
To measure improvement, the SAP-E defines 13 key performance indicators (KPIs) covering the full continuum of stroke care. SAP-E National Coordinators report annually on their country’s performance, offering a valuable overview of progress, gaps and priority areas for action.
Since its launch, the SAP-E has contributed to meaningful advances across Europe. By 2023, 24 countries had adopted a national stroke plan, with a further 16 in development. However, progress remains uneven. For example, the target of ensuring specialist stroke unit access for 90 per cent of patients has been met in only nine countries, and just 13 countries report having a national programme dedicated to life after stroke.
Looking ahead
SAFE and ESO, together with experts from across Europe, have recently completed a midpoint review of the SAP-E. This updated edition will integrate the latest scientific evidence and refine recommendations to support countries in achieving the 2030 targets. The revised plan is expected to be published in the European Stroke Journal in the coming months.
As a partner in the Umbrella, SAFE continues to play a vital role in ensuring that the perspectives of stroke survivors shape research, innovation and system-wide improvement in stroke care across Europe.
