World Heart Day 2000–2004 – A day that builds awareness and capacity

The World Heart Day program of the World Heart Federation (WHF) was first launched in September of the year 2000 [1,2]. At the time of its launch, skeptics called it ‘‘just another day’’; however, the exponential growth of the initiative and its impact in the global context of cardiovascular disease prevention has proved it to be otherwise. Initiated at a critical stage of the epidemiological transition, World Heart Day is a key advocacy tool of the WHF. It has helped to build national capacity, particularly in member foundations and societies in lowand middle-income countries. World Heart Day has assisted professional societies and heart foundations to step up health promotion, disease prevention and control activities at the population level in countries and galvanized their advocacy efforts. By steadily building capacity – year after year – in the World Heart Federation member network, this program has served as a catalyst to the network as a whole by strengthening the sense of cohesiveness of purpose and involvement in cardiovascular disease (CVD) prevention. It has stimulated the creation of new partnerships and coalitions, which add strength to global CVD prevention efforts. The World Heart Day program has served as a platform for growth and development for many of our national members, who have risen to the challenge of managing successful World Heart Day programs. Skills have been developed in the areas of advocacy, public health community interventions, public event management, fundraising, media management, and lobbying. National and community level partnerships have been created and expanded over time. In several cases, the primary healthcare sector has become engaged and involved.

The World Heart Day program of the World Heart Federation (WHF) was first launched in September of the year 2000 [1,2]. At the time of its launch, skeptics called it ''just another day''; however, the exponential growth of the initiative and its impact in the global context of cardiovascular disease prevention has proved it to be otherwise.
Initiated at a critical stage of the epidemiological transition, World Heart Day is a key advocacy tool of the WHF. It has helped to build national capacity, particularly in member foundations and societies in low-and middle-income countries. World Heart Day has assisted professional societies and heart foundations to step up health promotion, disease prevention and control activities at the population level in countries and galvanized their advocacy efforts. By steadily building capacityyear after year -in the World Heart Federation member network, this program has served as a catalyst to the network as a whole by strengthening the sense of cohesiveness of purpose and involvement in cardiovascular disease (CVD) prevention. It has stimulated the creation of new partnerships and coalitions, which add strength to global CVD prevention efforts.
The World Heart Day program has served as a platform for growth and development for many of our national members, who have risen to the challenge of managing successful World Heart Day programs. Skills have been developed in the areas of advocacy, public health community interventions, public event management, fundraising, media management, and lobbying. National and community level partnerships have been created and expanded over time. In several cases, the primary healthcare sector has become engaged and involved.
In 2000, World Heart Day was celebrated in 70 countries. By 2004, more than 100 countries were actively involved. Each year the participating member organizations send in a report of activities. The evolution of those reports provides substantial proof of the many ways in which capacity has been developed [3]. In the Philippines, neither of the two WHF member organizations participated in World Heart Day 2000. By 2001, the Philippine Heart Association invited media to a briefing and organized activities; by 2002, the President of the Philippines, Gloria Macapagal Arroyo, became involved and declared 2002 the year of the heart and 2002-2012 the decade of cardiology. In Mexico, the World Heart Day program has been successfully launched and developed by the Mexican Society of Cardiology [4]; in the first year, the program consisted of activities in professional circles; by 2001, a course of CVD prevention was introduced and a public education program launched; by 2002, the course expanded and open air activities were initiated whereas by 2003 the course for health workers was extended to more remote areas of the country. The Health and Heart Foundation of Bosnia and Herzegovina describe World Heart Day ''as an excellent tool to influence the public and decision-makers [5]''. The organization is confronted with a population suffering from post-war consequences and poor socio-economic conditions. This notwithstanding, it has stimulated mass distribution of locally translated World Heart Day marketing materials and the setting up of an insurance fund, a primary healthcare worker training and a Healthy Heart Hotline

Prevention and Control
now leads the national program on non communicable diseases for Pakistan in an innovative public-private arrangement with the Ministry of Health and WHO Pakistan office, rates the WHD campaign as one of its most effective advocacy tools which enabled it to garner the support of the First Lady, who issued a special message for Heartfile in the year 2003 on the occasion of WHD.
In some countries, World Heart Day has served as a launch pad for long-term campaigns. In Poland, the event was the kick-off for a 2-year educational campaign ''Mind Heart'' promoted by the Polish Ministry of Health and endorsed by the Polish Cardiac Society. This campaign includes broadcast educational TV spots related to healthy lifestyles, TV quizzes related to healthy lifestyles, morning shows focusing on prevention of cardiovascular diseases, as well as TV soap operas showing examples of possible outcomes of myocardial infarction followed by discussions between experts directly after the broadcast. It reached an audience of 6.8 million people. In the United Kingdom, the British Heart Foundation has used World Heart Day to launch a campaign addressing the growing problem of physical inactivity and obesity in young people. The campaign encourages young people to be more active through an integrated approach targeting policy makers, teachers, parents and children. Targeted conversations with every 11-year old in the United Kingdom, i.e., 750,000 children are planned. In Turkey, a diet and exercise program organized by the Turkish National Committee for UNICEF and the Turkish Heart Foundation, targeting overweight and obese children, was launched on the day. In Nigeria, the event was used to kick off advocating healthier school meals and a better schools health service.
Even in countries where the World Heart Federation has individuals as members, as in the case of Mozambique and Zimbabwe, a few dedicated people managed to join forces with the WHO and created sizeable public events or used WHD materials to set up locally relevant websites [8]. Clearly the tools of the World Heart Day program including marketing and PR materials as well as a website [9], have provided just enough impetus for creative individuals and organizations around the world.
The World Heart Day program has also transformed the way the member network functions, creating a far greater need for regular communications and meetings, benchmarking of activities, and speaking collectively to the public and policy makers. Sharing experiences has helped stimulate new thinking and raise the standard of programs for all those involved. The World Heart Day website has served as a central repository for member activities, helping to show the world that we are an extensive network that speaks with one voice. Use of common PR materials has dramatically increased the media coverage of cardiovascular disease prevention at the international, regional and national levels of the network. English language media reached 300 million people in 2003 and exceeded that number in 2004.
The specific World Heart Day themes developed each year offer opportunities for new partnerships or for fostering existing collaboration. The Union of European Football Associations' (UEFA) support [10] of World Heart Day was motivated by the theme of 2004: Children, adolescents and heart disease. UEFA promoted a healthy lifestyle through football which is one of the ways to encourage children worldwide to choose exercise, to burn off calories and have fun. The same year, UNESCO intensified its support distributing the World Heart Day materials to its 180 offices around the globe [11]. The organization is also interested in developing a healthy schools project with the World Heart Federation.
The World Heart Day program has also stimulated the creation and development of active international partnerships. The program is jointly sponsored by the WHF and the World Health Organization. Today, the WHO has committed to distributing World Heart Day materials in 46 countries in Africa as well as joining with the WHF in a press conference about CVD prevention in low and middle-income countries. Since the first World Heart Day launch, UNESCO has also supported the event. UNICEF has lent its voice by informing all its offices of our event.
The World Heart Day is more than just a day. It has galvanized the WHF board, members and partners and has enriched them capitalizing on sharing of experiences. Though an evaluation of its outcome is yet to be done, the portfolio of outputs indicates that this is just the beginning of a long and sustained effort to prevent and control CVD in low and middle-income countries. In the future, World Heart Day must become a permanent fixture on the calendars of the World Heart Federation members and the United Nations organizations. Beyond that, each regional and national member must work to place World Heart Day on the government's annual calendar. Once the public and policy makers become actively involved in the prevention and control of heart disease and stroke worldwide, we can hope to see a real impact on population risk profiles.