Stroke can be a devastating event, not only for the victims, but also for their families, friends, work colleagues, and

carers. The burden of stroke in terms of absolute numbers and number of disability adjusted life years (DALYs) is

increasing worldwide and is impacting health services on a global scale. Despite an earlier reluctance to prioritize

stroke as a health issue, authorities are now starting to realize that provision of organized stroke care does make

a difference to patient outcomes and long-term implications of stroke, including the economical consequences.

International guidelines recommend that acute stroke patients should have access to organized services, including priority emergency services, a pre-notification system to the receiving unit, rapid assessment and imaging protocols, and expert stroke care. Where this is not available, telemedicine facilities should be in place. Sadly, these guidelines are not met in many regions of the world. In part, this is due to the lack of tools, administrative support, and even incentive to change and improve systems of stroke care. The angels initiative was launched in 2015 with the aim of providing physicians with the tools they need to set up and optimize a stroke network. Registered physicians and stroke centers have free access to educational materials, standing orders, and protocols for acute stroke care, which were developed together with the international expert steering committee. In addition, quality analysis tools to create an initial benchmark and measure on- going performance of the stroke centre are available via an online platform.