Stroke caused an estimated 5·7 million deaths in 2005, and 87% of these deaths were in low-income and middle-income countries. Without intervention, the number of global deaths is projected to rise to 6·5 million in 2015 and to 7·8 million in 2030. The rising burden of stroke, especially in low-income and middle-income countries, leads us to propose a worldwide goal for stroke: a 2% reduction each year over and above that which may happen as a result of better case management and treatment. The experience of high-income countries indicates that sustained interventions can achieve at least the required 4% annual average decline in stroke mortality for people age 60–69 years. Achieving this goal for stroke would result in 6·4 million fewer deaths from stroke from 2005 to 2015. More of these deaths will be averted in low-income and middle-income countries than in high-income countries.