Stroke is the 2nd most common cause of death worldwide, occurring in approximately 7000 people in New Zealand (NZ) annually. It has an enormous physical, psychological and financial impact on patients, families, and health care systems, with costs of care for stroke in NZ estimated at $450M pa. Stroke incidence rates in Maori and Pacific Islanders in NZ are similar to those in the populations of developing countries and NZ's rate of decline in stroke incidence is about 4 times slower than that in other developed countries. Reasons for these differences remain unclear. There are also no accurate data on the current and future burden of stroke in NZ, thus hampering evidence-based stroke health care planning. In addition, stroke recurrence rate in NZ is high and has not changed over the last 30 years, indicating the urgent need for the clinical testing and implementation of improved secondary stroke prevention strategies in the community. This programme is designed to address all these issues and provide robust quantitative and qualitative evidence for reducing the stroke burden in our community and internationally.