NIHR Global Health Research Centre on Non-communicable Diseases (NCDs) and Environmental Change

Within 5 years, our NIHR Global Health Research Centre will be a recognised centre of excellence on non-communicable diseases (NCDs) and global environmental change in low and middle-income countries (LMICs), offering world-leading research, training and policy advice for health equity. LMICs face dual, intertwined challenges of a rapidly growing burden of

NCDs and the existential threat of global environmental change. In addition, health systems in LMICs face specific challenges in delivering high-quality, equitable services for NCDs prevention and care, especially for marginalised populations most impacted by environmental change. Despite an increasingly recognised imperative for action, there is a paucity of evidence on cost-effective interventions to address major challenges emerging at the nexus of NCDs and environmental change.

Our Centre will focus on Bangladesh, India, and Indonesia, LMICs highly impacted by the dual challenges of NCDs and environmental change. We will address crucial knowledge gaps through three integrated research themes:

1. Strengthening primary health care and essential public health services for NCD prevention and management in communities affected by rapid environmental change;

2. Developing and evaluating multi-sectoral interventions that have dual benefits in reducing the burden of NCDs and hazardous environmental exposures at the population level;

3. Strengthening engagement of communities in the generation and use of evidence and advocacy for health and environment policy change.

All interventions will have a focus on reducing inequities in addition to cost-effectively improving health outcomes. An example of the integrated research program relates to the burning of plastic wastes in Indonesia. In the same communities, dual benefit interventions (e.g. reduced burning within the context of improved waste management strategies) and an innovative technology-based primary health care model will focus on the prevention of exposure to environmental hazards, while also promoting screening for and management of air-pollution related NCDs, such as chronic obstructive pulmonary disease. Common systems to collect data for both implementation and evaluation of such complementary interventions will be deployed.

Throughout the research lifecycle, our Centre will emphasise systematic and meaningful engagement of community members and policymakers – including through co-design and evaluation of interventions. In addition to delivering high-quality impactful research, research capacity strengthening will be our joint top priority for which 55% of our total budget has been allocated. We will deliver several training and development opportunities targeting three critical career periods: (1) pre-doctoral, (2) early post-doctoral and (3) transitioning to senior leadership. Recruitment into these training opportunities and posts will ensure gender parity and we will monitor and report diversity in career progression for all staff and students across academic career levels. We will strengthen research capability at institution, network and ecosystems levels to enable LMIC-led production and use of high-quality evidence at the nexus of NCDs and environmental change.