NIHR Global Health Research Unit on Diabetes and Cardiovascular Disease in South Asians
Principal Investigator: Professor John Chambers (Medicine)
Duration: June 2017 – September 2021
Heart disease and stroke (the main forms of “cardiovascular disease”) and diabetes (abnormally high blood sugars) are the world’s leading health problems. 18 million people die from cardiovascular diseases each year (1/3rd of all deaths), while 420 million people live with diabetes. The burden of cardiovascular disease and diabetes are especially high in South Asia, one of most densely populated regions in the world. India alone has ~62 million people living with cardiovascular disease and ~56 million with diabetes. Both diseases cause an enormous financial burden on individuals, their families and the societies they live in. Cardiovascular disease and diabetes are thus important contributors to poverty, inequality and social instability. There is an urgent need to find new approaches to reducing the burden of these diseases, especially in South Asia Our Global Health Research Unit comes together as a close collaboration between experts at Imperial and leading academic and clinical institutions in Bangladesh, India, Pakistan and Sri Lanka.
We also involve key Government Organisations (eg the Ministries of Health) and Non-Governmental Organisations (eg Pakistan Red Crescent) responsible for providing healthcare on the ground. Together, in partnership, we aim to help deliver new approaches to reduce the burden of cardiovascular disease and diabetes in South Asia. We will deliver on our objectives by pursuing 4 complementary strategies:
- First, we will strengthen existing approaches for monitoring diabetes and cardiovascular disease in South Asia, including measuring how well these diseases are being treated. This will allow us to assess the needs of the population, the performance of the healthcare system, and to help determine priorities for action.
- Second, we will develop new approaches for i. preventing disease, ii. diagnosing disease at an early stage before complications occur, and iii. delivering better treatments to people in need. We will take advantage of what is already known to work in other parts of the world, including the UK. We will adapt and evaluate the approaches to ensure they are suitable (for example, acceptable to local populations, affordable, effective, fair to all sections of society, have potential to reach out across South Asia, and to be maintained over the longer term). We will take advantage of cheap, innovative approaches for delivering healthcare, for example using digital tools (eg internet, mobile phone), low-cost diagnostic tests and low-cost drugs. Our research will allow us to identify “what works, in which groups of people and in which regions”.
- Third, we will strengthen the ability of South Asian researchers to pursue these issues in the future, by helping our partners develop Centres of Excellence, clinical research networks and high-quality training.
- Finally, we will support strategies for sharing our findings with healthcare professionals and decision-makers, so that they can be put into practice. This includes helping to frame clinical guidelines, pathways for care, and quality standards for health workers and health systems. Our research has the potential for considerable impact: even a conservative 10% reduction in incidence will prevent ~6M people developing T2D and ~4M people dying from CVD in South Asia over the next 10 years. Our research will thus directly contribute to improving health and welfare, and reducing inequality, instability and poverty in South Asia
The project will address an important set of research questions on the social and economic impacts of childhood obesity by leveraging some of the most detailed longitudinal data sources available in the UK as well as innovative approaches to assessing causality and the links between health and social outcomes. It will do so with a view to making an impact on the actins of key stakeholders involved in addressing the problem. In particular, the study will rely on two national cohort studies reflecting the lives of individuals born in 1958 and 1970, and on a local cohort study of children born in 1991-92 providing a unique set of information based on biomarkers, anthropometric measures, linkages with rich administrative data, along with more traditional survey questions. The study will leverage biomarkers in the latter cohort and genetic information in all three cohorts in a detailed investigation of the causal pathways that link children early life exposures and background socioeconomic status to their likelihood of developing obesity in young age, to the social and economic outcomes associated with childhood obesity. In particular, the study will focus on dimensions of human capital (education and cognitive skills) and returns to human capital, in the form of employment and earnings, as well as forms of civic participation and social engagement.
- Sri Lanka