We are working on four multisectoral interventions
1. Implementing interventions in public food procurement systems to increase environmentally sustainable dietary diversity for the prevention of noncommunicable diseases in India
The Public Distribution System in India provides 800 million individuals on a low-income with food aid, which mainly consists of wheat and rice. Some states have experimented with adding pulses, fresh fruit and vegetables, oils, and iodised salt but this diversification has not been evaluated. The Centre’s work will include the implementation and evaluation of cost-effective, sustainable changes to food aid baskets in the state of Chhattisgarh and Andhra Pradesh. These changes aim to improve dietary diversity for NCD prevention, targeting diabetes and cardiovascular diseases.
- Describe and characterise the main public food procurement and distribution programmes in India including known impacts on dietary diversity, NCD risks and the environment.
- Undertake a comprehensive assessment of options to diversify food baskets in public procurement systems for optimal NCD and environmental outcomes.
- Co-design a package of environmentally sustainable interventions in the Public Distribution System (PDS) to improve delivery and uptake of diverse food items for NCD prevention.
- Implement the food basket intervention package within PDS systems in the two states and evaluate their efficacy, cost-effectiveness, acceptability, and scalability.
2. Effectiveness of water salinity adaptation for control of hypertension in coastal areas of Bangladesh
In Bangladesh storm surges caused by tropical cyclones have led to an increase in water salinity across the coastal belt. This has harmful health effects on local populations, including increased blood pressure, progressive kidney disease and gestational hypertension in pregnant women. The International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b) will work to identify and test cost-effective, sustainable solutions to reduce salinity in the water supply in the districts of Khulna and Satkhira.
- Undertake rapid evidence reviews and synthesis in order to determine location and specific form of interventions that may be available.
- Co-produce a basket of interventions to provide and promote use of alternative low salinity water to target populations.
- Implement and evaluate the basket of interventions
- Develop capacity needed for future innovation and implementation research on reducing drinking water salinity.
3. Identifying and implementing solutions to reduce the impact of plastics burning on NCDs in Indonesia
The unregulated burning of plastic waste in Indonesia releases harmful chemicals, such as dioxins, which pollute the environment and lead to negative health outcomes such as chronic lung disease, heart diseases, and cancers. Researchers will test a range of multi-sectoral interventions to reduce exposure to air pollutants caused by the burning of plastic waste in Malang district, in East Java, targeting cardiovascular disease and chronic obstructive pulmonary disease.
- Define plastic burning sources, the amounts of NCD-relevant pollutants emitted and the differential contribution of industry and community-level plastic burning to NCD-relevant pollutants in five study regions in Malang.
- Co-produce and select a basket of multisectoral interventions aimed at effectively reducing NCD-relevant plastic burning pollutants in the study regions.
- Implement and evaluate the basket of interventions.
- Develop the infrastructure and capacity needed for future atmospheric measurement, modelling and implementation research for NCD prevention related to plastics burning.
4. Enhancing primary healthcare to mitigate heat-related health risks and improving non-communicable disease management
Extreme heat is a growing public health threat, especially in low- and middle-income settings, where climate change is increasing both the frequency and intensity of heat events. In parts of India, prolonged heat exposure is already placing significant strain on health systems and communities. Vulnerable populations such as older adults, outdoor workers, and people with non-communicable diseases (NCDs) face heightened risk of dehydration, heat stress, and complications like kidney injury and cardiovascular strain.
The NIHR Global Health Research Centre for NCDs and Environmental Change is working with local communities, health workers and government partners in heat-vulnerable districts of Andhra Pradesh, India to co-design, implement and evaluate a heat adaptation intervention that is embedded within routine primary health care and community systems, rather than operating as a standalone programme. This multi-sectoral approach aims to develop sustainable, cost-effective tools and strategies to protect vulnerable groups from heat-related harms.
Key elements of this intervention include:
- Expansion of digital tools, such as the SMARThealth platform, to integrate heat exposure and early-warning information alongside traditional clinical risk factors for NCDs.
- Co-creation of heat adaptation strategies that build on existing Heat Action Plans and integrate community insights, health system readiness assessments and local priorities.
- Strengthening routine health service responses to heat stress through targeted training and practical toolkits for frontline health workers, enabling early detection, risk management, counselling and referral for heat-related conditions.
- Mixed-methods evaluation to understand how heat exposure affects NCD outcomes and to assess the feasibility, effectiveness and acceptability of the intervention components in real-world settings.
By linking community engagement, digital health innovation and primary health care strengthening, this intervention aims to reduce heat-related symptoms, prevent avoidable adverse health events, and support sustained heat-protective behaviours among high-risk populations. Evidence from this work will help inform future policy, program design, and scale-up of heat resilience strategies at local and national levels.